Enhancement Test: OB Disorders b.

Avoiding a paracervical block

1. A client is receiving education about preterm c. Immediate removal of the suture

labor during a prenatal visit. Which of the
following is a priority for the nurse to instruct d. Augmentation of the labor’
the client to report?
6. When caring for a client with an episiotomy
a. Nausea and vomiting during the postpartum period, the nurse
encourages sitz baths three times a day for 15
b. Feeling that the baby is balling up and minutes. Sitz baths primarily aid the healing
relaxing process by:

c. Back pain radiating to the buttocks and a. Cleansing the perineal area
legs
b. Tightening the rectal sphincter
d. Vaginal spotting after a vaginal exam
c. promoting vasodilation
2. The nurse should monitor which of the
following fetal life-threatening emergencies d. softening the incision site
when the fetal head is not engaged and the
7. When performing discharge teaching for a
membranes rupture?
postpartum client, the nurse should inform her
a. Uterine hyperstimulation that:

b. Placenta previa a. The episiotomy sutures will be

removed at the first postpartum check up
c. Cord prolapse
b. She may not have any bowel movements for
d. Abruptio placenta up to a week after the birth

3. The nurse is caring for a client postoperatively c. She has to schedule a postpartum checkup
following a caesarian section. It is a priority for as soon as her menses return
the nurse to monitor the client for:
d. The perineal tightening exercises started
a. Infection during pregnancy should be continued
indefinitely
b. Postpartum depression
Situation for number 8. Mrs. Chang tells the nurse that
c. Dehydration she drinks a beer every night before going to bed. She
asks the nurse if occasional alcohol consumption will
d. Blood clots harm her unborn baby.

4-5. Mrs. Berry, a G3P2, is concerned about another
fetal loss because of history of an incompetent cervical
os. She is scheduled for a McDonald procedure.
4. The nurse explains to Mrs. Berry that the
McDonald or Shirodkar procedure is used to:
a. Protect the fetus from infection
b. Reduce risk of premature rupture of
membrane
c. Prevent trauma to the fetus from rapid
delivery
d. Increase the probability of a term delivery
5. Mrs. Berry had a Shirodkar procedure, her
primary nursing care would be:
a. Preparation for infant resuscitation
8. Which response by the nurse is best?
a. “Occasional intake of a small amount of
alcohol during pregnancy will not adversely
affect the unborn baby.”
b. “alcohol consumption has a harmful effect on
the baby only if consumed during the first
trimester of pregnancy.”
c. “The minimal safe amount of alcohol
consumption during pregnancy has not yet
been determined.”
d. “Any alcohol consumption during pregnancy
will cause the infant to have complications at
birth.”
9. Which statement by the nurse best explains
what occurs with an incompetent cervix?
 a. The cervix is not large enough for passage of
the fetus
b. The cervix cannot support the weight of the
fetus
c. The cervix has an external opening but not
an internal opening
d. The cervix has an internal opening but not an
external opening
10. Which nursing intervention is most appropriate
when a spontaneous abortion is inevitable?
14. Before surgery to remove an ectopic
pregnancy and the fallopian tube, which of the
following would alert the midwife to the
possibility of tubal rupture?
a. Amount of vaginal bleeding and
discharge
b. Falling hematocrit and hemoglobin
levels
c. Slow, bounding pulse rate of 80 bpm
d. Marked abdominal edema

a. Place the client in Trendelenbur’s position 15. Hyperemesis gravidarum is a complication of

pregnancy because it most often leads to:
b. Prepare the client for D&C
a. Fluid intoxication
c. Prepare the client for placement of
pursestring stitch. b. Metabolic acidosis

d. Place the client in the side-lying position. c. Dehydration

11. Which assessment finding is considered a d. Proteinuria

predisposing factor for the development of
abruption placenta? 16. Which of the following would be a danger
signal of labor for a woman in labor?
a. Gestational diabetes
a. Blood-tinged vaginal discharge at full dilation
b. Hyperemesis gravidarum
b. Meconium-stained amniotic fluid
c. Oligohydramnios
c. Maternal pulse of 90 to 95 beats per minute
d. Pregnancy-induced hypertension
d. Fetus presenting in a LOA position
12. A new mother saturates a perineal pad in 15
minutes. Her fundus is firm and smooth, and 17. A pregnant woman is admitted to the hospital
there is a constant trickle of blood from the with a diagnosis of placenta previa. Which of
vagina. No clots can be depressed when the the following would be the priority for this
fundus is massaged. Which of the following woman on admission?
should the nurse suspect on the basis of these
findings? a. Performing a vaginal examination to assess
the extent of bleeding
a. Atonic bleeding
b. Helping the woman remain ambulatory to
b. Traumatic bleeding reduce bleeding.

c. Retained placental fragments c. Assessing fetal heart tones by use of an

external monitor.
d. Inverted uterus
d. Assessing uterine contractions by an internal
13. Which assessment of a woman in labor can be pressure gauge
determined by vaginal examinations?
18. The nurse assesses the client for symptoms of
a. Fetal weight abruption placenta, noting especially:

b. Cervical dilatation a. Excessive vaginal bleeding

c. Strength of contraction b. Abdominal rigidity

d. Fetal head circumference c. Titanic uterine contractions

 d. Preterm rupture of membranes a. Limit physical activity

19. When assessing a client with a tentative b. Reduce external stimuli in the room
diagnosis of H-mole, the nurse should be alert
for: c. Decrease fluid intake

a. Hypotension d. Avoid emotional upset

b. Unusual uterine enlargement 24. Which of the following findings on a newly

delivered woman’s chart would indicate she is
c. Decreased FHR at first risk for developing postpartal
hemorrhage?
d. Painless, heavy vaginal bleeding
a. Post term delivery
20. A primigravida client admitted to the hospital
with a diagnosis of hyperemesis gravidarum b. Epidural anesthesia
will be placed on NPO status and receive
intravenous therapy. Which of the following c. Grand multiparity
would the nurse most likely include when
explaining of the client about oral intake of d. Premature rupture of membranes
food and fluids?
25. Which of the following nursing observations
a.Withholding them indefinitely until acidosis is would indicate a sign of impending placental
corrected separation and expulsion?

b.Providing them as clear liquids after 24 hours a. Small gush of blood with an unchanged
if vomiting subsides length of the cord

c. Giving them in small quantities whenever the b. Steady trickle of blood with an
client desires unchanged cord length

c. No bleeding with lengthening of the

d. Withholding them until TPN replaces
cord
lost electrolytes
d. Small gush of blood with lengthening of
21. A multigravida is admitted with a diagnosis of
the cord
threatened abortion. Her initial nursing
management would include of the following?

a.Examining all perineal pads for tissues and

clots

b.Placing the bed in Trendelenburg’s position

c. Preparing her for Shirodkar procedure

d.Restricting all physical activity and fluid intake

22. The nurse is monitoring a patient with ectopic

pregnancy. She notes that vaginal bleeding is
scanty while the patient is showing signs of
hypovolemic shock. She evaluates that:

a. Shock signs are misleading in this case

b. Infection could cause signs of shock

c. Bleeding into pelvic cavity is occurring

d. Level of pain is causing signs of shock

23. A woman is hospitalized with placenta previa.

Which is the most important concern to teach
this client?