OB Review

Marks: 0/1
The three phases of puerperium as described by Reva Rubin are the following except:
Choose one answer.
a. Taking hold
b. Taking in
c. Holding on
d. Letting go
Your answer is incorrect. Please select another option.
Incorrect
Marks for this submission: 0/1.
Question 2
Marks: 1/1
The postpartal client develops breast engorgement and asks for advice concerning breastfeeding. The
nurse should tell the client to:
Choose one answer.
a. Get an antibiotic from the physician and start the baby on bottle feedings
b. Start to wean the baby from the breast to reduce pain
c. Pump her breasts and wear a loose fitting bra to suppress milk production
d. Breastfeed often because this will keep the breasts empty and reduce pain
This will fade as the infant sucks and empties the breasts of milk. Some mothers find that warm packs
applied for about 20 minutes before feeding afford the most relief. In addition, good breast support
from a firm fitting bra prevents a pulling and heavy feeling.
Reference: Pilliterri, A.(2003) Maternal and Child Health Nursing: Care of the Childbearing and
Childrearing Family. 4th ed. 682
Correct
Question 3
Marks: 1/1
What do you call the symptoms that wherein the partner/husband also experiences physical symptoms such as nausea, vomiting,
backache or even more intensely that their partners do?
Choose one answer.
a. Braxton Hicks
b. Goodell’s sign
c. Couvade syndrome
d. McDonald’s rule
These symptoms are often the result of stress, anxiety and empathy for the pregnant woman. It has been common enough that it
has been given the name: Couvade syndrome. The more the partner is attuned or involved in the changes of the pregnancy, the
more symptoms he may experience.
For reference, see Maternal and Child Health Nursing by: Pillitteri, A. 4th ed. Page 214
Correct
Question 4
Marks: 0/1
Which hormone is responsible for stimulating milk production?
Choose one answer.

a. Prolactin
b. Progesterone
c. Estrogen
d. Oxytocin
Incorrect
Question 5
Marks: 0/1
Which of the following would be contraindicated in a client diagnosed with placenta previa?
Choose one answer.
a. A dministering intravenous fluids
b. Performing a vaginal exam
c. Inserting an indwelling catheter
d. Obtaining an ultrasound
Incorrect
Question 6
Marks: 1/1
Mrs. Torres, a mother with 6 children, wants advice regarding contraception. She asks the nurse if she can use a diaphragm.
Which of the following information in the client’s history would be a contraindication to the use of a diaphragm?
Choose one answer.
a. Smokes 2 packs/day
b. Obesity
c. Blood pressure of 160/100 mmHg
d. She had recurrent UTI’s for the past 6 months
The diaphragm may cause bacteria to remain in the vagina increasing the chance of a UTI. The contraindications to the use of
diaphragm are the following:
• May not be effective if the uterus is prolapsed, retroflexed or anteflexed to such a degree that the cervix is also displaced in
relation to the vagina
• Intrusion on the vagina by a cystocoele or a rectocele
• Should not be used in the presence of acute cervicitis
• History of TSS ( staphylococcal infection introduced through the vagina)
• Allergy to rubber or spermicides
• History of recurrent UTI’s
Childrearing Family. 5th ed.
Correct
Question 7
Marks: 0/1
When using Depo Provera, which of the following instructions should the nurse give the client?
Choose one answer.
a. Depo-provera contains only estrogen
b. If she has a baby, she cannot breastfeed while taking Depo Provera
c. She should return for injection every week
d. Potential side effects are irregular menstrual cycle, headache and weight gain
Incorrect
Question 8
Marks: 1/1
The discomfort expected with true labor contractions is most accurately described by which of the
following?
Choose one answer.
a. Discomfort that radiates downward to the cervix then later to the anal area.
b. Discomfort begins in the lower back that goes to the abdominal area.
c. Pain radiates to the nipple area.
d. Discomfort that is superb in the vaginal area.
Radiation of discomfort from the lower abdomen and back to the entire abdomen is characteristic for
most labors. For occiput posterior positions of the fetuses, “back labor” with pain centered in the lower
back is the expected finding.
Correct
Question 9
Marks: 0/1
A 24-year-old patient comes to the clinic because she wants to know about the morning-after-pill. Which of the following
statements would be correct?
Choose one answer.
a. The morning after pill may cause diarrhea
b. The morning after pill destroys the rapidly dividing cells of an embryo
c. You cannot take the morning after pill
d. The morning after pill contains a high dose of estrogen
Incorrect
Question 10
Marks: 1/1
During discharge teaching for a client with a hydatidiform mole, the nurse must include which of the
following?
Choose one answer.
a. Avoid taking birth control pills
b. A hysterectomy will be required in the future
c. No specific restrictions are necessary
d. Avoid pregnancy for a year
Gestational trophoblastic disease or hydatidiform mole is the proliferation and degeneration of the
trophoblastic villi. As the cells degenerate, they become filled with fluid and appear as fluid-filled,
grape-sized vesicles. Hydatidiform moles may be precancerous. The hormones involved pregnancy
may increase the patient’s risk of cancer.The woman is usually advised to use a reliable contraceptive
method such as an oral contraceptive so that a positive pregnancy test ( the presence of hCG)
resulting from a new pregnancy will not be confused with the increasing levels and the developing
malignancy. The other options are incorrect.
Correct
Question 11
Marks: 1/1
The most common site of an ectopic pregnancy is in the:
Choose one answer.
a. Fallopian tube
b. Surface of the ovary
c. Cervix
d. Uterus
The most common site, approximately 95% of all ectopic pregnancies, is in the fallopian tubes. Other
sites such as the surface of the ovary or the cervix is less common.
Reference: Pillitteri, A. (2007) Maternal and Child Health Nursing: Care of the Childbearing and
Childbearing Family. 5th Edition. Vol. 1. Page 388
Correct
Question 12
Marks: 0/1
A client who is 12-weeks pregnant calls the prenatal clinic and states that she is bleeding and passed a
few clots. She is advised to come to the office for an examination. Uopn examination, she is noted to
have passed the fetus but not the placenta. She is admitted for a D & C. Which of the following types
of abortions would this be?
Choose one answer.
a. Complete
b. Threatened
c. Incomplete
d. Inevitable
Incorrect
Question 13
Marks: 0/1
The nurse is caring for a client in the fourth stage of labor. The initial priority nursing assessment in
this stage of labor is:
Choose one answer.
a. Providing privacy for the parents with their newborn
b. Assisting the client to breastfeed
c. Assessing vital signs and the uterine fundus
d. Encouraging food and fluid intake
Incorrect
Question 14
Marks: 0/1
At the time of the ovulation, what happens to the basal body temperature (BBT)?
Choose one answer.
a. It is affected by the increase of progesterone
b. It falls slightly then increases
c. It is affected by the increase of Follicle Stimulating Hormone (FSH)
d. It rises slightly then falls
Incorrect
Question 15
Marks: 0/1
A client who has had a premature rupture of membranes (PROM) is highly at risk for:
Choose one answer.
a. Hypertension
b. C-section delivery
c. Infection
d. Abruptio placenta
Incorrect
Question 16
Marks: 1/1
The nurse is teaching the postpartum client about the sitz bath. The nurse tells the client that sitz
baths are prescribed to:
Choose one answer.
a. Cleanse the perineum and prevent hemorrhoids
b. Reduce edema and numb the tissue
c. Promote healing and provide comfort
d. Reduce infection and stimulate peristalsis
Warm, moist heat is employed after the first 24 hours following a vaginal birth to provide comfort,
promote healing, and reduce the incidence of infection. Ice is used the first 24 hours to reduce the
edema and numb the tissue. Stimulation of peristalsis is better achieved by ambulation. A sitz bath
may provide comfort for hemorrhoids but does not prevent them.
Correct
Question 17
Marks: 1/1
The client’s fundus is checked every 15 minutes for the first hour after delivery. The fundus should be
massaged if it:
Choose one answer.
a. Is firm and hard
b. Begins to decrease in size
c. Is lower than midway between the umbilicus and symphysis pubis
d. Is soft and boggy
A well contracted fundus is firm and hard. It can be compared to the size of a grapefruit in size and
tenseness or consistency. If it feels soft and boggy, it is not contracted as it should be and should be
massaged. Massaging the uterus causes it to contract and become firm immediately.
Childrearing Family. 4th ed 603
Correct
Question 18
Marks: 0/1
The nurse receives an order to administer methylergonovine (Methergine) to a postpartum client with
uterine atony. The nurse would contact the physician to verify the order if which of the following
conditions is present in the client?
Choose one answer.
a. Excessive Lochia
b. Hypertension
c. Excessive bleeding
d. Difficulty locating the uterine fundus
Incorrect
Question 19
Marks: 0/1
Which of the following nursing diagnoses would be most appropriate for a client admitted with an
imminent abortion who is found crying in her room?
Choose one answer.
a. Altered Thought Process
b. Anticipatory Grieving
c. Anxiety
d. Dysfunctional Grieving
Incorrect
Question 20
Marks: 0/1
The nurse is caring for a client who's in the first stage of labor. What is the shortest but most difficult
part of this stage?
Choose one answer.
a. Complete phase
b. Transitional phase
c. Latent phase
d. Active phase
Incorrect
Question 21
Marks: 0/1
The nurse enters the patient’s room and notes late decelerations on the monitor. Which of the
following should the nurse do first?
Choose one answer.
a. Call the physician
b. Increase IV fluids
c. Place the patient in supine position
d. Place the patient in left lateral position
Incorrect
Question 22
Marks: 1/1
The husband of a client diagnosed with hyperemesis gravidarum asks the nurse, "Why does my wife
keep throwing up? I thought that stopped after a few months." The nurse's response is based on the
knowledge that continued vomiting in pregnancy is related to which of the following?
Choose one answer.
a. Decreased serum progesterone level
b. Elevated human chorionic gonadotropin level (HCG)
c. Decreased serum estrogen level
d. Elevated serum glucose level
Several theories suggest that rapidly increasing levels of HCG in early pregnancy may be the cause of
severe nausea and vomiting that persist for a prolonged time. Serum estrogen level is elevated during
pregnancy. Elevation may contribute to nausea and vomiting. Serum progesterone level is elevated
during pregnancy and does not contribute to nausea and vomiting. Serum glucose level should not be
elevated in pregnancy and does not cause nausea and vomiting unless severely elevated.
Childbearing Family. 5th Edition. Vol. 1. Page 320
Correct
Question 23
Marks: 0/1
A woman who has cervical cerclage for incompetent cervix is being instructed by the nurse. The nurse
should include which of the following?
Choose one answer.
a. Come to the hospital at the first signs of labor
b. Come to the hospital when having contractions that are five minutes apart
c. Come to the hospital two days prior to the due date
d. Avoid sexual intercourse during the third trimester
Incorrect
Question 24
Marks: 0/1
Nurse Diana teaches the group about the rhythm method of birth control. She says that the rhythm method of birth control
depends on basal body temperature (BBT) during the menstrual cycle. She is correct in saying that the hormone responsible for
the elevation in BBT is:
Choose one answer.
a. Progesterone
b. Human Chorionic Gonadotropin (HCG)
c. Estrogen
d. Follicle Stimulating Hormone (FSH)
Incorrect
Question 25
Marks: 0/1
A client with type 1 diabetes mellitus is pregnant for the second time. Her previous pregnancy ended
in spontaneous abortion at 18 weeks' gestation. She's now at 22 weeks' gestation. The nurse is
responsible for teaching the client about exercise during her pregnancy. Which of the following
statements indicates that the client has an appropriate understanding of her exercise needs?
Choose one answer.
a. "I know I need to walk with a friend or family member
b. "I know I need to exercise before meals
c. "I know I need to drink fluids while I walk."
d. "I know I need to vary the times of day when I exercise
Incorrect
Question 26
Marks: 1/1
Accompanied by her husband, a client seeks admission to the labor and delivery area. She states that
she's in labor and says she attended the facility clinic for prenatal care. Which question should the
nurse ask her first?
Choose one answer.
a. "Do you have any allergies?"
b. "What is your expected due date?"
c. "Do you have any chronic illnesses?"
d. "Who will be with you during labor?"
When obtaining the history of a client who may be in labor, the nurse's highest priority is to determine
her current status, particularly her due date, gravidity, and parity. Gravidity and parity affect the
duration of labor and the potential for labor complications. Later, the nurse should ask about chronic
illnesses, allergies, and support persons.
Childbearing Family. 5th Edition. Vol. 1. Page 512-513
Correct
Question 27
Marks: 1/1
A nursing student who is sexually active asks their professor which of the following methods would be most effective in
preventing STD’s. The nurse responds by stating that the most effective in preventing STD’s are:
Choose one answer.
a. Spermicidal foams
b. IUD’s
c. Condoms
d. Diaphragms
Condom is the only birth control that prevents the mixing of body fluids. It is said to be effective in preventing sexually
transmitted diseases. Latex condoms have the additional potential of preventing the spread of STI’s and their use has become a
major part oft the fight to prevent infection with human immunodeficiency virus (HIV). It has been recommended that they
always be worn during coitus between partners who do not maintain a monogamous relationship. Both male and female condoms
provide an effective protection against STI’s/STD’s.
Correct
Question 28
Marks: 0/1
There are two main causes of bleeding during the second trimester of pregnancy. One is the condition
in which there is proliferation and degeneration of the trophoblastic villi. This is known as:
Choose one answer.
a. Abdominal pregnancy
b. Premature cervical dilatation
c. Hydatidiform mole
d. Ectopic pregnancy
Incorrect
Question 29
Marks: 1/1
Internal rotation of the head follows which maneuver of the head?
Choose one answer.
a. Engagement
b. Expulsion
c. Flexion
d. Descent
Passage of the fetus through the birth canal involves a number of different position changes to keep
the smallest diameter of the fetal head. These position changes are termed the cardinal movements of
labor: Descent, flexion, internal rotation, extension, external rotation and expulsion/
Childrearing Family. 4th ed.475
Correct
Question 30
Marks: 0/1
The nurse is developing a care plan for a client in her 34th week of gestation who is experiencing
premature labor. What nonpharmacologic intervention should the plan include to halt premature
labor?
Choose one answer.
a. Promoting adequate hydration
b. Encouraging ambulation
c. Performing nipple stimulation
d. Serving a nutritious diet
Incorrect
Question 31
Marks: 1/1
Which of the following is not a normal side-effect of oral contraceptives?
Choose one answer.
a. Leg cramps and headaches
b. Nausea and vomiting
c. Breast tenderness
d. Chloasma
Headaches and leg cramps may be signs of thromboembolism caused by the change in clotting factors
that occurs during the stimulation of estrogen and progesterone. Other options are incorrect because
these are normal side effects and not clinically significant.
Correct
Question 32
Marks: 1/1
The nurse is assessing a client who has been admitted to the labor and delivery area. Which technique
does the nurse use to determine fetal position and presentation?
Choose one answer.
a. Palpation of contractions
b. Leopold's maneuvers
c. Abdominal ultrasonography
d. Fetal heart tone auscultation
Leopold's maneuvers, a series of abdominal palpations, are used to determine fetal position,
presentation, and lie. First maneuver determines whether fetal head or breech is in the fundus. Second
maneuver locates the back of the fetus. Third maneuver determines the part of the fetus at the inlet
and its mobility. Fourth maneuver determines fetal attitudes and degree of fetal extension into the
pelvis, it should be done only if the fetus is in cephalic peresention. Information about the infant’s
anterior position may also be gained from this maneuver.
Abdominal ultrasonography is used throughout pregnancy to determine the positions of the uterus and
cervix, detect an abnormal fetus, determine the number of fetuses, take fetal measurements, and
estimate gestational age. Fetal heart tone auscultation is done to assess the fetal heart rate. Palpation
of contractions helps to distinguish true labor contractions from Braxton Hicks contractions.
Correct
Question 33
Marks: 1/1
All of the following are normal changes during pregnancy, except:
Choose one answer.
a. Esophageal regurgitation
b. Elongation of the urethra by 1.5 to 3 inches
c. Hydroureter
d. Loss of teeth due to depletion of calcium and phosphorous stores
Loss of teeth due to depletion of calcium and phosphorus stores is not within normal limits of pregnancy because if calcium is
inadequate, maternal stores other than the teeth are tapped to meet the tremendous fetal need.
Normal:
Urethra elongates by 1.5 – 3 inches –perineal structures are enlarged due to increase vasculature and hypertrophy of the perineal
body
Hydroureter occurs – especially on the right side because of the general dilatation and loss of tone from estrogen and
progesterone effect and compression of the ureters against the pelvic brim by the enlarged uterus.
Esophageal regurgitation occurs – delayed emptying of the stomach and upper pressure from the enlarged uterus.
Correct
Question 34
Marks: 0/1
The client asks the nurse when she can be able to know the sex of her baby. The nurse responds by
telling the client that the sex of the fetus can be determined using ultrasound during:
Choose one answer.
a. Weeks 5-8
b. Weeks 8-10
c. Weeks 13-16
d. Weeks 18-22
Incorrect
Question 35
Marks: 1/1
A woman who has been on the pill for 6 months calls the clinic and tells the nurse that she forgot to take her pill yesterday. The
nurse instructs the client to:
Choose one answer.
a. Take the forgotten pill immediately plus the pill scheduled for that day
b. Stop taking the pill for this month, use an alternative form of birth control
c. Throw away the pill that she forgot to take and continue with the rest of the month’s
supply
d. Double up on the pill for one week
One missed dose can be corrected by taking the forgotten pill immediately plus the pill scheduled for that day. I she forgot to take
two pills, she is advised to take two pills immediately plus the scheduled pill for that day. Anymore than that (3 forgotten pills or
more) and the client must stop the cycle and restart again after her period.
Correct
Question 36
Marks: 0/1
Human papilloma virus causes fibrous tissue overgrowth on the external vulva. It appears to have no
effect on the fetus during pregnancy but if they obstruct the birth canal, a C-section may be necessary.
HPV infections are serious because they are associated with:
Choose one answer.
a. HIV
b. Hepatitis
c. Cervical cancer
d. Gestational diabetes
Incorrect
Question 37
Marks: 1/1
The client has herpes simplex virus type II (genital herpes). For which of the following related to the
client’s delivery should the nurse prepare?
Choose one answer.
a. Cesarean delivery
b. Forceps delivery
c. Artificial rupturing of membranes
d. Precipitate delivery
Indications for cesarean delivery include umbilical cord prolapse, breech presentation, fetal distress,
dystocia, previous cesarean delivery, herpes simplex infection, condyloma acuminatum, placenta
previa, abruptio placentae, and unsuccessful labor induction. Insufficient perineal stretching; rapid,
progressive labor; and fetal prematurity aren't indications for cesarean delivery.
Correct
Question 38
Marks: 1/1
Pregnancy induced hypertension (PIH) usually occurs:
Choose one answer.
a. On the first trimester
b. Before the 20th week AOG
c. Anytime during pregnancy
d. After the 20th week AOG
PIH rarely occurs before 20 weeks of pregnancy. It usually occurs after 20th week AOG.
Correct
Question 39
Marks: 0/1
Shortly after delivery, the lochia should be:
Choose one answer.
a. Pink
b. White
c. Red
d. Brown
Incorrect
Question 40
Marks: 1/1
A pregnant mother undergoes a non-stress test. When is a nonstress test considered non-reactive?
Choose one answer.
a. Three accelerations of fetal heart rate lasting for 15 seconds occur after movement within
the chosen time period
b. Two accelerations of fetal heart rate lasting for 15 seconds occur after movement within
c. One acceleration of fetal heart rate lasting for 15 seconds occur after movement within
d. There is low short term fetal heart rate variability
A nonstress test measures the response of the fetal heart rate to the fetal movement. The woman is
positioned and the fetal heart rate and uterine contractions monitors are attached as for obtaining a
rhythm strip. When the fetus moves, the fetal heart rate should increase about 15 beats per minute
and remain elevated for about 15 seconds. It should decrease to its average rate again as the fetus
quiets. This test is usually done for 10-20 minutes. A test is reactive if two accelerations of fetal heart
rate (15 beats or more) lasting for 15 seconds occur after movement within the chosen time period.
The test is nonreactive if no accelerations occur with the fetal movements or if there is low short term
fetal heart rate variability (less than 6 beats per minute).
Correct
Question 41
Marks: 0/1
The nurse is teaching a client who is 28 weeks pregnant and has gestational diabetes how to control
her blood glucose levels. Diet therapy alone has been unsuccessful in controlling her blood glucose
levels, so she has started insulin therapy. The nurse should consider the teaching effective when the
client says:
Choose one answer.
a. "I won't use insulin if I'm sick."
b. "I need to use insulin each day."
c. "I'll monitor my blood glucose levels twice a week."
d. "If I give myself an insulin injection, I don't need to watch what I eat."
Incorrect
Question 42
Marks: 1/1
What is the purpose of applying ice for the first 24 hours to the perineum of a postpartal woman?
Choose one answer.
a. Increases circulation
b. Promotes healing fast
c. Promotes vasodilation and increases comfort
d. Reduces pain, perineal edema and hematoma formation
During the first 24 hours, apply ice pack or cold compress to reduce perineal edema, reduce pain and
hematoma formation
After 24 hours, healing increases best with the application of heat that promotes vasodilation ,
increases blood circulation and hastens healing.
Correct
Question 43
Marks: 0/1
Nurse Diana proceeds and discusses the cervical mucus method. The cervical mucus, at the time of the ovulation, has all of the
following characteristics except:
Choose one answer.
a. Transparent
b. Spinnbarkeit
c. Sticky
d. Watery
Incorrect
Question 44
Marks: 0/1
A nurse is caring for a client with suspected pregnancy induced hypertension (PIH). The nurse expects
to note which of the following findings if PIH is present?
Choose one answer.
a. Edema, tachycardia, ketonuria
b. Edema, proteinuria, hypertension
c. Hypertension, obesity, glycosuria
d. Edema, obesity, ketonuria
Incorrect
Question 45
Marks: 1/1
The type of lochia the nurse would expect on the fifth postpartum day is:
Choose one answer.
a. Lochia serosa
b. Lochia Rubra
c. Lochia alba
d. Lochia nigra
Note: Lochia rubra (red) 1-3 days postpartum, Lochia serosa (pink) 3-10 days postpartum, lochia alba
(white) 10-14 days post partum
Childrearing Family. 4th ed.603
Correct
Question 46
Marks: 1/1
Which of the following is the first thing that a nurse must ensure when the baby’s head comes out?
Choose one answer.
a. The cord is still pulsating
b. The cord is intact
c. No part of the cord is encircling the infants head
d. The cord is still attached to the placenta
Immediately after birth of the infant, the physician or the nurse suctions out the infants mouth with a
bulb syringe (airway) then passes his or her fingers along the occiput to the newborn’s neck to
determine whether a loop of umbilical cord is encircling the neck (circulation). If a loop of cord is felt, it
is gently loosened and drawn down over the fetal head.
Correct
Question 47
Marks: 1/1
During the first twelve (12) weeks of gestation, the hormones progesterone and estrogen are produced primarily by the:
Choose one answer.
a. Corpus luteum
b. Trophoblasts
c. Anterior pituitary gland
d. Placenta
The corpus luteum produces estrogen and progesterone during the first 8 weeks. The other options are
incorrect because the placenta is not mature enough during this period and the anterior pituitary gland
and trophoblasts do not produce estrogen and progesterone.
Correct
Question 48
Marks: 0/1
Which of the following nursing measures is least appropriate during the first stage of labor?
Choose one answer.
a. Urging the client to breathe deeply
b. Having the client push with each contraction
c. Encouraging the client to void
d. Helping the client lie on her left side
Incorrect
Question 49
Marks: 0/1
The function of the placenta includes all of the following, except:
Choose one answer.
a. Acts as the organ of respiration of the fetus
b. Secretes HCG, estrogen and progesterone
c. Provides for the passage of nutrients to the fetus and removal of wastes
d. Screens out viruses, bacteria and toxins
Incorrect
Question 50
Marks: 1/1
There are certain psychological behaviors common to each trimester of pregnancy. During the second trimester, the woman is
generally:
Choose one answer.
a. Is ready to begin learning breathing exercises
b. Is more outgoing
c. Fantasizes about the child and withdraws from other relationships
d. Is ambivalent about the pregnancy
The mother fantasizes about the child and may withdraw from other relationships (period of
introspection and introversion). This anticipatory role playing is an important task for the pregnant
woman.
Is ambivalent about the pregnancy – 1st trimester
(Is more outgoing) contradicts (Fantasizes about the child and withdraws from other relationships) and
(Is ready to begin learning breathing exercises) – the woman is ready to begin learning breathing
exercises during her third trimester when she is approaching labor.
Correct

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