NSG 1600 Unit 1 OB; Complete Q&A Spring 2023. Rx = prescription/medication order Hx = history Dx = diagnosis Tx = treatment 1) Which list of s/s most accurately describes hyperthyroidism? a) Weight gain, tiredness, and c
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NSG 1600 Unit 1 OB; Complete Q&A Spring 2023. Rx = prescription/medication order Hx = history Dx = diagnosis Tx = treatment 1) Which list of s/s most accurately describes hyperthyroidism? a) Weight gain, tiredness, and cold intolerance b) b) Bulging eyes, goiter, HR of over 100 c) SOB when lying supine, edema in lower extremities d) Seizure activity related to hypertension 2) A nurse is taking a gestational Hx of a mother presenting to an ER with preeclampsia like symptoms. She states “I’m currently 39 weeks pregnant, I have had two children born at 37 and 35 weeks. I lost 3 pregnancies prior to 12 weeks and have 2 living children.” Which of the following is the correct GTPAL breakdown? a) G6 T1 P1 A3 L2 b) G5 T2 P1 A2 L2 c) G6 T1 P1 A3 L1 d) G6 T1 P2 A2 L2 3) A nurse is counting “beats” as her pt’s foot relaxes after dorsiflexion. Her nursing student asks what she is testing for. What is the most likely response from the nurse? a) Opioid overdose b) GDM c) Mg toxicity d) Daily kick counts 4) What is the most common endocrine disorder during pregnancy? a) Hyperthyroidism b) Hypothyroidism c) Adrenal cancer a) Gestational diabetic mellitus 5) A nurse is orienting a new graduate nurse who barely passed their OB exam at Sinclair Community College, which statement about when to screen for GDM would not require correction from the precepting nurse? a) “We screen mom every 6 months” b) “Mom should be checked weeks 24-28” c) “Mom should be checked every 4 weeks after week 6” d) “I don’t know. I forgot all this stuff after the NCLEX” 6) A 23-year-old female presents to the emergency room with complaints of abdominal pain, dysuria, and purulent cervical discharge as well as a positive home pregnancy test. She reports frequent sexual activty with her partner, upon questioning she mentions her partner refuses to wear condoms and remains sexually active with other partners. Additionally she works as a radiology technician at a local hospital. Please answer the next few questions regarding her case study. Find answers at the end of each question. 6a) Which orders can you expect to see from the MD? 6b) What are the 5 P’s of sexual Hx and STI prevention? 6c) Are there any concerns with her daily environment? 6d) Which of the “Ps of Pregnancy” is the pt in? a) Presumptive b) Probable c) Positive d) Pleasant 6e) Given her current intimate situation, s/s, and demographic, what STI is most likely to appear? 6f) After confirming Dx of her STI and pregnancy at 5wks via ultrasound, MD Rx an antibiotic. What education should the nurse provide to the pt before discharging home? 7) While on a postpartum unit, a pt asks the nurse if she is at risk for future diabetes. Which answer from the nurse would be most appropriate? A a) “Yes, you are at risk for GDM as well as type 2 diabetes we will reassess in 6-12wks” b) “No, your risk of diabetes decreases once you give birth” c) “No, after delivering the placenta you body completely reverts to normal function” d) “No, you are no longer at risk for diabetes. However, your baby is at increased risk of pancreatitis” 8) A nurse manager is rounding on her intrapartum unit for high risk mothers. While assessing a GDM pts IV, which finding would the nurse manager require education to the pts nurse? a) An IV pump running an insulin infusion b) An IV pump running MgSO4 c) An IV running D5W d) An IV running LR full bore on a mother who just received an epidural 9) During pregnancy, which compilation of vital signs is correct for the mother? a) HR increases, BP increases b) HR increases, BP decreases c) HR decreases, BP increases d) HR decreases, BP decreases 10) Which position is the best for both mom and baby? a) Lateral Recumbent b) Supine c) Fowlers d) Whatever keeps mom comfortable 11) T / F - Iron and folic acid deficiency anemia can be prevented 12) What is thalassemia? a) Low hematocrit b) High iron c) Low calcium d) Low hemoglobin 13) Which department should be contacted in which both legal and moral dilemmas can be answered? a) Legal b) HR c) Ethics d) DON 14) Which Dx method is the “gold standard” of fetal health and development a) CT b) MRI c) Ultrasound d) Manual aging 15) Which hepatitis is commonly immunized against at birth and considered an STI? a) Hep A b) Hep B c) Hep C d) Hep Z 16) Which hepatitis is commonly acquired through drug use? a) Hep A b) Hep B c) Hep C d) Hep D 17) Which hepatitis is acquired through fecal-oral transmission, either through food or person- person? a) Hep A b) Hep B c) Hep C d) Hep Q 18) T / F - Mom should not breastfeed if positive and the baby has received prophylaxis Tx 19) While in an antepartum unit, an expecting mother was just diagnosed with HIV. At which levels of viral load at 36 wks is C/S an option? Select all that apply. a) 1245 copies/mL b) 3500 copies/mL c) 260 copies/mL d) 980 copies/mL e) 2400 copies/mL f) 490 copies/mL 20) T / F - Mom is safe to breastfeed if HIV (+) 21) What is a normal vaginal environment? Select all that apply a) pH of 6.3 - 7.5 b) Yellowish liquid discharge c) Irritating discharge d) Mild odor e) pH 4 - 5 22) Combine the noteworthy s/s or case study with the correct/most likely STI 1) Cauliflower genital wart A) Chlamydia (Bacterial) 2) 3 different stages and fatal if un-Tx B) Syphilis (Bacterial) 3) Greenish discharge in a 20 y/o F C) HIV / AIDS (Viral) 4) 24 y/o F w/ postcoial bleeding and mucoid/purulent discharge D) Gonorrhea (Bacterial) 5) Bisexual 25y/o M with sudden trush E) Herpes (Viral) 6) Open sore on mouth/genitals F) HPV (Viral) 23) During a group prenatal visit at an OB office, one mother asks which disease is the most likely to cause disability is neonates. Which answer is an appropriate response from the nurse? a) GBS b) HIV c) EDD d) AGA 24) A student nurse is asked about the risk of UTIs in mothers and how to help reduce the risk. Select all of the items that would help reduce UTIs in mothers a) Avoid condoms to improve natural vaginal flora b) Wear synthetic fabric underwears c) Eat yogurt d) Void before and after intercourse e) Wear cotton underwear f) Increase time in damp clothing, such as bathing suits 25) Label the following terms in the correct order on the timeline. No word bank. 26) Define each aspect of GTPAL. Find the answers at the end of each letter below. Additionally G/P but not listed below. G – T - P - A – L - 27) Connect is Dx measure of pregnancy with its description and its level of probability Sign / Dx Tool Description (white text so highlight below) Level of probability Goodell’s sign Chadwick’s sign Hegar’s sign Braxton Hicks contractions Ballottement Fetal Ultrasound (+) Home Preg. Test Fetal Heart Tones Amenorrhea Quickening 28) Which two hormones are primarily responsible for uterine growth? a) Progesterone and Oxytocin b) Oxytocin and Estrogen c) Estrogen and Progesterone d) Estrogen and Prolactin 29) At what point should fundal height be equal to the wks pregnant? a) 20-22wk b) 32-34wk c) 23-26wk d) 12-15wk 30) T / F - Milky white discharge is normal during the start of preg 31) At what point is mom ready to breastfeed? a) 12wk b) 20wk c) 10wk d) 16wk 32) Which precaution should not be used in mothers? a) Fall Risk b) DVT Risk c) Isolation precautions d) Standard precautions 33) Which combination is correct? a) H&H increase, WBC increase b) H&H increase, WBC decrease c) H&H decrease, WBC increase d) H&H decrease, WBC decrease 34) Which combination is correct? a) PaCO2 increase, PaO2 increase b) PaCO2 increase, PaO2 decrease c) PaCO2 decrease, PaO2 increase d) PaCO2 decrease, PaO2 decrease 35) Which combination of metabolic states is most likely in pregnant women? a) Metabolic alkalosis, resp. alkalosis b) Metabolic acidosis, resp. alkalosis c) Metabolic alkalosis, resp. acidosis d) Metabolic acidosis, resp. acidosis 36) What lab values are considered abnormal in a pregnant woman? a) Proteinuria 327 mg/24hr b) Proteinuria 133 mg/24hr c) Proteinuria 254 mg/24hr 37) T / F - Striae gravidarum are also known as stretch marks and are premanate 38) A mother is in depression over finding out that her melasma is permanent and will be made worse as her pregnancy continues. Which answer from the nurse is most appropriate? 39) A mother finds a strange drive to eat items like clay, toothpaste, and/or cotton balls. Which disease symptoms is she expressing? No options see answer here → 40) An expecting mother calls the OB office to speak to a nurse. After picking up the phone the nurse listens to the patient's concerns: vomiting 5 times a day, losing 5lbs, and expressing a fluttering feeling in her chest. What is the most appropriate response from the nurse? a) “Go to an ER immediately” b) “No big deal. It is normal” c) “What is the color of your BM?” d) “See your OB as soon as possible” 41) A family attempting to conceive and having difficulties. Which response from the nurse would elicit the most therapeutic conversation? a) “Why do you feel this way?” b) “At least you both are healthy” c) “I am sorry you feel this way. What can I do to help?” d) “It’ll all be ok” 42) A nurse is working at a family planning tent at an LGBTQIA+ pride event. There a 19 y/o F wishes to start a family. What quote from the nurse would not be considered therapeutic? a) “Let’s discuss your options!” b) “I want to make sure you are ready for a baby, what is your home life like?” c) “You are far too young to have a kid” d) “That’s exciting. When were you planning on having the child?” 43) Which method of contraception is the most effective? a) Hysterectomy b) Condoms c) IUDs d) Coitus interruptus (“Pull out method”) 44) A 32 y/o sexually active woman presents to an emergecny department with abdominal pain. She reports that there is, “no chance of being pregnant because I had my tubes tied last year.” The provider orders blood and urine screens and finds a hCG of 1700. What should the nurse expect to be as the final admitting Dx? a) GDM b) Ketoacidosis c) Ectopic pregnancy d) Traditional pregnancy 45) A student nurse who views abortion as murder is going through a pts chart to find that the pt has “Hx of 3 abortions” with no further context from previous provider. The clinical instructor overhears the student speaking negatively about the pt. What response from the clinical instructor would be most accurate? a) “ b) “An abortion is just a number refering to the number of lost pregnancies before 20 weeks gestation” c) “An abortion is when a woman makes the choice to end an abortion before the gestational age of 20wks” d) “An abortion is a woman’s right” 46) T / F - White women are most likely to experience health disparities of all pregnant women. 47) A person who presents with a vagina, breasts, and a uterus but identifies as a man, going by he/him pronouns - which definition best classifies this individual? a) Transman b) Transwoman c) Lesbian d) Intersex 48) A pts chart mentions the pt’s sex is male and identifies as such. What should the nurse expect to find on examination and/or what should the nurse do to make the pt most comfortable? a) Use she/her pronouns b) Clinical findings of a penis c) Upon questioning, an attraction to men d) Clinical findings of a vagina 49) When a researcher studies the BRCA gene is studies ? a) Genetics b) Genomics c) Chromosomes d) Cells 50) During education an expecting mother asks the nurse how blood is moved from the fetus to her. What response from the student nurse would require additional education? D a) “Blood goes from the fetus via 2 veins to you” b) “Blood goes from the fetus via 1 vein to you” c) “Blood goes from the fetus via 2 arteries to you” d) “Blood goes from the fetus via 1 artery to you” 51) During a routine examination, the radiology tech running the ultrasound asks for a nurse or provider to under the room quickly. The rad tech describes a nuchal cord. The nurse knows a nuchal cord is…? a) When the umbilical cord appears outside of the cervix b) When the baby holds onto the umbilical cord c) When the umbilical cord is wrapped around the fetal neck d) When the placenta is being obstructed by a blood clot 52) A couple is trying to avoid having a child while also enaging in regular safe sex. However during intercourse the boyfriend believes his condom broke and reached out to a family planning center. What time frame should the nurse inform the couple to start testing for? a) 5-7 days post-suspected-conception b) 8-10 days post-suspected conception c) 12-14 days post-suspected-conception 53) Which fetal HR would warrant a message to a provider? a) 140bpm b) 125bpm c) 80bpm d) 110bpm 54) While working on a breast cancer screening truck at a local fair, a 17 year old with a family Hx of breast cancer. She wants to know when she should choose to examine her breast. Which statement from the nurse is best in decreasing risk of false positives or negatives related to hormonal changes? a) “Perform your exam during a full moon” b) “Preform your exam at the same time each month” c) “Make sure to apply lotion prior to examination” d) “Examine the same breast first in order to form a habit” 55) 12 y/o overweight female and her father walk into the emergency room with CC of vaginal bleeding. The father is concerned the daughter may be internally bleeding because she is, “too young to have started her period.” The nurse sends in the student nurse to help educate the father. Which statement by the student nurse requires correction from the nurse? a) “We are not too concerned. In the US the average age of menarche (your first period) is around 13 years old” b) “She is overweight. Evidence does show that menarche age is getting younger. This has been linked to increased rates of juvenile obesity” c) “You daughter is menstruating due to a change in the levels of hCG in her body” d) “Your daughter is likely having a period. Make sure she understands that blood is normal but she should not be changing pads/tampons out more frequently than every hour” 56) 19 y/o fit female presents to an OB/GYN office with concern for her menses. Upon taking a Hx the provider finds that the pt has yet to have a menses. Which of the following activities could be a reason for a lack of meses? Select All that Apply a) Professional Chess player b) Gymnast c) Marathon runner d) Full time student e) Computer science major f) Office secretary 57) Fill in the chart below Periodic uterine bleeding occurs after ovulation Average menses period lasts Average bleeding phase lasts Average blood loss is The first day of menstrual cycle is denoted by ( This acronym ) is one of the first things suspected with an altered menses cycle 58) If a pt has very high or very low FSH which aspect of the endocrine system should be examined? a) Anterior pituitary b) Posterior pituitary c) Adrenal medulla d) Adrenal cortex 59) PMDD is a significantly worse presentation of which other s/s / condition? a) PMS b) CHF c) COPD d) BPD 60) Match the medical term with its definition 1) Oligomenorrhea A) Bleeding between expected periods 2) Hypomenorrhea B) Everything is abnormal 3) Menorrhea C) Infrequent menstruation 4) Metrorrhagia D) Excessive bleeding during menstruation 5) Abnormal uterine bleeding (AUB) E) Scant bleeding during menstruation 61) A pt wishes to relieve pain connected to her endometriosis. Which medication / Tx option is best if she wishes to retain the option of becoming pregnant safely in the future? a) Morphine b) Hysterectomy c) Acetaminophen d) Methamphetamine 62) TAH w/ BSO means , and should only be used in woman who have no wish to 63) Which items are unique and special for hysterectomy? Select All That Apply a) Cervical exam b) H&H monitoring c) Careful monitoring of perineal pad d) Advancing diets as tolerated 64) When is someone officially considered menopausal? a) 6 months after birthing last child b) When she stops having PMS symptoms c) When uterus reaches less than 20% hydration d) After 12 months after last known menstruation 65) Which sign can be related to endometrial cancer? a) Increased breast softness b) Vaginal bleeding after menopause declared c) Decreased hCG levels d) Decreased pain with menses 66) Osteoporosis can increase risk of fracture in the event of a fall. What vitamin can help ensure the absorption of Ca in the bones? a) Vit A b) Vit K c) Vit E d) Vit D 67) During shift change, the oncoming nurse receives a report stating that Room 12 is at 8cm, effaced 90% and dilated with contractions every 3 mins lasting roughly 60 seconds. What phase of labor is she in? a) Active b) Early c) After birth d) Tranitional 68) After a long but successful delivery process, a healthy baby boy was born. While the healthcare goes to assess the newborn, the provider encourages the mother to continue pushing to deliver the placenta. What stage of labor is she in? a) Recovery b) Early c) Afterbirth d) Dilation 69) During the initial assessment of the newborn the following findings are charted: cyanosis present from phalanges to elbow and knees respectively, HR of 120, full facial movement, activity in extremities are present but weak, and baby crying upon clearing of airway. Which APGAR score would most likely be seen? a) 12 b) 3 c) 8 d) -2 70) During the delivery of a LGA baby a provider wishes to conduct an episiotomy in order to assist with the delivery without going into an OR. Which description of the procedure is correct? a) Cutting from the posterior aspect of the vagina to the perineal region b) Rotating the fetus in order to deliver gluteal first c) Using forceps to deliver the fetus d) Calling the PICC team to insert a foley catheter 71) A nurse is getting ready to perform a cervical exam. Which preparation action is correct and requires no additional education? a) Using clean gloves b) Using sterile gloves c) Using no gloves but clean hands to get a better feel d) Using no gloves but dirty hands to improve the flora 72) During a prenatal visit a patient tells you her last menstrual period was May 21, 2020. Based on the Naegele's Rule, when is the estimated due date of her baby? a) Feb 21, 2021 b) Feb 27, 2020 c) Feb 28, 2021 d) April 16, 2021 73) During a prenatal visit a patient tells you her last menstrual period was November 25, 2020. Based on the Naegele's Rule, when is the estimated due date of her baby? a) Sept 1, 2021 b) Aug 28, 2021 c) Oct 1, 2021 d) Sept 8, 2021 74) During a prenatal visit a patient tells you her last menstrual period was August 15, 2020. Based on the Naegele's Rule, when is the estimated due date of her baby? a) May 4, 2020 b) May 4, 2021 c) May 22, 2021 d) May 23, 2021 75) What is the differentiating feature between preeclampsia and eclampsia? a) High Hgb b) Jaundice c) +4 pitting edema d) Seizure activity 76) Which case study should be reported immediately to a provider as a positive result of the mother being in or at very high risk of preeclampsia? a) Mother at 30 weeks gestation, BP of 160/90 checked once, then again 2 hours later with a result of 130/70. UA shows 250mg, Hx of hypertension b) Mother at 15 weeks gestation, BP of 150/60 taken once, but complains of headache and contractions getting closer together, no Hx of HT c) Mother 25 weeks gestation, with two BP readings. One at 150/100 and another 4 hours later at 145/95. UA shows proteinuria of 350mg. No Hx of HT d) Mother at 10 weeks gestations with a BP of 120/80 and a second reading of 110/75 4 hours later. Proteinuria shows 400/mg. No Hx of HT 77) A 36 y/o white expecting mother presents to an ED with platelets of 120,000/mcL, elevated liver enzyme, and RUQ pain at night. What Dx and Tx is most likely going to be ordered from the provider? a) Hemorrhaging; hang blood b) HELLP; MgSO4 c) HELLP; Oxytocin d) HELLP; Epinephrine 78) If a nurse is assessing for cluness, which body part is she examining? a) Wrist b) Foot c) Abdomen d) Head 79) When admitting an expecting mother - select all of the recommendations by the nurse is appropriate? a) Maintain a quiet non stimulating environment b) Ensure seizure precautions are readily available c) Ensure crash cart is loaded with additional medications, such as calcium gluconate d) Emergency birth pack e) Advising family that they may be asked to leave when contractions begin to worsen f) Ensure the mother avoids foods such as chocolate and strawberries to prevent PROM g) Encourage mother to stay in bed to avoid stimulating the baby 80) While on an intrapartum unit, a nurse is doing rounds. During this time she notices that her pt (who has MgSO4 running) is experiencing absent deep tendon reflexes, respiratory depression, and stroke-like symptoms. What is the priority nursing intervention? a) Administer calcium gluconate, following ACLS protocol b) Administer calcium chloride, following ACLS protocol c) Call the provider d) Stop MgSO4 infusion 81) Which of the following is not a treatment for hyperemesis? a) NG b) Ondansteron pump c) TPN d) Large spicy meals 82) A provider notes the mother has an incompetant cervix. Which Tx is most likely to be performed? a) Cerclage b) Pain management c) C/S d) AROM 83) A provider finds a fallopian ectopic pregnancy. Which medications can help prevent the pregnancy from advancing into a medical emergency? a) Oxytocin b) Estrogen c) Methotrexate d) MgSO4 84) What is the appropriate Tx for placenta previa? a) Methotrexate b) AROM c) C/S d) Movement 85) T / F - In order to reduce the risk of fetal harm, the CDC recommends that mom no longer wears a seatbelt 86) When is the ideal time to do daily kick counts? a) 4 times a day, before and after each BM b) 2 times a day, before sleep and right after waking up c) 3 times a day, after meals d) 2 times a day, after brushing teeth 87) Vibrocentsis does what? A a) Stimulates the baby with vibrations b) Stimulates mom with sound c) Removes kidney stones d) Assists with Dx of deafness 88) What event allows the use of internal baby monitoring? a) ROM b) Contractions within 2 minutes c) +2 clones beats d) Baby external HR of more than 120 89) Fill out the following table V - C - M - E - H - I - A - O - N - L - P - E - 90) Which of the following events require an emergency C/S? Select all that apply. a) Uterine abruption b) Uterine rupture c) Prolapsed cord d) Preeclampsia e) LGA f) Breech birth g) Active infection (ie HIV) h) Multiples 91) A mother is requesting an epidural. Which description is the most accurate representation of the procedure? a) A cut at the base of the vagina extending to the perineum b) A pain medication given rectally c) An anesthetic procedure to block sensation from a given region d) Pushing onto the cervix in order to feel a baby rebound onto the examiners finger to confirm pregnancy 92) A nursing student is asking a nurse why a pts BP went from 125/65 to 95/55 after receiving an epidural. Which answer is most likely to be said by the nurse? a) “Baby is relaxing so mom’s BP drops to compensate” b) “Mom is less anxious so her BP drops” c) “Hit the code button” d) “Her veins are dilating, so there is less vascular resistance” 93) While in A&P a student is asked which part of the fetal skull is where two bones meet. Which anatomical part is correct? a) Fontanel b) Suture c) Fundus d) Symphysis Pubis 94) A mother is pushing to deliver her baby. The fetus’ presenting part is a leg up to the greater trochanter. Which breaking style is this? a) Frank breech b) Single footling breech c) Complete breech d) Shoulder breech 95) During a cervical exam directly before delivery the nurse finds the fetus in a complete breech. Which description would best describe the position of the baby? a) Sacrum presenting, legs folded to the anterior portion of the fetal abdomen b) Foot presenting, remaining leg tucked on top of maternal pelvis c) Sacrum and feet presenting d) Shoulder presening, fetal head lateral to the symphysis pubis 96) A note reads, “presenting head found at +2” which landmark and measurement is accurate? a) Symphysis pubis, 2in superior b) Symphysis pubis, 2cm superior c) Symphysis pubis, 2cm inferior d) Iliac spine, 2cm inferior
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