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OB Lippincott 1

Front Back

Fertilization usually takes place in which structure?

Outer third of the fallopian tube 2

Viablility of the ovum after ovulation, the ovum remains alive for how many hours?

24 hours 3

To improve sperm production, the nurse should instruct the client’s husband to avoid which activity?

Sitting in hot tubs- because it can damage or kill sperm 4

Proper response on concern about small hips

“the size of your true pelvis, not the size of your hips, determines whether or not you can deliver a baby vaginally” 5

Sex of a baby is determined at which point?

When the sperm fertilizes the ovum in the fallopian tube 6

Bleeding is the sloughing of which structure?

Endometrium 7

22 yo visit prenatal clinic for the first time

She may be 2 months pregnant

How to record on client’s pregnancy status on the prenatal records?

Primigravida 8

Which explanation correctly describes the occurrence of identical twins?

one fertilized ovum divides into two identical halves 9

Represents a probable sign of pregnancy

Abdominal enlargement 10

Type of pregnancy lab test

Human Chorionic gonadotropin (HCG) 11

Proper response regarding ultrasound

“Transvaginal ultrasound is used to diagnose pregnancy as early as 2 1/2 to 3 weeks” 12

Proper response regarding Chadwick’s sign

“It’s a bluish discoloration of the cervix, vagina, and vulva that occurs as a result of the presence of an increased number of blood vessels” 13

Client has ballottement, the nurse can assume that the client is at least how many months pregnant?

5 months – Ballottment is observed when the fetus rises (or bounces) in the amniotic fluid, then returns to its normal position after a gentle push or tapping of the lower portion of the uterus by the examiner- usually observed on the 4th or 5th month of pregnancy 14

Which assessment finding best represents a positive sign of pregnancy?

Fetal heartbeat 15

In primigravid client, when is fetal movement typically felt for the first time?

Between 16 and 20 weeks 16

A 32 yo multigravid client visits prenatal clinic and states she is pregnant and has felt her baby move, what can the nurse conclude?

Client is between 14 and 18 weeks’ gestation 17

Client says she has 3 children- a son and twin daughters

She has not had any abortions or stillbirths, Based on TPAL method, how to record?

T2P0A0L3 18

Client LMP began on March 13, Using Nagele’s rule, EDD is

December 20 19

In a Pelvic examination, nurse correctly assists the client into which position?

Lithotomy 20

Prior to pelvic examination, which intervention by the nurse is most appropriate?

Instruct client to empty bladder 21

Which method best promotes client comfort during pelvic exam?

Tell client to let her knees fall outward 22

How early in pregnancy can the fetal heartbeat be heard using a Doppler device?

8-10 weeks 23

Which action best ensures that an accurate fetal heart rate is obtained?

Assess the maternal pulse and fetal heart rate and compare the two 24

Which fetal heart rate must be reported to the physician immediately?

100 beats/ minute – normal heart beat is 120-160bpm 25

Which test can detect spina bifida during pregnancy?

MSAFP test can detect this type of defect – Maternal Serum Alpha FetoProtein is used to screen for neural tube defects such as spina bifida- this test should be performed between 14 and 16 weeks’ gestation 26

Regarding Prenatal Visits, the client with uncomplicated pregnancies, plans monthly visits for the first 28 weeks and then more frequent visits following which schedule?

Every 2 weeks upn to 36 weeks, then weekly for the last month 27

Which nursing instructions concerning exercise during pregnancy are accurate?

avoid exercising during hot, humid weather – avoid any jerking, bouncing, or jumping movements- drink plenty of fluids before and after exercising 28

Client at 20 weeks gestation, where can the nurse expect to palpate the fundus at this time?

Near the level of the umbilicus 29

At 24 weeks gestation, the nurse prepares the client for which routine test?

Glucose tolerance test – screening tool for gestational diabetes – between 24-28 wks gestation 30

The physician orders a nonstress test, when planning for this test, the nurse should have which of the following available?

a fetal monitor 31

A physician recommends amniocentesis to a pregnant woman whose first child has down syndrome, this test is typically performed at which time during the pregnancy?

Early in the second trimester 32

Prior to teaching the client about the nutritional needs during pregnancy, what should the nurse do?

Assess the client’s current eating pattern and preferences 33

Which explanation by the nurse accurately identifies the recommended weight gain for a woman who has a normal pregnancy weight?

25 – 35 lbs (11 to 15

8 kg) 34

Client is not getting an adequate intake of calcium, the nurse correctly instructs the client to drink how many glasses of milk per day to meet her calcium requirements?

3-4 cups (servings) 35

Client does not like milk, which food provides the best alternative source of calcium?

Leafy green vegetables 36

When providing information about iron supplements, which instruction by the nurse is most appropriate?

“make sure you drink plenty of fluids” 37

The nurse should also include which information about the side effects of iron supplements during her instruction?

“you may notice that your stools will be black” 38

When client asks why folic acid is important, which response by the nurse is most accurate?

“Folic acid helps prevent your baby from developing neural tube defects such as spina bifida” 39

17 yo primigravid, seen first time, which dietary adjustment is most appropriate for a pregnant teenager?

Increase caloric intake to 2,500 calories/day 40

Client lives with bf, works several hours per week, frequently skips meals or eats at a fast food restaurant, drinks beer or wine when with friends, constantly concerned about appearance and weight gain, how many factors in this scenario place the client at risk for nutritional deficiencies and the need for dietary guidance and counseling?

five 41

Client is eating a bag of potato chips and drinking a diet cola, nurse revises client’s care plan accordingly, which expected outcome should the nurse include based on the client’s eating habits?

the client will eat 3 balanced meals and 2 snacks daily while pregnant 42

Client expresses concern about her increased weight gain over the past month, which response by the nurse is most appropriate?

“The average weight gain during pregnancy is between 25 and 35 pounds 43

Which of the following beverages should be included in the list of unhealthy drinks to avoid?

Alcohol, coffee, tea, cola beverages, sports drinks 44

Client complains of edema in her lower extremities, after more information, the nurse advises her to limit her intake of which substance?

Sodium – edema is affected by sodium retention- Therefore, omitting or limiting salt from the diet will help alleviate lower extremity edema 45

Which of the following clients are at risk for nutritional problems during pregnancy?

a 17 yo primigravid client – a 25 yo woman who weighs 250 lbs at conception- a 19 yo woman who admits that she smokes cigarettes and drinks alcohol- a 30 yo woman who is unemployed and uses food stamps 46

Which client statement regarding bathing indicates a need for additional teaching?

“I should avoid taking tub baths at any time during my pregnancy” 47

The nurse correctly explains that sexual intercourse should be avoided at what time?

once the membranes rupture 48

Which response by the nurse regarding travel is most appropriate?

“carry a copy of your medical record with you when travelling” 49

Client is spotting, the nurse correctly explains that the spotting is probably normal and the result of what occurrence?

the baby implanting in the lining of the uterus 50

The nurse explains that between 8-12 weeks’ gestation, the baby has what characteristics?

the fetus has fully developed arms and legs 51

Purpose of amniotic fluid, which response by nurse is most appropriate?

it helps protect the fetus from external injury 52

In a discussion about hormonal changes, the nurse informs the client that the placenta produces which hormone?

Estrogen 53

Client asks how to relieve constipation, which response by nurse is most appropriate?

“Exercising can help relieve constipation” 54

The nurse explains that in addition to increased blood volume, which condition causes varicose veins during pregnancy?

Impaired venous return 55

The nurse correctly explains to the group that the discomfort associated with varicose veins is relieved by which activity?

Moving around when standing in one position 56

When teaching the class about varicose veins, which symptom should the clients be instructed to report immediately?

Calves that become red, tender and warm – it could signal thrombophlebitis 57

Which nursing instruction is most appropriate regarding the relief of itchy skin during pregnancy?

Increase fluid intake 58

Which information about shortness of breath during pregnancy is correct?

it is probably caused by the enlarged uterus pressing against the diaphragm 59

Which nursing instruction given to the client complaining about shortness of breath is most appropriate?

“Sleep with your upper body elevated on pillows” this may help relieve SOB 60

The nurse explains to the group that frequent urination during early pregnancy usually subsides when what occurs?

the uterus rises into the abdominal cavity 61

The nurse correctly explains to the group that the most probable cause of frequent urination late in pregnancy is related to what factor?

the enlarging uterus exerting pressure on the bladder 62

Which statement made by a participant indicates the need for additional teaching regarding management of urinary frequency?

“Limiting my fluid intake will help me control this problem” 63

5 month pregnant client complaining of annoying backaches, which advice can the nurse give to relieve the client’s backache?

wear low-heeled shoes- helps maintain the back in a more proper alignment and may relieve backaches associated with pregnancy 64

Which statement made by a participant regarding remedies for heartburn and nausea indicates that teaching has been effective?

“I should eat frequent, small meals 65

When one participant asks the nurse what she can do to relieve leg cramps, which instructions by the nurse would be correct?

Place a heating pad on the affected leg 66

Which response by the nurse is most appropriate when another participant states that she is concerned about having frequent mood swings?

“You should try to avoid fatigue and decrease your stress” 67

The nurse considers her teaching successful when the class correctly identifies which of the following as a danger sign of pregnancy?

headache and swelling of the face and fingers – a sign of pregnancy induced hypertension 68

Which client would the nurse identify as being the highest risk for developing complications during pregnancy?

a 35 yo gravida V client 69

A client drinks a beer every night before going to bed, asks the nurse if occasional alcohol consumption will harm her unborn baby, which response by the nurse is best?

the minimal safe amount of alcohol consumption during pregnancy has not yet been determined 70

The nurse correctly informs the participants that women who smoke during pregnancy have a greater risk of which problem?

Having a premature delivery 71

A 40 yo gravid V para 1 in her 10th week pregnancy, at this point, which test is typically used to detect genetic disorders?

Chorionic Villi Sampling (CVS) – preferred procedure because CVS can be done as early as 8-11 wks gestation 72

Which assessment finding best indicates the presence of chlamydia, an STD ?

heavy, grayish white discharge 73

Which statement by the client indicates a need for additional teaching regarding chlamydial infection?

“I will have to have a cesarean birth to protect my baby” 74

The nurse correctly instructs the client to contact the physician immediately under which circumstances?

when she experiences vaginal bleeding 75

Client has hyperemesis gravidarum and is moderately dehydrated, which equipment should the nurse plan to have available to treat this client?

IV start kit 76

Which client is most likely to be identified as being at high risk for pregnancy complications?

a client who has primary hypertensive disease 77

What can the nurse advise the client to do to avoid complications during the last part of her pregnancy?

avoid standing in one place for prolonged periods of time 78

Which statement by the nurse best explains what occurs with an incompetent cervix?

the cervix cannot support the weight of the fetus 79

At the end of the first trimester, the physician puts a cerclage in the client’s cervix, the nurse correctly explains to the client that the physician will probably leave the cerclage in place until what occurs?

the client is near term 80

When assessing a client with a history of PIH, the nurse should thoroughly explore which finding at each visit?

any sudden weight gain 81

Which assessment finding is most indicative of mild PIH?

a +1 protein reading on the urine reagent test strip 82

Which instruction regarding the home care of PIH is most appropriate?

eat high protein foods 83

While the client is receiving magnesium sulfate, the nurse should routinely assess the client’s vital signs and what else?

deep tendon reflexes – in addition, urine output, fetal heart tones and serum magnesium blood level, to detect magnesium toxicity 84

Which medication should the nurse have on hand when the client is receiving magnesium sulfate?

calcium gluconate (Kalcinate) – antidote for magnesium toxicity, given IV and injected over 3 or more minutes to prevent occurrence of ventricular fibrillation 85

Which assessment finding best indicates the presence of magnesium sulfate toxicity?

Respiratory rate less than 14 breaths/minute 86

Client’s condition has progressed to eclampsia, the nurse knows to notify the physician immediately when the client has which assessment finding?

Seizures – severe headache, abdominal pain, muscle hyperirritablity, apprehension and twitching often precede seizures associated with eclampsia 87

A 28 yo multipara admitted during 10th wk of pregnancy with history of spontaneous abortion and is spotting, which finding reported by client best suggests a spontaneous abortion?

Abdominal cramping – other typical symptom – vaginal bleeding or backaches 88

Client’s cervix is dilated but the fetus and placenta are still in the uterus, which nursing intervention is most appropriate when a spontaneous abortion is inevitable?

Prepare the client for dilation and curettage (D&C) – to remove the remaining products of conception 89

Client comments to the nurse, “this is like a recurring nightmare, this same thing happened last year, I don’t want to lose another baby” which response is appropriate?

“I know this is painful for you, would you like to talk about how you are feeling about this?” 90

A 22 yo gravid 1, para 0 has IDDM and is being seen by OB for the first time, she was diagnosed at 6, well controlled DM, client asks nurse if pregnancy will increase need for insulin, which explanation is correct?

Insulin level will most likely fluctuate- during the first 18 weeks of pregnancy, need for insulin decreases because the mother is transporting increased amounts of glucose to the growing fetus, later in pregnancy, the need for insulin usually increases because increasing amounts of hormones cause insulin resistance in the client 91

Client asks the nurse what kinds of diabetes related complications she should expect during her pregnancy, the nurse correctly informs the client that she is at risk for developing which condition?

Pregnancy Induced hypertension 92

Client in her last trimester of pregnancy and her diabetes well controlled, tells she is scared because of her diabetes, which response by the nurse is most appropriate?

Your baby may be large and initially will need blood glucose monitoring 93

21 yo multigravid client, 8 months pregnant admitted, diagnosis is partial placenta previa, which response by the nurse provides the best explanation regarding placenta previa?

“the placenta is implanted over or close to the internal cervical opening” 94

Client’s partner verbalizes concern about how placenta previa is treated, the nurse correctly states that the physician most likely to do which of the following if client’s condition remains stable?

Require the client to be on bed rest until she’s at full term 95

After a short observation, the client with placenta previa is sent home, one week later,client report back with complications, the nurse would report which finding?

Painless bleeding from the vagina 96

Based on client’s clinical presentation (placenta previa), which admission information should the nurse obtain first?

Blood pressure and pulse rate 97

30 yo multigravid in her last trimester diagnosed with abruption placentae, which assessment finding is considered predisposing factor for the development of abruption placentae?

Pregnancy Induced Hypertension 98

Which finding is most indicative of abruption placentae and should be reported to the physician immediately?

Rigid, boardlike, tender abdomen 99

If client develops a complete abruption, which nursing action is most appropriate?

Obtain a written consent for an immediate cesarean birth 100

A client gravid 1, para 0, 3 months pregnant, tells nurse she had rubella (German measles) 2 months ago, which possible complication should the nurse discuss with the client?

Fetal deformities 101

Which of the following is most indicative of the presence of hydatidiform mole?

a uterus that is larger than expected 102

Which pregnant client should the nurse encourage to undergo hepatitis B testing?

a client who emigrated from Haiti 103

18 yo primigravid considering terminating her pregnancy, asks nurse “at what point during pregnancy can a baby live outside the mother”?

It is usually estimated to be 20 to 24 weeks