OB/ Maternity
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QuestionaryWeek1.pdf
Questionary Week 1
1- The nurse preparing an educational seminar on sexually transmitted infections for female college students should advise that which 2 infections are leading causes of pelvic inflammatory disease and infertility?
1.
Genital herpes and HIV
2.
Gonorrhea and chlamydia
3.
Human papillomavirus and syphilis
4.
Yeast and trichomoniasis
2- After six months of unprotected intercourse and failing to conceive, a 37-year-old female client reports feeling anxious and depressed because of her situation. Which response by the nurse is most appropriate?
1.
"It is recommended to try to conceive for one year before undergoing a fertility evaluation."
2.
"Let's review how you are timing intercourse, as optimal timing will increase your
chances."
3.
"Reflecting on positive things in your life may help alleviate your anxiety and depression."
4.
"Tell me more about how this has affected you and your family in the last six months."
3- The nurse is caring for a client with suspected pelvic inflammatory disease (PID). When the nurse is obtaining the client's health history, which of the following questions would provide pertinent data about the client's risk factors for PID? Select all that apply.
1.
"Are you currently taking oral contraceptives?"
2.
"At what age did you experience your first menstrual cycle?"
3.
"Do you engage in sexual intercourse with multiple partners?"
4.
"Have you ever been diagnosed with a sexually transmitted infection?"
5.
"Have you recently had an abortion or pelvic surgery?"
4- The nurse educates a group of clients in the infertility clinic about risk factors contributing to infertility. Which factors should the nurse include in the teaching? Select all that apply.
1.
BMI of 22 kg/m2
2.
Endometriosis
3.
Maternal age >35
4.
Polycystic ovarian syndrome
5- The nurse is reviewing the history of several female clients. The nurse will
recommend a Pap test to screen for cervical cancer for which individual?
1.
18-year-old who reports being sexually active for the last 3 years
2.
26-year-old whose last Pap screening at age 23 was negative
3.
51-year-old who had a total hysterectomy (with cervix removal) for benign reasons
4.
72-year-old who has never had an abnormal Pap test result
6- The nurse caring for a group of clients on the gynecology unit recognizes that which are at increased risk for developing breast cancer? Select all that apply.
1.
24-year-old whose sister had breast cancer at age 38
2.
32-year-old with genetic mutations in the BRCA1 and BRCA2 genes
3.
45-year-old whose menstrual period began at age 17
4.
56-year-old who is postmenopausal and has gained 50 lb (22.6 kg) in the last 5 years
5.
65-year-old who took combined oral contraceptives for 15 years
7- The nurse obtains the breast self-examination (BSE) history of a group of female clients. Which client needs further teaching on the best timing of monthly BSEs?
1.
A 28-year-old taking oral contraceptives who performs BSE when beginning a new set of
pills
2.
A 35-year-old with regular periods who performs BSE 5 days after menstruation
3.
A 42-year-old with irregular periods who performs BSE when menstruation ends
4.
A 56-year-old postmenopausal woman who performs BSE on the first day of the month
8- The nurse provides education to a female client about the use of a cervical cap to prevent pregnancy. Which of the following statements by the client indicates a need for further teaching?
1.
"I should apply spermicide inside the cap, with a thin layer to the rim."
2.
"I should use a different birth control method during my period."
3.
"I will remove and clean the cap as soon as possible after intercourse."
4.
"It is okay for me to insert the cap several hours before I have sex."
9- The nurse is providing education to a client with a new prescription for progestin- only pills (POPs). Which statement about POPs is appropriate for the nurse to include?
1.
"If you begin vomiting any time within 24 hours of taking the pill, take an additional pill."
2.
"If you take your pill 3 or more hours after your usual time, use a backup contraceptive."
3.
"In your pill pack, there are 21 days of progestin pills and 7 days of inactive iron pills."
4.
"The use of POPs increases your risk of developing deep venous thrombosis."
10- The nurse prepares a community education program about health promotion strategies for postmenopausal women. Which of the following teaching points are appropriate to include? Select all that apply.
1.
Consider seeing a dietitian for help with healthy weight maintenance
2.
Consult with a health care provider for cholesterol monitoring
3.
Engage in a daily weight-bearing exercise regimen
4.
Prioritize consumption of green, leafy vegetables and dairy products
5.
Seek support to cope with any emotional symptoms
11- While reviewing prenatal records with a client and her partner, the nurse notes documentation in the medical record indicating that the client is a G2P0. However, the client denies a previous pregnancy. Which action by the nurse is appropriate?
1.
Adjust documentation to indicate that the client is a G1P0
2.
Ask the client and partner about a previous miscarriage or abortion
3.
Confirm the obstetric history when the client is alone
4.
Explain the importance of accurate information to the client and partner
12- The nurse employed in a woman's health care clinic would be most concerned about which client statement?
1.
"I recently noticed a small, round, painless, mobile lump in my left breast while showering."
2.
"Last night while breastfeeding, my nipples were cracked and my breasts were painful."
3.
"My right breast is red and warm with little tiny indented areas on the surface of the skin."
4.
"Sometimes during my cycle, I notice breast nodules that are movable and feel soft to the
touch."
13- The nurse is teaching at a conference on cervical cancer prevention. One of the attendees asks about risk factors. The nurse teaches about which factors as risks for cervical cancer? Select all that apply.
1.
Human papillomavirus infection
2.
Long-term corticosteroid therapy
3.
Multiple sexual partners
4.
Oral contraceptive use
5.
Sexual activity before age 18
14- The nurse educates a group of clients in the infertility clinic about risk factors contributing to infertility. Which factors should the nurse include in the teaching? Select all that apply.
1.
BMI of 22 kg/m2
2.
Endometriosis
3.
Maternal age >35
4.
Polycystic ovarian syndrome
5.
Recurrent chlamydial infections
15- A pregnant client arrives in the labor and delivery unit with mild contractions and brisk, painless vaginal bleeding. The client received no prenatal care and reports being "about 7-8 months." Which actions should the nurse anticipate? Select all that apply.
1.
Blood draw for type and screen
2.
Electronic fetal monitoring
3.
Initiation of 2 large-bore IV catheters
4.
Pad counts to assess bleeding
5.
Vaginal examination for cervical dilation
16- The nurse performs initial assessments of four clients in a prenatal clinic. Which client findings are abnormal and require further assessment?
1.
Client at 9 weeks gestation with a normal BMI and a weight gain of 2 lb (1 kg) from pre-
pregnancy weight
2.
Client at 15 weeks gestation with headaches relieved by acetaminophen
3.
Client at 19 weeks gestation with bleeding gums after brushing and flossing teeth
4.
Client at 20 weeks gestation with an increase in diastolic blood pressure of 15 mm Hg since
last visit
17- A client at 38 weeks gestation is brought to the emergency department after a motor vehicle crash. She reports severe, continuous abdominal pain. The nurse notes frequent uterine contractions and mild, dark vaginal bleeding. What actions should the nurse take? Select all that apply.
1.
Anticipate emergent cesarean birth
2.
Apply continuous external fetal monitoring
3.
Assess routine vital signs every 4 hours
4.
Draw blood for type and crossmatch
5.
Initiate IV access with a 22-gauge catheter
18- A client at 34 weeks gestation reports constipation. The client has been taking 325 mg ferrous sulfate tid for anemia since the last appointment 4 weeks ago. Which recommendations should the nurse make for this client? Select all that apply.
1.
Decreased daily dairy intake
2.
Increased fruit and vegetable intake
3.
Moderate-intensity regular exercise
4.
One laxative twice daily for a week
5.
Two cups of hot coffee each morning
19- A client at 39 weeks gestation with preeclampsia has a blood pressure of 170/100 mm Hg, 2+ proteinuria, and moderate peripheral edema. Immediately after hospital admission, she develops seizures and uterine contractions. Magnesium sulfate is prescribed. Which finding indicates that the drug has achieved the desired therapeutic effect?
1.
Blood pressure <130/80 mm Hg
2.
Seizure activity stops
3.
Urine has 1+ protein
4.
Uterine contractions stop
20- The nurse assesses a client at term gestation who reports having contractions for the last 2
hours. The client states, "I'm not sure, but I think my water broke." The nurse performs a
nitrazine pH test, which turns blue. When documenting the results of the test, which
client statement is most concerning to the nurse?
1.
"I did have sexual intercourse with my partner 1 hour before coming in today."
2.
"I have noticed constant wetness in my panties since I thought my water broke."
3.
"It is difficult for me to tell if my water broke or if I just peed on myself a little bit."
4.
"With my last three pregnancies, my water never broke on its own."
21- The nurse provides discharge instructions to a client at 14 weeks gestation who has received a prophylactic cervical cerclage. Which client statement indicates an understanding of teaching?
1.
"I need to be on bed rest for the duration of my pregnancy."
2.
"I will notify my health care provider if I start having low back aches."
3.
"Pelvic pressure is to be expected after cerclage placement."
4.
"The cerclage will be removed once my baby is at 28 weeks."
22- A client suspects she is pregnant and comes for prenatal evaluation. Which assessment findings indicate definitive evidence (positive signs) of pregnancy? Select all that apply.
1.
Cervical softening on examination
2.
Fetal heart tones detected by Doppler device
3.
Positive serum human chorionic gonadotropin test
4.
Report of fetal movement felt by client
5.
Visualization of fetus by ultrasound
23- The nurse is providing education to several first-trimester pregnant clients. Which client requires priority anticipatory teaching?
1.
Client who gardens and eats homegrown vegetables
2.
Client who has gained 4 lb (1.8 kg) from prepregnancy weight
3.
Client who has noticed thin, milky white vaginal discharge
4.
Client who practices yoga and swims in a pool 3 times a week
24- A client at 20 weeks gestation states that she started consuming an increased amount of cornstarch about 3 weeks ago. Based on this assessment, the nurse should anticipate that the health care provider will order which laboratory test(s)?
1.
Hemoglobin and hematocrit levels
2.
Human chorionic gonadotropin level
3.
Serum folate level
4.
White blood cell count
25- A nurse is caring for a pregnant client who has hyperemesis gravidarum. Which findings should the nurse anticipate? Select all that apply.
1.
Blood pressure of 160/94 mm Hg
2.
Large amounts of urine protein
3.
Positive urine ketones (moderate)
4.
Potassium of 3.2 mEq/L (3.2 mmol/L)
5.
Pulse rate of 106/min
26- When triaging 4 pregnant clients in the obstetric clinic, the nurse should alert the health care provider to see which client first?
1.
First-trimester client reporting frequent nausea and vomiting
2.
Second-trimester client with dysuria and urinary frequency
3.
Second-trimester client with obesity reporting decrease in fetal movement
4.
Third-trimester client with right upper quadrant pain and nausea
27- The nurse is caring for a client in the first trimester during an initial prenatal clinic visit. Based on the information provided by the client, which factor places the client at an increased risk for preterm labor?
1.
Age 25
2.
Periodontal disease
3.
Vegetarian diet
4.
White ethnicity
28- The nurse receives report on 4 first-trimester pregnant clients. Which client should the nurse assess first?
1.
Client with hydatidiform mole reporting dark brown vaginal discharge
2.
Client with hyperemesis gravidarum reporting excessive vomiting and weight loss
3.
Client with suspected ectopic pregnancy reporting abdominal and shoulder pain
4.
Client with threatened miscarriage who says, "I am a Jehovah's Witness."
29- A client with diabetes visits the clinic reporting breast tenderness, vaginal discharge, and urinary frequency. Which action is mostimportant for the nurse to perform?
1.
Ask if the client performs breast self-exams
2.
Ask the client about characteristics of vaginal discharge
3.
Assess the date of the client's last menstrual period
4.
Review the client's home blood sugar logs
30- A nurse is caring for a pregnant client at 27 weeks gestation after a motor vehicle collision with side airbag deployment. The client's blood type is O negative. Which laboratory test should the nurse anticipate?
1.
Group B streptococcal culture
2.
Indirect Coombs test
3.
Rubella immunity titer
4.
Serum alpha-fetoprotein
31- A client comes to the clinic indicating that a home pregnancy test was positive. The client's last menstrual period was September 7. Today is December 7. Which are true statements for this client? Select all that apply.
1.
According to Naegele's rule, the expected date of delivery is June 14
2.
Detection of the fetal heart rate via Doppler is possible
3.
Fundal height should be 24 cm above the symphysis pubis
4.
The client should be feeling fetal movement
5.
Urinary frequency is a common symptom
32- The nurse is preparing to assess a client visiting the women's health clinic. The client's obstetric history is documented as G5T1P2A1L2. Which interpretation of this notation is correct?
1.
The client had 1 birth at 37 wk 0 d gestation or beyond
2.
The client had 3 births between 20 wk 0 d and 36 wk 6 d gestation
3.
The client has 3 currently living children
4.
The client is currently not pregnant
33- A client at 30 weeks gestation is hospitalized for preeclampsia. Which assessment finding requires priority intervention?
1.
Elevated liver enzymes
2.
Lower abdominal pain and vaginal bleeding
3.
Swelling of the hands, feet, and face
4.
Urine output of 25 mL/hr
34- A client, gravida 4 para 3, at 38 weeks gestation arrives in the emergency
department with strong contractions that began 1 hour ago. The client is
diaphoretic, grunting, and yelling loudly that she wants an epidural because she
feels the need to push. What priorityaction should the nurse take?
1.
Apply gloves and assess perineal area
2.
Initiate large-bore IV access
3.
Notify anesthesia provider of client's request for epidural
4.
Obtain fetal heart tones via Doppler
35- Which actions should the labor and delivery nurse perform when caring for a client who has decided to relinquish her newborn to an adoptive parent? Select all that apply.
1.
Avoid discussing the adoption details until after the birth
2.
Encourage the birth mother to hold the newborn
3.
Notify other staff who may interact with the client of the adoption plan
4.
Offer the birth mother a chance to say goodbye to the newborn
5.
Use phrases that illustrate adoption as a decision of love, not abandonment
36- A laboring client reports feeling the need to have a bowel movement and begins vomiting. The nurse notes that the client's legs are trembling. What cervical examination finding would the nurse most expect this client to have?
1.
2 cm dilated, 50% effaced, −2 station
2.
6 cm dilated, 70% effaced, −1 station
3.
7 cm dilated, 80% effaced, 0 station
4.
8 cm dilated, 100% effaced, +1 station
37- The nurse is admitting a pregnant client who is experiencing intense "back labor." The
nurse suspects the fetus is in which position?
1.
2.
3.
4.
38- A nulliparous client asks about being in "real" labor. The nurse should teach that which signs are most indicative of true labor? Select all that apply.
1.
Contractions that increase in frequency
2.
Contractions that lessen after resting
3.
Increased blood-tinged, mucoid vaginal discharge
4.
Pain in lower back that moves to lower abdomen
5.
Progressive cervical effacement and dilation
39- The nurse is monitoring a client who is in active labor with a cervical dilation of 6 cm. Which uterine assessment finding requires an intervention by the nurse?
1.
Contraction duration of 95 seconds
2.
Contraction frequency of every 3 minutes
3.
Contraction intensity of 45 mm Hg
4.
Uterine resting tone of 10 mm Hg
40- A client at 41 weeks gestation is admitted to the labor and delivery unit for labor induction. The nurse is assisting the health care provider with an amniotomy. What actions should the nurse anticipate? Select all that apply.
1.
Assessing the fetal heart rate before and after the procedure
2.
Checking the client's temperature every 2 hours
3.
Informing the client she will feel a sharp pain during the procedure
4.
Keeping the client in a supine position after the procedure
5.
Noting the characteristics of the amniotic fluid
41- A client in labor with a history of a previous cesarean birth has chosen to attempt a vaginal birth. During labor, which finding would be most concerning to the nurse?
1.
Cessation of contractions and maternal tachycardia
2.
Fetal tachycardia with moderate variability
3.
Increased anxiety and discomfort with contractions
4.
Painful, strong contractions every 3-4 minutes
42- The nurse in the operating room is preparing for an emergency dilation and curettage post
vaginal delivery for placenta accreta. What information is most important when
reviewing this client's chart?
1.
Client has been NPO and has no metal on the body
2.
Client has stable vital signs and has signed consent
3.
Client has type and crossmatch on file and at least 2 patent large-bore IV sites
4.
Client is on oxygen and has a patent IV site
43- A primigravid client in early labor is admitted and reports intense back pain with contractions. The fetal position is determined to be right occiput posterior. Which action by the nurse would be most helpful for alleviating the client's back pain during early labor?
1.
Applying counterpressure to the client's sacrum during contractions
2.
Encouraging the client to remain in bed during early labor
3.
Positioning the client on the left side with pillows for support
4.
Requesting that the nurse anesthetist administer epidural anesthesia
