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Obstetric Nursing Practice Test Part 1 4.

During one of the sessions a pregnant mother is expressing concern on her


baby. She is voicing apprehensions on the outcome of her delivery that might be
1. Childbirth education is vital for a successful and comfortable childbirth method.
stressful to her baby. Birth without violence is under which theory?
The first method that includes the father as a support person while embracing the
belief that childbirth is a natural event and with the right preparation most women
can have spontaneous and unmedicated vaginal births is:
a. Lamaze method

a. Lamaze method b. Leboyer method

b. Leboyer method c. Bradley method

c. Bradley method
d. Grantly Dick-Read method

d. Grantly Dick-Read method 5. A sensitive and unobtrusive technique of care while respecting the natural
2. The easiest method for determining if a woman’s caloric intake is adequate is process and promoting a peaceful atmosphere at birth will help the baby to be
assessing: born with a minimum stress. This is least likely achieved by:

a. Food intake
a. Keeping the room noise to a minimum

b. Bowel pattern
b. Not delaying the cutting of the cord

c. Weight she is gaining


c. Giving the newborn a warm bath after delivery
d. A “typical day” history or a 24 hour nutrition recall
3. The total weight gain in pregnancy for women who have multiple fetuses is:
d. Not assisting or pulling the baby’s head in expulsion

6. A pregnant woman came in to the clinic expressing concern about her


a. 20-25 lbs genitalia that has been observed for a change in color. The nurse explained the
physiology adaptations to pregnancy and stated that this discoloration of the
vagina is called:
b. 25-35 lbs

c. 35-40 lbs a. Hegar’s sign

d. 40-45 lbs
b. Chadwick’s sign
a. Dr. Grantly Dick-Read

c. Goodell’s sign
b. Dr. Robert Bradley

d. Vaginal sign
c. Dr. Ferdinand Lamaze
7. The entitled Childbirth without Fear is authored by:

d. Dr. Frederick Leboyer

a. Dr. Grantly Dick-Read 10. A patient on labor is offered ice chips. What is the purpose of giving ice chips
to a woman on labor?
b. Dr. Robert Bradley

a. To reduce a woman’s anxiety


c. Dr. Ferdinand Lamaze

b. To prevent impulses reach the distracted brain


d. Dr. Frederick Leboyer

8. Physical assessment is very important during prenatal visits to evaluate the c. To promote cutaneous stimulation
overall health status of a pregnant woman. Weight is one indicator of the health
status. A pregnant woman on her second trimester of pregnancy should gain how
many kilograms per month? d. To allow more blood to pool in the uterus, thus alleviating pain

11. The following concepts are emphasized in a Bradley class apart from:

a. 0.45 kg

a. Avoidance of drugs throughout the pregnancy


b. 1.82 kg

c. 1.36 kg b. Natural breathing methods (without patterns)

d. 2 kg c. Coaching techniques
9. The obstetrician who pointed out that a baby born in a less stressful
environment is more content is:
d. Woman should change position during labor

12. The priority management for Hyperemesis Gravidarum is:


decreases gastric motility thus causing reverse peristaltic waves.”

a. Easting dry toast or crackers 30 minutes before arising in the morning d. “Some cases of morning sickness can also be due to emotional factors.”

15. The structure which contains high amount of estrogen is called:


b. Complete bed rest (CBR)

c. D5NSS 3L in 24 hours a. Corpus albicans

d. Administer Milk of Magnesia b. Corpus luteum

13. A pregnant woman is diagnosed with toxemia. The following are signs of c. Primordial follicles
toxemia apart from:
d. Graafian follicles

a. Edema of the lower extremities


16. Change in the consistency of the lower uterine segment causing extreme
softening is referred as:
b. Sudden Weight gain

c. Blurry vision a. Hegar’s sign

d. Protein in urine b. Chadwick’s sign

14. A pregnant woman is asking about the possible causes of morning sickness.
c. Goodell’s sign
The nurse least likely identifies the cause by stating which of the following?

d. Vaginal sign
a. “It is due to the increased human chorionic gonadotrophin levels during
pregnancy.” 17. The nurse is conducting a health teaching on expectant mothers. She is
stressing the importance of childbirth education classes in one of her
discussions. Most pregnant women are expressing concern about their fear on
b. “It may be due to increased acidity of the GI tract.”
the upcoming labor. The nurse is discussing about the ways of alleviating labor
pains using the mind which is based on which childbirth principle?
c. “It may be the result of increased progesterone level which in return

a. Lamaze method
b. Leboyer method
a. Moniliasis

c. Bradley method
b. Candidiasis

d. Grantly Dick-Read method


c. Syphilis
18. A diagnosis of Moniliasis is made. The nurse is aware that symptoms of
Moniliasis typically has a symptom of:
d. Vaginitis

21. The obstetrician who associated childbirth method with Pavlov’s conditioning
a. White patchy and cheese like particles that adheres to the vaginal wall studies is:

b. Chancres on the vulva


a. Dr. Grantly Dick-Read

c. Frothy, cream-colored vaginal discharge


b. Dr. Robert Bradley

d. A non-itchy rash covering the whole body or appearing in patches.


c. Dr. Ferdinand Lamaze
19. The hallmark techniques of Leboyer method are the following except:

d. Dr. Frederick Leboyer

a. Newborn warm bath 22. Mrs. White, a pregnant woman, is 5’4” tall and weighs 130 lbs. Calculate her
body mass index.
b. Husband as a coach throughout labor and delivery

a. 22 BMI
c. Infant massage

b. 30 BMI
d. Immediate maternal-newborn bonding

20. During a prenatal visit the pregnant woman is complaining of itchy, foul- c. 24 BMI
smelling vaginal discharges that are frothy and cream-colored. This is a hallmark
sign of:
d. 28 BMI
a. Lamaze method

23. What is the best interpretation of Mrs. White’s calculated BMI?


b. Leboyer method

a. Underweight c. Bradley method

b. Normal weight d. Grantly Dick-Read method

c. Overweight

d. Obese

24. The nurse is calculating a pregnant woman’s BMI. Her calculated result is 26
BMI. This BMI belongs to the category of:

a. Underweight

b. Normal weight

c. Overweight

d. Obese

25. Myra, a 25-year old woman, on labor firmly told her doctor not to give her
pain medications during labor and delivery. She believes that it is best for her
baby if she would not receive pain medications and no physiological events such
as birth can give rise to pain under the condition that she is free from underlying
diseases. Myra insisted that knowing what are expected and being tension-free
during the delivery process would need no pain medications. Her principle is
based on the philosophy of which method?
 a. Food intake
 b. Bowel pattern
 c. Weight she is gaining
 d. A “typical day” history or a 24 hour nutrition recall
The easiest method for determining if a woman’s caloric intake is adequate is
assessing the weight she is gaining. (Pillitteri, 5th Ed). A typical day history or a
24 hour nutrition recall is the best method for assessing overall nutritional intake.
3. The total weight gain in pregnancy for women who have multiple fetuses is:
 a. 20-25 lbs
 b. 25-35 lbs
 c. 35-40 lbs
 d. 40-45 lbs
For women who have twins or multiple fetuses the weight gain should be 1
lb/week for a total of 40-45 lbs. (Adelle Pillitteri, 5th Ed p.302). 25-35 lbs is the
average and recommended weight gain for pregnant woman with one fetus only.
4. During one of the sessions a pregnant mother is expressing concern on her
ANSWERS
baby. She is voicing apprehensions on the outcome of her delivery that might be
1. Childbirth education is vital for a successful and comfortable childbirth method. stressful to her baby. Birth without violence is under which theory?
The first method that includes the father as a support person while embracing the  a. Lamaze method
belief that childbirth is a natural event and with the right preparation most women  b. Leboyer method
can have spontaneous and unmedicated vaginal births is:  c. Bradley method
 a. Lamaze method  d. Grantly Dick-Read method
 b. Leboyer method Leboyer childbirth method sometimes termed as “birth without violence,” views
 c. Bradley method birth as a stressful experience for the newborn. The focus of this method is to
 d. Grantly Dick-Read method primarily improve the quality of the birth experience for the baby.
Bradley childbirth method was the first technique to include the father as a 5. A sensitive and unobtrusive technique of care while respecting the natural
support person during delivery. This method embraces the belief that childbirth is process and promoting a peaceful atmosphere at birth will help the baby to be
a natural event and with the right preparation most women can have born with a minimum stress. This is least likely achieved by:
spontaneous and unmedicated vaginal births. Lamaze method is a prepared  a. Keeping the room noise to a minimum
labor and delivery technique. It is often called psychoprophylactic method as it  b. Not delaying the cutting of the cord
uses the mind (psyche) to prevent labor pains (prophylaxis). Leboyer childbirth  c. Giving the newborn a warm bath after delivery
method sometimes termed as “birth without violence,” views birth as a stressful  d. Not assisting or pulling the baby’s head in expulsion
experience for the newborn. The focus of this method is to primarily improve the Because of the word “least likely” the correct option is B. The method employed
quality of the birth experience for the baby. Grantly Dick-read Method is a in promoting a sensitive and unobtrusive technique of care while respecting the
psychophysiological preparation for childbirth. This technique alleviates pain natural process and promoting a peaceful atmosphere at birth to help the baby
during childbirth by blocking feelings of fear and tension. be born with a minimum stress is LeBoyer Childbirth Method. To decrease the
2. The easiest method for determining if a woman’s caloric intake is adequate is trauma at birth this technique is an advocate of the following: • The birthing room
assessing: is darkened or dimmed. Doing so prevents sudden contrast of light that might
distress the newborn. Leboyer thought that this is less shocking for the neonate’s Coached Childbirth,” was written by Dr. Bradley and his principles and theories
eyes that have been in semi-darkness for several months. • A soft music is paved the way for fathers to be present in the delivery room. This changed the
played or at least harsh noises are kept to a minimum. All the talking inside the face of childbirth around the globe. Lamaze childbirth method is an alternative to
delivery room is done by whispering. • The room is kept pleasantly warm, not the use of medical intervention during childbirth. The method was originally
chilled, to help the newborn be comfortable with the new environment and adapt developed in Russia (based on Pavlov’s conditioning studies) but was
to extrauterine life more easily. • Newborns are handled gently and carefully. popularized by a French obstetrician Dr. Ferdinand Lamaze. After watching a
Leboyer recommends not pulling the baby’s head to completely allow a natural woman gave birth in Russia Dr. Lamaze developed his own system of painless
childbirth. • The umbilical cord is cut late (It is cut after it has stopped pulsating). childbirth. Leboyer childbirth method was introduced by Frederick Leboyer. He is
According to Leboyer, this allows the newborn to continue receiving the maternal a French obstetrician who believed that the traditional hospital births of the time
hormones and oxygen carrying red blood cells. This is also done to allow the (1975) were traumatic for the infant. In 1975, he published a book entitled “Birth
baby to breathe when he is ready and not have to be rushed. • The infant without Violence,” where depth of a newborn’s sensitivity and the importance of
receives a warm bath immediately after birth for relaxation. • Before maternal and how the baby is handled by the people around him were emphasized. He pointed
newborn bonding is done, the infant is massage to ease crying. Nowadays, out that babies born in a less stressful environment were more content.
mothers do this massaging to encourage immediate bonding. • Placing the infant 8. Physical assessment is very important during prenatal visits to evaluate the
in the mother’s abdomen is done for maternal-neonate bonding. overall health status of a pregnant woman. Weight is one indicator of the health
6. A pregnant woman came in to the clinic expressing concern about her status. A pregnant woman on her second trimester of pregnancy should gain how
genitalia that has been observed for a change in color. The nurse explained the many kilograms per month?
physiology adaptations to pregnancy and stated that this discoloration of the  a. 0.45 kg
vagina is called:  b. 1.82 kg
 a. Hegar’s sign  c. 1.36 kg
 b. Chadwick’s sign  d. 2 kg
 c. Goodell’s sign Normal weight gain pattern in pregnancy is 1 lb (0.45 kg) per month in the first
 d. Vaginal sign trimester and 1 lb per week in the second and third trimesters. Meaning to say, in
Chadwick’s sign is the increased vascularity of the vagina changing its color from the second and third trimester the pregnant woman should be gaining 4 lbs (1.82
light pink to deep purple or violet. Hegar’s sign is the softening of the uterus. kg) per month. To easily remember the pattern of weight gain in pregnancy is 3-
Goodell’s sign is the change in cervix consistency resembling to that of an 12-12. 3 lbs in the first trimester and 12 lbs each in the second and third
earlobe. There is no known vaginal sign in pregnancy. trimester.
7. The entitled Childbirth without Fear is authored by: 9. The obstetrician who pointed out that a baby born in a less stressful
 a. Dr. Grantly Dick-Read environment is more content is:
 b. Dr. Robert Bradley  a. Dr. Grantly Dick-Read
 c. Dr. Ferdinand Lamaze  b. Dr. Robert Bradley
 d. Dr. Frederick Leboyer  c. Dr. Ferdinand Lamaze
Dr. Grantly Dick-Read is an English obstetrician who was practicing medicine in  d. Dr. Frederick Leboyer
1900’s. On 1933 his book, “Childbirth without Fear,” was published. He explained Leboyer childbirth method was introduced by Frederick Leboyer. He is a French
in this publication that no physiological function in a person’s body can give rise obstetrician who believed that the traditional hospital births of the time (1975)
to pain under the condition that it is of normal course of health. Unless a disease were traumatic for the infant. In 1975, he published a book entitled “Birth without
process is taking place, pain or agony would associate delivery Bradley Method Violence,” where depth of a newborn’s sensitivity and the importance of how the
was named after an American obstetrician Dr. Robert Bradley. “Husband
baby is handled by the people around him were emphasized. He pointed out that 13. A pregnant woman is diagnosed with toxemia. The following are signs of
babies born in a less stressful environment were more content. toxemia apart from:
10. A patient on labor is offered ice chips. What is the purpose of giving ice chips  a. Edema of the lower extremities
to a woman on labor?  b. Sudden Weight gain
 a. To reduce a woman’s anxiety  c. Blurry vision
 b. To prevent impulses reach the distracted brain  d. Protein in urine
 c. To promote cutaneous stimulation Toxemia or Pregnancy induced hypertension has the following manifestations:
 d. To allow more blood to pool in the uterus, thus alleviating pain Edema of the face, hands, ankle and feet, proteinuria, visual disturbances,
In Lamaze method one technique of alleviating pain is by cutaneous stimulation. sudden weight gain, headache, fever. Edema of lower extremity alone is not a
It is done by effleurage, sacral pressure, thermal stimulation (offering ice chips) sign of toxemia as it is a normal adaptation to pregnancy that is the result of the
and positioning. Preventing impulses to reach the brain is employing the poor circulation in the lower extremities due to the pressure from the gravid
distraction or imagery technique. Reducing a woman’s anxiety is done by a uterus. It is managed by raising the legs above the hip level. Edema of the Lower
continuous support system. Allowing more blood to pool in the uterus to alleviate Extremities plus the upper extremities is a sign of toxemia.
pain is a principle in Dick-Read method. 14. A pregnant woman is asking about the possible causes of morning sickness.
11. The following concepts are emphasized in a Bradley class apart from: The nurse least likely identifies the cause by stating which of the following?
 a. Avoidance of drugs throughout the pregnancy  a. “It is due to the increased human chorionic gonadotrophin levels during
 b. Natural breathing methods (without patterns) pregnancy.”
 c. Coaching techniques  b. “It may be due to increased acidity of the GI tract.”
 d. Woman should change position during labor  c. “It may be the result of increased progesterone level which in return
Encouraging a woman on labor to change position during labor is a concept of decreases gastric motility thus causing reverse peristaltic waves.”
Lamaze method to stimulate cutaneous stimulation. The following concepts are  d. “Some cases of morning sickness can also be due to emotional factors.”
taught in Bradley Classes: • Natural birth process • Active involvement of the Heartburn not morning sickness is the result of increased progesterone level
husband as a coach • Proper nutrition during pregnancy • Avoidance of drugs which in return decreases gastric motility thus causing reverse peristaltic waves.
throughout the pregnancy • Natural breathing methods (without patterns) • 15. The structure which contains high amount of estrogen is called:
Coaching techniques • Natural pain coping methods • Maternal-newborn bonding  a. Corpus albicans
• Breastfeeding • Education on emergent situations throughout pregnancy and  b. Corpus luteum
delivery (CS) • Postpartum and newborn care • Responsible parenthood  c. Primordial follicles
12. The priority management for Hyperemesis Gravidarum is:  d. Graafian follicles
 a. Easting dry toast or crackers 30 minutes before arising in the morning Graafian follicles are structures containing high amounts of estrogen. Graafian
 b. Complete bed rest (CBR) follicle are derived from primordial follicles. Corpus Luteum is the structure
 c. D5NSS 3L in 24 hours containing high amounts of progesterone and is yellow in color. If no fertilization
 d. Administer Milk of Magnesia occurs corpus luteum turns white and is now called Corpus Albicans.
The priority treatment for Hyperemesis gravidarum is giving 3 L of D5NSS for 24 16. Change in the consistency of the lower uterine segment causing extreme
hours. CBR is also important but the main treatment is D5NSS to replace the lost softening is referred as:
fluids. Eating dry crackers before arising in the morning is the management for  a. Hegar’s sign
morning sickness not Hyperemesis gravidarum. Milk of magnesia is an antacid  b. Chadwick’s sign
used to manage heartburn in pregnant woman.  c. Goodell’s sign
 d. Vaginal sign
Hegar’s sign is the softening of the uterus. Goodell’s sign is the change in cervix Infant massage, a warm bath and immediate bonding with the mother are all
consistency resembling to that of an earlobe. Chadwick’s sign is the increased hallmarks of the Leboyer method. Bradley childbirth method was the first
vascularity of the vagina changing its color from light pink to deep purple or technique to include the father as a support person during delivery.
violet. There is no known vaginal sign in pregnancy. 20. During a prenatal visit the pregnant woman is complaining of itchy, foul-
17. The nurse is conducting a health teaching on expectant mothers. She is smelling vaginal discharges that are frothy and cream-colored. This is a hallmark
stressing the importance of childbirth education classes in one of her sign of:
discussions. Most pregnant women are expressing concern about their fear on  a. Moniliasis
the upcoming labor. The nurse is discussing about the ways of alleviating labor  b. Candidiasis
pains using the mind which is based on which childbirth principle?  c. Syphilis
 a. Lamaze method  d. Vaginitis
 b. Leboyer method Frothy, cream-colored vaginal discharges, vulvar edema and hyperemia are
 c. Bradley method hallmark signs of Trichomoniasis or vaginitis. Moniliasis or Candidiasis is caused
 d. Grantly Dick-Read method by a fungus Candida Albicans (Monilia). Symptoms include: white patchy and
Lamaze method is a prepared labor and delivery technique. It is often called cheese like particles that adheres to the vaginal wall, irritatingly itchy and foul
psychoprophylactic method as it uses the mind (psyche) to prevent labor pains smelling vaginal discharges. Chancres on vulva and non-itchy rash covering the
(prophylaxis). The Lamaze method of prepared childbirth is based on the gating whole body or appearing in patches are manifestations of syphilis.
control theory of pain relief. It involves concentration and conditioning to help the 21. The obstetrician who associated childbirth method with Pavlov’s conditioning
woman respond to contractions with relaxation from techniques thereby studies is:
alleviating pain. This is based on the theory that through stimulus-response  a. Dr. Grantly Dick-Read
conditioning, women can learn to use controlled breathing to reduce the pain in  b. Dr. Robert Bradley
the labor. Lamaze method is the most popular approach used to today.  c. Dr. Ferdinand Lamaze
18. A diagnosis of Moniliasis is made. The nurse is aware that symptoms of  d. Dr. Frederick Leboyer
Moniliasis typically has a symptom of: Lamaze childbirth method is an alternative to the use of medical intervention
 a. White patchy and cheese like particles that adheres to the vaginal wall during childbirth. The method was originally developed in Russia (based on
 b. Chancres on the vulva Pavlov’s conditioning studies) but was popularized by a French obstetrician Dr.
 c. Frothy, cream-colored vaginal discharge Ferdinand Lamaze. After watching a woman gave birth in Russia Dr. Lamaze
 d. A non-itchy rash covering the whole body or appearing in patches. developed his own system of painless childbirth.
Moniliasis or Candidiasis is caused by a fungus Candida Albicans (Monilia). 22. Mrs. White, a pregnant woman, is 5’4” tall and weighs 130 lbs. Calculate her
Symptoms include: white patchy and cheese like particles that adheres to the body mass index.
vaginal wall, irritatingly itchy and foul smelling vaginal discharges. Chancres on  a. 22 BMI
vulva and non-itchy rash covering the whole body or appearing in patches are  b. 30 BMI
manifestations of syphilis. Frothy, cream-colored vaginal discharges, vulvar  c. 24 BMI
edema and hyperemia are hallmark signs of Trichomoniasis or vaginitis.  d. 28 BMI
19. The hallmark techniques of Leboyer method are the following except: 22 BMI To compute for BMI 1. Convert weight into kilograms: 130 lbs / 2.2=
 a. Newborn warm bath 59.09 kg (1 kg=2.2 lbs) 2. Convert height into cm: 5’4” ( 5 feet 4 inches) 1
 b. Husband as a coach throughout labor and delivery foot=12 inches; 1 inch = 2.54 cm CONVERT TO INCH FIRST: 5 x 12 = 60 inches
 c. Infant massage + 4 inches = 64 inches INCN TO CM: 64 x 2.54 = 162.56 cm 3. Square the height
 d. Immediate maternal-newborn bonding in meters (1 m = 100 cm) CONVERT CM TO METER: 162.56 / 100 = 1.6256 m
or 1.63 m SQUARE THE HEIGHT IN METER: 1.63 x 1.63 = 2.6569 or 2.66 4. supply to the uterus and alleviating labor pains. He also identified that laboring
Divide weight (kg) by meter squared 59.09 / 2.66 = 22 BMI women needed constant emotional support to help them cope.
23. What is the best interpretation of Mrs. White’s calculated BMI?
 a. Underweight
 b. Normal weight
 c. Overweight
 d. Obese
Normal weight a. Underweight – under 18.5 BMI b. Normal weight – 18.5-24.9
BMI c. Overweight – 25-29.9 BMI d. Obese – above 30.0
24. The nurse is calculating a pregnant woman’s BMI. Her calculated result is 26
BMI. This BMI belongs to the category of:
 a. Underweight
 b. Normal weight
 c. Overweight
 d. Obese
a. Underweight – under 18.5 BMI b. Normal weight – 18.5-24.9 BMI c.
Overweight – 25-29.9 BMI d. Obese – above 30.0
25. Myra, a 25-year old woman, on labor firmly told her doctor not to give her
pain medications during labor and delivery. She believes that it is best for her
baby if she would not receive pain medications and no physiological events such
as birth can give rise to pain under the condition that she is free from underlying
diseases. Myra insisted that knowing what are expected and being tension-free
during the delivery process would need no pain medications. Her principle is
based on the philosophy of which method?
 a. Lamaze method
 b. Leboyer method
 c. Bradley method
 d. Grantly Dick-Read method
Question was not answered
Grantly Dick-read Method is a psychophysiological preparation for childbirth. This
technique alleviates pain during childbirth by blocking feelings of fear and
tension. Dr. Dick-Read postulated that this fear felt by women during delivery
causes the blood to be carried away from the uterus to be used by the muscles
needing it due to perceived pain. This results to an unoxygenated uterus which
would be unable to perform its function well leading to pain, a phenomenon
called “the fear-tension-pain syndrome.” Dick-Read believed that presence of
fear and tension result to labor pains. Thus, eliminating fear would increase blood