OB NCLEX Questions

Alvin L. Rozier

1. A client with pregnancy-induced hypertension (PIH) receives magnesium sulfate, 4 g in 50% solution I.V. over 20 minutes. What is the purpose of administering magnesium sulfate to this client. a. to lower blood pressure b. to prevent seizures c. to inhibit labor d. to block dopamine receptors B. Mag sulfate is given to prevent and control seizures in clients with PIG. Mag sulfate has no effect on labor or dopamine receptors.

Initial client assessment information includes: 2. BP - 160/110 mmHg, Pulse - 88 bpm, RR - 22 bpm, reflexes +3/+4 w/ 2 beat clonus. Urine specimen reveals +3 negative sugar, & ketones. Based on these findings, the nurse would expect the client to have which complaints? a. headache, blurred vision, facial and extremity swelling b. abdominal pain, urinary frequency, and pedal edema c. diaphoresis, nystagmus, and dizziness d. lethargy, chest pain, and SOB A. headache, blurred vision, and facial and extremity swelling. 3. Which of the following is the most serious adverse affect associated with oxytocin administration during labor? a. tetanic contractions b. elevated blood pressure c. early decelerations of FHR d. water intoxication A. tetanic contractions - are most serious adverse effect associated with oxytocin. When tetanic contractions occur, the fetus is at high risk for hypoxia and the mother is at risk for uterine rupture

OB NCLEX Questions

Alvin L. Rozier

4. A client in labor receives epidural anesthesia. The nurse should assess carefully for which adverse reaction to the anesthetic agent? a. hypotensive crisis b. fetal tachycardia c. renal toxicity d. increased beat-to-beat variability in the FHR

5. Hypotensive crisis - may occur after epidural anesthesia administration as the anesthetic agent spreads through the spinal canal, blocking sympathetic innervations.A client is in the second stage of labor. during this stage, how frequently should the nurse assess her uterine contractions? a. every 5 minutes b. every 15 minutes c. every 30 minutes d. every 60 minutes B. every 15 minutes

6. The cervix is not completely dilated and the client has a strong urge to push. The nurse-midwife tells her not to push yet. What is the rationale for this instruction?
a. early pushing may cause edema and impede fetal descent b. the nurse-midwife isn't ready to assist her c. the fetus hasn't rotated into the proper position d. pushing at this time may cause rupture of the membranes

A. Pushing bfore the cervix is completely dilated may cause edema and tissue damage and may impede fetal descent.

OB NCLEX Questions

Alvin L. Rozier

7. The gonorrhea culture is positive in a pregnant mom. What is the significance of this finding? a. may cause neural tube defect in fetus b. may cause an eye infection in the neonate c. may cause acute liver changes in the fetusd. may cause anemia in neonate d. may cause anemia in neonate B. gonorrhea in the cervix may cause neonatal eye infection during delivery 8. In the 1st stage of labor, a client with a full-term pregnancy has an electronic fetal monitor (EFM) in place. Which EFM pattern suggests adequate uteroplacental-fetal perfusion? a. persistent fetal bradycardia b. variable decelerations c. average variability d. late decelerations B. average variability - 6 to 10 bpm accurately predicts adequate uteroplacental-fetal perfusion. Persistant bradycardia may indicate hypoxia, arrhythmias, or umbilical cord compression. Variable decelerations suggest umbilical cord compression. Late decelerations may reflect decreased blood flow and oxygen to the intervillous spaces during contractions. 9. The physician orders I.V. administration of oxytocin. Why must the nurse monitor the client's fluid intake and output closely during oxytocin administration? a. oxytocin is toxic to the kidneys b. oxytocin causes excessive thirst c. oxytocin causes water intoxication d. oxytocin has a diuretic effect C. the nurse should monistor I/Os b/c prolonged oxytocin infusion may

OB NCLEX Questions

Alvin L. Rozier

cause severe water intoxication, leading to seizures, coma, and death 10. What condition would place the client at risk for

disseminated intravascular coagulation? (DIC)

a. intrauterine fetal death b. placenta accreta c. dysfunctional labor d. premature rupture of the membranes A. Intrauterine fetal death, abruptio placentae, septic shock, and amniotic fluid embolism may trigger normal clotting mechanisms; if clotting factors are depleted, DIC may occur.