Maternal Newborn OB Final Exam Questions and Answers

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b. Correct. Pregnant women and women who are attempting pregnancy should avoid contact with cat feces. Exposure occurs when the protozoan parasite found in cat feces and uncooked or rare beef and lamb... is ingested. Wearing a mask will not decrease the risk through ingestion of the parasite. - ANSWER Which of the following statements by a pregnant woman indicates she needs additional teaching on ways to reduce risks to her unborn child from the potential effects of exposure to toxoplasmosis?a. "I will avoid rare lamb."b. "I will wear a mask when cleaning my cat's litter box."c. "I understand that exposure to toxoplasmosis can cause blindness in the baby."d. "I will avoid rare beef." c. Correct. - ANSWER The fetal circulatory structure that connects the pulmonary artery with the descending aorta is known as which of the following?a. Ductus venosusb. Foramen ovalec. Ductus arteriosusd. Internal iliac artery d. Correct. Oligohydramnios refers to a decreased amount of amniotic fluid of less than 500 mL at term or 50% reduction of normal amounts. - ANSWER A woman at 40 weeks' gestation has a diagnosis of oligohydramnios. Which of the following statements related to oligohydramnios is correct?a. It indicates that there is a 25% increase in amniotic fluid.b. It indicates that there is a 25% reduction of amniotic fluid.c. It indicates that there is a 50% increase in amniotic fluid.d. It indicates that there is a 50% reduction of amniotic fluid C - ANSWER The nurse takes the history of a client, G2 P1, at her first prenatal visit. The client is referred to a genetic counselor, due to her previous child having a diagnosis of __________. a. Unilateral amblyopia b. Subdural hematoma c. Sickle cell anemia d. Glomerular nephritis D - ANSWER A nurse is teaching a woman about her menstrual cycle. The nurse states that __________ is the most important change that happens during the secretory phase of the menstrual cycle. a. Maturation of the graafian follicle b. Multiplication of the fimbriae c. Secretion of human chorionic gonadotropin d. Proliferation of the endometrium A - ANSWER An ultrasound of a fetus' heart shows that "normal fetal circulation is occurring." Which of the following statements is consistent with the finding? a. A right to left shunt is seen between the atria. b. Blood is returning to the placenta via the umbilical vein. c. Blood is returning to the right atrium from the pulmonary system. d. A right to left shunt is seen between the umbilical arteries. C - ANSWER The clinic nurse knows that the part of the endometrial cycle occurring from ovulation to just prior to menses is known as the: a. Menstrual phase b. Proliferative phase c. Secretory phase d. Ischemic phase C - ANSWER A clinic nurse explains to the pregnant woman that the amount of amniotic fluid present at 24 weeks' gestation is approximately: a. 500 mL b. 750 mL c. 800 mL d. 1000 mL B - ANSWER Information provided by the nurse that addresses the function of the amniotic fluid is that the amniotic fluid helps the fetus to maintain a normal body temperature and also: a. Facilitates asymmetrical growth of the fetal limbs b. Cushions the fetus from mechanical injury c. Promotes development of muscle tone d. Promotes adherence of fetal lung tissue A - ANSWER During preconception counseling, the clinic nurse explains that the time period when the fetus is most vulnerable to the effects of teratogens occurs from: a. 2 to 8 weeks b. 4 to12 weeks c. 5 to 10 weeks d. 6 to 15 weeks D - ANSWER A major fetal development characteristic at 16 weeks' gestation is: a. The average fetal weight is 450 grams b. Lanugo covers entire body c. Brown fat begins to develop d. Teeth begin to form A - ANSWER A couple who has sought infertility counseling has been told that the man's sperm count is very low. The nurse advises the couple that spermatogenesis is impaired when which of the following occur? a. The testes are overheated. b. The vas deferens is ligated. c. The prostate gland is enlarged. d. The flagella are segmented. True - ANSWER The perinatal nurse explains to the student nurse that in the fetal circulation, the lowest level of oxygen concentration is found in the umbilical arteries. B, C, D - ANSWER A woman seeks care at an infertility clinic. Which of the following tests may this woman undergo to determine what, if any, infertility problem she may have? (Select all that apply.) a. Chorionic villus sampling b. Endometrial biopsy c. Hysterosalpingogram d. Serum FSH analysis A, B - ANSWER Which of the following places a couple at higher risk for conceiving a child with a genetic abnormality? (Select all that apply.) a. Maternal age over 35 years b. Partner who has a genetic disorder c. Maternal type 1 diabetes d. Paternal heart disease C - ANSWER During a routine prenatal visit in the third trimester, a woman reports she is dizzy and lightheaded when she is lying on her back. The most appropriate nursing action would be to:a. Order an EKG. b. Report this abnormal finding immediately to her care provider. c. Teach the woman to avoid lying on her back and to rise slowly because of supine hypotension. d. Order a nonstress test to assess fetal well-being. D - ANSWER Blood volume expansion during pregnancy leads to: a. Iron-deficiency anemiab. Maternal iron stores being insufficient to meet the demands for iron in fetal developmentc. Plasma fibrin increase of 40% and fibrinogen increase of 50%d. Physiological anemia of pregnancy A - ANSWER A woman presents to the prenatal clinic at 30 weeks' gestation reporting dysuria, frequency, and urgency with urination. Appropriate nursing actions include:a. Obtain clean-catch urine to assess for a possible urinary tract infection.b. Reassure the woman that the signs are normal urinary changes in the third trimester.c. Teach the woman to decrease fluid intake to manage these symptoms.d. Perform a Leopold's maneuver to assess fetal position and station. B - ANSWER At the end of her 32-week prenatal visit, a woman reports discomfort with intercourse and tells you shyly that she wants to maintain a sexual relationship with her partner. The best response is to: a. Reassure woman/couple of normalcy of responseb. Suggest alternative positions for sexual intercourse and alternative sexual activity to sexual intercoursec. Recommend cessation of intercourse until after delivery due to advanced gestationd. Suggest woman discuss this with her care provider at her next appointment D - ANSWER The clinic nurse talks to a 30-year-old woman at 34 weeks' gestation who complains of having difficulty sleeping. Jayne has noticed that getting back to sleep after she has been up at night is difficult. The nurse's best response is: a. "This is abnormal; it is important that you describe this problem to the doctor." b. "This is normal, and many women have this same problem during pregnancy; try napping for several hours each morning and afternoon." c. "This is abnormal; tell the doctor about this problem because diagnostic testing may be necessary." d. "This is normal in pregnancy, particularly during the third trimester when you also feel fetal movement at night; try napping once a day." A. a. The progesterone-induced prolonged emptying time of bile from the gallbladder, combined with elevated blood cholesterol levels, may predispose the pregnant woman to gallstone formation (cholelithiasis). Pain in the epigastric region following ingestion of a high-fat meal constitutes the major symptom of these conditions. The pain is self-limiting and usually resolves within 2 hours. - ANSWER A 26-year-old woman at 29 weeks' gestation experienced epigastric pain following the consumption of a large meal of fried fish and onion rings. The pain resolved a few hours later. The most likely diagnosis for this symptom is: a. Cholelithiasis b. Influenza c. Urinary tract infection d. Indigestion B. During pregnancy the woman's hematocrit values may appear low due to the increase in total plasma volume (on average, 50%). Because the plasma volume is greater than the increase in erythrocytes (30%), the hematocrit decreases by about 7%. This alteration is termed "physiologic anemia of pregnancy," or "pseudo-anemia." The hemodilution effect is most apparent at 32 to 34 weeks. The mean acceptable hemoglobin level in pregnancy is 11 to 12 g/dL of blood. - ANSWER The clinic nurse reviews the complete blood count results for a 30-year-old woman who is now 33 weeks' gestation. Tamara's hemoglobin value is 11.2 g/dL, and her hematocrit is 38%. The clinic nurse interprets these findings as: a. Normal adult values b. Normal pregnancy values for the third trimester c. Increased adult values d. Increased values for 33 weeks' gestation C - ANSWER The clinic nurse is aware that the pregnant woman's blood volume increases by: a. 20% to 25% b. 30% to 35% c. 40% to 45% d. 50% to 55% A - ANSWER The clinic nurse uses Leopold maneuvers to determine the fetal lie, presentation, and position. The nurse's hands are placed on the maternal abdomen to gently palpate the fundal region of the uterus. This action is best described as the: a. First maneuver b. Second maneuver c. Third maneuver d. Fourth maneuver B - ANSWER The clinic nurse talks with Kathy about her possible pregnancy. Kathy has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. These symptoms are best described as: a. Positive signs of pregnancy b. Presumptive signs of pregnancy c. Probable signs of pregnancy d. Possible signs of pregnancy A - ANSWER Lina is an 18-year-old woman at 20 weeks' gestation. This is her first pregnancy. Lina is complaining of fatigue and listlessness. Her vital signs are within a normal range: BP = 118/60, pulse = 70, and respiratory rate 16 breaths per minute. Lina's fundal height is at the umbilicus, and she states that she is beginning to feel fetal movements. Her weight gain is 25 pounds over the prepregnant weight (110 lb), and her height is 5 feet 4 inches. The perinatal nurse's best approach to care at this visit is to: a. Ask Lina to keep a 3-day food diary to bring in to her next visit in 1 week. b. Explain to Lina that weight gain is not a concern in pregnancy, and she should not worry. c. Teach Lina about the expected normal weight gain during pregnancy (approximately 20 pounds by 20 weeks' gestation). d. Explain to Lina the possible concerns related to excessive weight gain in pregnancy, including the risk of gestational diabetes. B - ANSWER A woman presents to a prenatal clinic appointment at 10 weeks' gestation, in the first trimester of pregnancy. Which of the following symptoms would be considered a normal finding at this point in pregnancy? a. Occipital headache b. Urinary frequency c. Diarrhea d. Leg cramps C - ANSWER The nurse is providing prenatal teaching to a group of diverse pregnant women. One woman, who indicates she smokes two to three cigarettes a day, asks about its impact on her pregnancy. The nurse explains that the most significant risk to the fetus is: a. Respiratory distress at birth b. Severe neonatal anemia c. Low neonatal birth weight d. Neonatal hyperbilirubinemia C - ANSWER While performing Leopold's maneuvers on a woman in early labor, the nurse palpates a flat area in the fundal region, a hard round mass on the left side, a soft round mass on the right side, and small parts just above the symphysis. The nurse concludes which of the following? a. The fetal position is right occiput posterior. b. The fetal attitude is flexed. c. The fetal presentation is scapular. d. The fetal lie is vertical. A. Soft cheese may harbor Listeria. The patient should avoid consuming uncooked soft cheese. - ANSWER A nurse is reviewing diet with a pregnant woman in her second trimester. Which of the following foods should the nurse advise the patient to avoid consuming during her pregnancy? a. Brie cheese b. Bartlett pears c. Sweet potatoes d. Grilled lamb A - ANSWER A gravida, G4 P1203, fetal heart rate 150s, is 14 weeks pregnant, fundal height 1 cm above the symphysis. She denies experiencing quickening. Which of the following nursing conclusions made by the nurse is correct? a. The woman is experiencing a normal pregnancy. b. The woman may be having difficulty accepting this pregnancy. c. The woman must see a nutritionist as soon as possible. d. The woman will likely miscarry the conceptus. B. The EDC is calculated as April 13, 2008. Naegele's rule: subtract 3 months and add 7 days to the first day of the last normal menstrual period. - ANSWER A pregnant woman informs the nurse that her last normal menstrual period was on July 6, 2007. Using Naegele's rule, which of the following would the nurse determine to be the patient's estimated date of delivery (EDC)? a. January 9, 2008 b. April 13, 2008 c. April 20, 2008 d. September 6, 2008 [Show More]

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