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QUIZ 2 OBSTETRICS NURSING

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SITUATION: Mrs. Benitez came in to the clinic for check up. She missed her
period for about 2 weeks already and she complains of excessive vomiting.
In hyperemesis gravidarum, there is severe nausea and vomiting. What
would be the implication of this? *

a. H-mole

b. Increase HCG level

c. Increase estrogen level

d. Psychogenic factor

Other:

After instructing Mrs. Benitez about measures to overcome early morning

nausea and vomiting, which of the following client statements indicate the
need for additional teaching? *
a. “I’ll eat dry crackers or toast before arising in the morning”

b. “I’ll drink adequate fluids separate from my meals or snacks”

c. “I’ll eat two large meals daily with frequent protein snacks”

d. “I’ll snack on a small amount of carbohydrate throughout the day”

Other:

Mrs. Benitez was admitted in the hospital. The doctor ordered Ringer’s
lactate intravenously over an 8-hours period. The nurse would administer the
intravenous infusion at which of the following rates? *

a. 60ml/hr

b. 125ml/hr

c. 100ml/hr

d. 150ml/hr

Other:
As part of health teaching, the nurse gives information to the pregnant
woman about food items high in folic acid. Which of the following mid
afternoon snacks would be recommended to supply folic acid? *

a. 1 medium banana

b. Nuts and green leafy vegetables

c. 1 cup milk 2 graham crackers

d. 1 cup yoghurt

Other:

SITUATION: Ms. Mary Ann Dionisio is having twin pregnancy. The

following situation refers to this. When cleavage of the fertilized ovum occurs
more than 13 days after fertilization, the type of twinning will be? *
a. Conjoined twins

b. Diamniotic dichorionic twins

c. Diamniotic monochorionic twins

d. Monoamniotic monochorionic twins

Other:

SITUATION: Mrs. Gold is carrying twins and now is in the 36th week of
pregnancy. She is admitted to the hospital in labor. Her membranes have
just ruptured. The nurse attending to Mrs. Gold hears only one heartbeat.
Which of the following should the nurse take? *

a. Immediately notify the physician of these findings

b. Increase the frequency of assessment of fetal heartbeats

c. Take no additional action since this is a normal occurrence

d. Examine the amniotic fluid for meconium staining

Other:

Which instrument used in completion of abortion (completion curettage) that

can cause perforation of the uterus? *

a. All of these

b. Ultrasound

c. Hegar dilator
 d. None of these

Other:

When nurse reviews a prenatal record, what information places the pregnant
woman most at risk of premature rupture of membranes? *

a. Chlamydia infection

b. First pregnancy

c. PIH

d. Single-fetus pregnancy

Other:

What question would the nurse ask a client with gestational hypertension to
asses for cerebral edema? *

a. Are you experiencing any difficulty of breathing?

a. Do you have a headache?

c. Do you have swelling of your hands?

d. How much weight have you gained this week?

Other:

A woman with gestational hypertension is receiving magnesium sulfate

therapy. Nursing assessments include deep tendon reflexes absent,
respirations 14, pulse 60, BP 100/60 and urine output of 20cc per hour.
What is the priority nursing action? *

a. Continue MgSO4 therapy

b. Decrease the dosage

c. Discontinue the MGSO4 therapy

d. Notify physician of findings

Other:

A woman hospitalized with preeclampsia complains of pain in her upper

abdomen and blurred vision. What is the first nursing action? *
 a. Administer corticosteroids

b. Check seizure precaution equipment

c. Prepare for cesarian delivery

d. Review lab reports of liver function tests

Other:

When caring for a woman in 2nd stage labor with Class I cardiac disease,
what action by the nurse would be most appropriate? *

a. Encourage her to push with contractions

b. Maintain side-lying position

c. Monitor maternal oxygen saturation

d. Prepare for forceps delivery

Other:

A 14-year old primigravida attends an adolescent prenatal clinic. For what

obstetrical complication would this client be most at risk? *

a. Gestational DM

b. Macrosomia

c. Placenta previa

d. Pregnancy induced hypertension

Other:

Which of the following statements best describes hyperemesis

gravidarum? *

a. Severe anemia leading to electrolyte, metabolic, and nutritional imbalances in the

absence of other medical problems

b. Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional

imbalances in the absence of other medical problems

c. Loss of appetite and continuous vomiting that commonly results in dehydration

and ultimately decreasing maternal nutrients

d. Severe nausea and diarrhea that can cause GI irritation and possibly internal
bleeding

Other:
In which of the following clients would the nurse suspect anemia? *

a. Client in her 1st trimester with a hgb level of 12g/dl

b. Client in her 2nd trimester with a hgb level of 11g/dl

c. Client in her 3rd trimester with a hgb level of 8g/dl

d. Client in her 1st trimester with a hgb of 10.5g/dl

Other:

Which of the following would the nurse identify as a classic sign of PIH? *

a. Edema on the feet and ankle

b. Edema of the hands and face

c. Weight gain of 1lb/wk

d. Early morning headache

Other:

Which of the following is described as premature separation of a normally

implanted placenta during the 2nd half or pregnancy, usually with severe
hemorrhage? *

a. Placenta previa

b. Ectopic pregnancy

c. Incompetent cervix

d. Abruptio placenta

Other:

Which of the following best describes gestational trophoblastic disease? *

a. A hypertensive disorder of pregnancy that develops after 20 weeks’ gestation and

is characterized by edema, hypertension, and proteinuria

b. The implantation of the products of conception in the fallopian tubes, ovaries,

cervix, or peritoneal cavity

c. Expulsion of the fetus and other products of conception from the uterus before the
fetus is viable
 d. An alteration of early embryonic growth, causing placental disruption, rapid
proliferation of abnormal cells, and destruction of the embryo

Other:

A client at 24 weeks gestation has gained 6 pounds in 4 weeks. Which of the

following would be the priority when assessing the client? *

a. Glycosuria

b. Depression

c. Edema of the face and hands

d. Dietary intake

Other:

A nurse on the obstetrics unit cares for several pregnant clients. Which client
is most likely to be identified as being high risk for pregnancy
complications? *

a. The client who is pregnant for the third time

b. The client who has gained 30 pounds during the pregnancy

c. The client who has a history of twins in the family

d. The client who has primary hypertensive disease

Other:

A 31-year old multipara in her 1st trimester of pregnancy is seen by the

obstetrician. When sharing her health history, the client tells the nurse that
her last pregnancy ended in a spontaneous abortion because of an
incompetent cervix. She asks the nurse to clarify what is meant by an
incompetent cervix. The nurse best responds by explaining that an
incompetent cervix means that the cervix: *

a. is not large enough for passage of the fetus

b. is not able to support the weight of the fetus

c. has an external opening but does not have an internal opening

d. has an internal opening but does not have and external opening

Other:
At the end of the first trimester, the physician puts a cerclage in the client's
cervix. The client asks the nurse how long the cerclage will remain in place.
The nurse explains to the client that the physician will probably leave the
cerclage in place until: *

a. she goes into labor

b. after she delivers the baby

c. the end of the second trimester

d. she is near term

Other:

A 28 year-old primigarvida is in her 22nd week of pregnancy. The physician

informs the client that she ahs pregnancy induced hypertension (PIH). When
assessing a client with the history of PIH, the nurse observes: *

a. a decrease in urine proteins

b. an increase in urine output

c. a decrease in the pulse rate

d. and sudden gain in weight

Other:

Which assessment finding is most indicative of mild PIH? *

a. A 15mm Hg rise in the baseline systolic blood pressure

b. A weight gain of 1 pound per week in the 2nd trimester

c. A +1 protein reading on the urine reagent test strip

d. The presence of frequent ankle edema

Other:

The nurse frequently assesses the client and finds that her condition has
progressed to eclampsia. Which assessment finding best indicates that the
nurse should notify the physician immediately? *

a. The client develops convulsions

 b. The client sleeps for long periods of time

c. The fetal heart tones are greater than 100

d. The client begins to vomit

Other:

Which medication should the nurse have available when the client is
receiving magnesium sulfate (MgSO4)? *

a. Hydralazine (Apresoline)

b. Oxytocin (Pitocin)

c. Methylergonometrine (Methergine)

d. Calcium gluconate (Kalcinate)

Other:

Which assessment finding best indicates the presence of Magnesium

Sulfate (MgSO4) toxicity? *

a. Brisk deep tendon reflexes

b. Respiratory rate less than 14 breaths /minute

c. Protein in the urine

d. Magnesium blood level of 5mg/dl

Other:

On admission, the nurse expect the client with placenta previa to report
which finding? *

a. Sudden, sharp abdominal pain

b. Painless bleeding from the vagina

c. Persistent headache

d. Continuous, painless contractions

Other:
A 30 year-old multigravida who is in her last trimester of pregnancy is
diagnosed with abruptio placenta. Which assessment finding is considered
as predisposing factor for the development of abruptio placenta? *

a. Gestational diabetes

b. Hyperemesis gravidarum

c. Oligohydramnios

d. PIH

Other:

Which of the following is the most indicative of abruptio placenta and should
be reported to the physician immediately? *

a. Rigid, board like, tender abdomen

b. Severe nausea and vomiting

c. FHR of 110/bpm

d. Painless vaginal bleeding

Other:

If the client develops a complete abruptio the nurse should plan to: *

a. obtain written consent for a cesarian section

b. give the client an enema and prep the abdomen

c. place the client in Trendelenburg position

d. prepare the client for a contraction stress test

Other:

Which of the following is most indicative of the presence of H Mole? *

a. A blotchy brown discoloration on the face

b. A positive Chadwick's sign

c. The presence of ballottement

d. A uterus that is larger than the expected for dates

Other:
A 25 year-old primigravida is in the active phase of the 1st stage of delivery
when her membrane rapture. The nurse note a decrease in the FHT . Upon
inspection of the perineum, the nurse observes that the umbilical cord is
protruding through the vagina. Which action is the most appropriate for the
nurse to take initially? *

a. Turn the client on her left side and administer oxygen

b. Notify the physician of the findings

c. Place the client in the Trendelenburg position

d. Prepare the sterile field for delivery of the baby

Other:

The nurse observes the client for the signs of impending delivery of the
placenta. Which observation regarding the delivery of the placenta should
the nurse report to the physician? *

a. Bulging perineum

b. Shortening of the umbilical cord (not sure)

c. Rise of the fundus of the abdomen

d. Decreased vaginal discharge

Other:

The physician instruct the nurse to incorporate Oxytocin to the intravenous

fluid of the client. The oxytocin is given after the delivery of the baby and
placenta to: *

a. increase the blood pressure

b. prevent the uterus from inverting

c. decrease likelihood of hemorrhage

d. prevent rapture of the uterus

Other:

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