OB GYNE & DR CONCEPTS

1. A pregnant client in the last trimester A. Blood pressure reading is at the

has been admitted to the hospital prenatal baseline.
with a diagnosis of severe
B. Urinary output has increased.
preeclampsia. A nurse monitors for
complications associated with the C. The client complains of a
diagnosis and assesses the client headache and blurred vision.
for: D. Dependent edema has been
A. Any bleeding, such as in resolved.
the gums, petechiae, and
purpura.
B. Enlargement of the breasts. 5. A nurse implements a teaching plan for a
C. Periods of fetal movement pregnant client who is newly diagnosed with
followed by quiet periods. gestational diabetes. Which statement, if
D. Complaints of feeling hot made by the client, indicates a need for
when the room is cool. further education?
A. “I need to stay on the diabetic diet.”
2. A client in the first trimester of pregnancy B. “I will perform glucose monitoring at
arrives at a health care clinic and reports home.”
that she has been experiencing vaginal C. “I need to avoid exercise because
bleeding. A threatened abortion is of the negative effects of insulin
suspected, and the nurse instructs the client production.”
regarding management of care. Which D. “I need to be aware of any infections
statement, if made by the client, indicates a and report signs of infection
need for further education? immediately to my health care
A. “I will maintain strict bedrest provider.”
throughout the remainder of the
pregnancy”
B. “I will avoid sexual intercourse until 6. A primigravida is receiving magnesium
the bleeding has stopped, and for 2 sulfate for the treatment of pregnancy
weeks following the last evidence of induced hypertension (PIH). The nurse who
bleeding.” is caring for the client is performing
assessments every 30 minutes. Which
C. “I will count the number of perineal
assessment finding would be of most
pads used on a daily basis and note
concern to the nurse?
the amount and color of blood on the
pad.” A. Urinary output of 20 ml since the
previous assessment
D. “I will watch for the evidence of the
passage of tissue.” B. Deep tendon reflexes of 2+
C. Respiratory rate of 10 BPM
D. Fetal heart rate of 120 BPM
3. A prenatal nurse is providing instructions
to a group of pregnant clients regarding
measures to prevent toxoplasmosis. Which 7. A nurse is caring for a pregnant client
statement, if made by one of the clients with preeclampsia. The nurse prepares a
indicates a need for further instructions? plan of care for the client and documents in
A. “I need to cook meat thoroughly.” the plan that if the client progresses from
B. “I need to avoid touching mucous preeclampsia to eclampsia, the nurse’s first
membranes of the mouth or eyes action is to:
while handling raw meat.” A. Administer magnesium sulfate
C. “I need to drink unpasteurized intravenously
milk only” B. Assess the blood pressure and fetal
D. “I need to avoid contact with heart rate.
materials that are possibly C. Clean and maintain an open
contaminated with cat feces.” airway.
D. Administer oxygen by face mask.
4. A homecare nurse visits a pregnant client
who has a diagnosis of mild Preeclampsia 8. A nurse is monitoring a pregnant client
and who is being monitored for pregnancy with pregnancy induced hypertension who is
induced hypertension (PIH). Which at risk for preeclampsia. The nurse checks
assessment finding indicates a worsening of the client for which specific signs of
the preeclampsia and the need to notify the preeclampsia? Select all that apply.
physician?
A. Elevated blood pressure
B. Negative urinary protein

MENDEZ, ANILETH DL.

 OB GYNE & DR CONCEPTS
C. Facial edema 13. A pregnant client is making her first
D. Increased respirations antepartum visit. She has a 2-year-old son
born at 40 weeks, a 5-year-old daughter
E. Polydipsia born at 38 weeks, and 7-year-old twin
daughters born at 35 weeks. She had a
9. Rho (D) immune globulin (RhoGAM) is spontaneous abortion 3 years ago at 10
prescribed for a woman following delivery of weeks. Using the GTPAL format, the nurse
a newborn infant and the nurse provides should identify that the client is:
information to the woman about the purpose A. G4 T3 P2 A1 L4
of the medication. The nurse determines B. G5 T2 P2 A1 L4
that the woman understands the purpose of
the medication if the woman states that it C. G5 T2 P1 A1 L4
will protect her next baby from which of the D. G4 T3 P1 A1 L4
following?
A. Being affected by Rh 14. An expected cardiopulmonary
incompatibility. adaptation experienced by most pregnant
B. Having Rh-positive blood. women is:
C. Developing a rubella infection. ​ A. Tachycardia
D. Developing physiological jaundice. ​ B. Dyspnea at rest
​ C. Progression of dependent edema
10. A woman with preeclampsia is receiving ​ D. Shortness of breath on
magnesium sulfate. The nurse assigned to exertion
care for the client determines that the
magnesium therapy is effective if:
15. During a prenatal examination, the
A. Ankle clonus is noted. nurse draws blood from a young
B. The blood pressure decreases. Rh-negative client and explain that an
C. Seizures do not occur. indirect Coombs test will be performed to
predict whether the fetus is at risk for:
D. Scotomas are present.
​ A. Acute hemolytic disease
​ B. Respiratory distress syndrome
11. In the 12th week of gestation, a client
completely expels the products of ​ C. Protein metabolic deficiency
conception. Because the client is ​ D. Physiologic hyperbilirubinemia
Rh-negative, the nurse must:
A. Administer RhoGAM within 72 16. The nurse teaches a pregnant woman to
hours. avoid lying on her back. The nurse has
based this statement on the knowledge that
B. Make certain she receives RhoGAM
the supine position can:
on her first clinic visit.
​ A. Unduly prolonged labor.
C. Not give RhoGAM, since it is not
used with the birth of a stillborn. ​ B. Cause decreased placental
perfusion.
D. Make certain the client does not
receive RhoGAM since the gestation ​ C. Lead to transient episodes of
only lasted 12 weeks. hypotension.
​ D. Interfere with free movement of
the coccyx.
12. The nurse is aware that an adaptation of
pregnancy is an increased blood supply to
the pelvic region that results in a purplish 17. Which of the following symptoms occurs
discoloration of the vaginal mucosa, which with a hydatidiform mole?
is known as: ​ A. Heavy, bright red bleeding every
A. Ladin’s sign 21 days.
B. Hegar’s sign ​ B. Fetal cardiac motion after 6
C. Goodell’s sign weeks gestation.
D. Chadwick’s sign ​ C. Benign tumors found in the
smooth muscle of the uterus.
​ D. “Snowstorm” pattern on
ultrasound with no fetus or
gestational sac.

MENDEZ, ANILETH DL.

 OB GYNE & DR CONCEPTS
18. Which of the following conditions is ​ C. Hemorrhage
common in pregnant women in the 2nd ​ D. Postpartum infections
trimester of pregnancy?
​ A. Mastitis
24. A nurse is monitoring a client in labor.
​ B. Metabolic alkalosis The nurse suspects umbilical cord
​ C. Physiologic anemia compression if which of the following is
​ D. Respiratory acidosis noted on the external monitor tracing during
a contraction?
19. A 21-year old client, 6 weeks pregnant ​ A. Early decelerations
is diagnosed with hyperemesis gravidarum. ​ B. Variable decelerations
This excessive vomiting during pregnancy
​ C. Late decelerations
will often result in which of the following
conditions? ​ D. Short-term variability
​ A. Bowel perforation
​ B. Electrolyte imbalance 25. A nurse in the postpartum unit is caring
​ C. Miscarriage for a client who has just delivered a
newborn infant following a pregnancy with
​ D. Pregnancy induced hypertension placenta previa. The nurse reviews the plan
(PIH) of care and prepares to monitor the client
for which of the following risks associated
20. Clients with gestational diabetes are with placenta previa?
usually managed by which of the following ​ A. Disseminated intravascular
therapies? coagulation
​ A. Diet ​ B. Chronic hypertension
​ B. NPH insulin (long-acting) ​ C. Infection
​ C. Oral hypoglycemic drugs ​ D. Hemorrhage
​ D. Oral hypoglycemic drugs and
insulin 26. A nurse in the labor room is performing
a vaginal assessment on a pregnant client
21. The antagonist for magnesium sulfate in labor. The nurse notes the presence of
should be readily available to any client the umbilical cord protruding from the
receiving IV magnesium. Which of the vagina. Which of the following would be the
following drugs is the antidote for initial nursing action?
magnesium toxicity? ​ A. Place the client in
​ A. Calcium gluconate Trendelenburg’s position.
​ B. Hydralazine (Apresoline) ​ B. Call the delivery room to notify
the staff that the client will be
​ C. Narcan transported immediately.
​ D. RhoGAM ​ C. Gently push the cord into the
vagina.
22. A pregnant woman’s last menstrual ​ D. Find the closest telephone and
period began on April 8, 2020, and ended stat page the physician.
on April 13. Using Naegele’s rule her
estimated date of birth would be:
27. A maternity nurse is caring for a client
​ A. January 15, 2021 with abruptio placenta and is monitoring the
​ B. January 20, 2021 client for disseminated intravascular
​ C. July 1, 2021 coagulopathy. Which assessment finding is
least likely to be associated with
​ D. November 5, 2020 disseminated intravascular coagulation?
​ A. Swelling of the calf in one leg
\23. A pregnant client is admitted to the ​ B. Prolonged clotting times
labor room. An assessment is performed,
and the nurse notes that the client’s ​ C. Decreased platelet count
hemoglobin and hematocrit levels are low, ​ D. Petechiae, oozing from injection
indicating anemia. The nurse determines sites, and hematuria
that the client is at risk for which of the
following?
​ A. A loud mouth
​ B. Low self-esteem

MENDEZ, ANILETH DL.

 OB GYNE & DR CONCEPTS
28. A nurse is assessing a pregnant client in ​ A. Severe postpartum headache
the 2nd trimester of pregnancy who was ​ B. Limited perception of bladder
admitted to the maternity unit with a fullness
suspected diagnosis of abruptio placentae.
Which of the following assessment findings ​ C. Increase in respiratory rate
would the nurse expect to note if this ​ D. Hypotension
condition is present?
​ A. Absence of abdominal pain 33. The nurse is assessing a client who is 6
​ B. A soft abdomen hours PP after delivering a full-term healthy
​ C. Uterine tenderness/pain infant. The client complains to the nurse of
feelings of faintness and dizziness. Which of
​ D. Painless, bright red vaginal the following nursing actions would be most
bleeding appropriate?
​ A. Obtain hemoglobin and
29. A maternity nurse is preparing for the hematocrit levels.
admission of a client in the 3rd trimester of ​ B. Instruct the mother to request
pregnancy that is experiencing vaginal help when getting out of bed.
bleeding and has a suspected diagnosis of
placenta previa. The nurse reviews the ​ C. Elevate the mother’s legs.
physician’s orders and would question ​ D. Inform the nursery room nurse to
which order? avoid bringing the newborn infant to
​ A. Prepare the client for an the mother until the feelings of
ultrasound. lightheadedness and dizziness have
subsided.
​ B. Obtain equipment for external
electronic fetal heart monitoring.
​ C. Obtain equipment for a manual 34. A nurse is caring for a PP woman who
pelvic examination. has received epidural anesthesia and is
monitoring the woman for the presence of a
​ D. Prepare to draw a Hgb and Hct vulva hematoma. Which of the following
blood sample. assessment findings would best indicate the
presence of a hematoma?
30. An ultrasound is performed on a client at ​ A. Complaints of a tearing
term gestation that is experiencing sensation.
moderate vaginal bleeding. The results of ​ B. Complaints of intense pain.
the ultrasound indicate that an abruptio
placenta is present. Based on these ​ C. Changes in vital signs.
findings, the nurse would prepare the client ​ D. Signs of heavy bruising.
for:
​ A. Complete bed rest for the 35. A postpartum (PP) client is being treated
remainder of the pregnancy. for DVT. The nurse understands that the
​ B. Delivery of the fetus. client’s response to treatment will be
​ C. Strict monitoring of intake and evaluated by regularly assessing the client
output. for:
​ D. The need for weekly monitoring ​ A. Dysuria, ecchymosis, and vertigo
of coagulation studies until the time ​ B. Epistaxis, hematuria, and dysuria
of delivery. ​ C. Hematuria, ecchymosis, and
epistaxis
31. Which of the following observations ​ D. Hematuria, ecchymosis, and
indicates fetal distress? vertigo
​ A. Fetal scalp pH of 7.14
​ B. Fetal heart rate of 144 36. A nurse performs an assessment on a
beats/minute client who is 4 hours PP. The nurse notes
​ C. Acceleration of fetal heart rate that the client has cool, clammy skin and is
with contractions restless and excessively thirsty. The nurse
prepares immediately to:
​ D. Presence of long-term variability
​ A. Assess for hypovolemia and
notify the health care provider.
32. The nurse should realize that the most ​ B. Begin hourly pad counts and
common and potentially harmful maternal reassure the client.
complication of epidural anesthesia would
be:

MENDEZ, ANILETH DL.

 OB GYNE & DR CONCEPTS
​ C. Begin fundal massage and start
oxygen by mask.
​ D. Elevate the head of the bed and
assess vital signs.

37. Which of the following behaviors

characterizes the PP mother in the taking in
phase?
​ A. Passive and dependent
​ B. Striving for independence and
autonomy
​ C. Curious and interested in care of
the baby
​ D. Exhibiting maximum readiness
for new learning

38. Which of the following complications is

most likely responsible for a delayed
postpartum hemorrhage?
​ A. Uterine subinvolution
​ B. Clotting deficiency
​ C. Perineal laceration
​ D. Cervical laceration

39. Which of the following circumstances is

most likely to cause uterine atony and lead
to PP hemorrhage?
​ A. Hypertension
​ B. Cervical and vaginal tears
​ C. Urine retention
​ D. Endometritis
40.

MENDEZ, ANILETH DL.