Obstetrics Nursing Practice Exam 2 with Answer
1. Mr.
and Mrs. Cremasteric arrive at the clinic for their first pre natal visit. Mr.
Crema tells the nurse that the women in his family usually have girl babies
first and wonders why some women always have girls. The nurse correct response
is:
a. “The sex of the baby
is determined by the sperm.”
b. “Some women are just more fertile with females.”
c. “Nature determines whether the baby will be a girl or a boy.”
d. “The sex of the baby is determined by the egg.”
2. The hormone responsible for the development of the ovum during the menstrual
cycle is?
a. Estrogen
b. Progesterone
c. Follicle Stimulating
hormone (FSH)
d. Luteneizing hormone (LH)
3. Which hormone is not responsible for differentiation of male reproductive
organs during fetal life?
a. Mullerian duct inhibitor (MDI)
b. Dyhydrotestosterone
c. Dehydroepiandosterone
sulfate
d. Testosterone
4. Which principal factor causes vaginal pH to be acidic?
a. Cervical mucus changes
b. Secretion of the Skene’s gland
c. The action of the
doderlein bacillus
d. Secretion of the bartholins gland
5. Family centered nursing care for women and newborn focuses on which of the
following?
a. Assisting individuals
and families achieve their optimal health
b. Diagnosing and treating problems promptly
c. Preventing further complications from developing
d. Conducting nursing research to evaluate clinical skills
6. When reviewing the ethical dilemmas facing maternal and newborn nurses
today, which of the following has contributed to their complexity?
a. Limitation of available options
b. Support for one viable action
c. Advancement in technology
d. Consistent desirable standards
7. The frenulum and prepuce of the clitoris are formed by the?
a. Fossa Navicularis
b. Mons veneris
c. Labia majora
d. Labia minora
8. The vas deferens is a:
a. storage for spermatozoa
b. Site of spermatozoa production
c. Conduit of
spermatozoa
d. Passageway of sperm
9. Cremasteric visits the clinic and is told that his sperm count is normal. A
normal sperm count ranges from:
a. 20 to 100/ml
b. 100, 000 to 200, 000/ml
c. 100 to 200/ml
d. 20 to 100 million/ml
10. During which of the following phase of the menstrual cycle is it ideal for
implantation of a fertilized egg to occur?
a. Ischemic phase
b. Menstrual phase
c. Proliferative phase
d. Secretory phase
11. Variation on the length of menstrual cycle is due to variations in the
number of days in which of the following phase?
a. Proliferative phase
b. Luteal phase
c. Ischemic phase
d. Secretory phase
Situation: Mrs. Calamares G2P1 1001, comes out of the labor and delivery room
and reports ruptured amniotic membranes and contractions that occur every 3
minutes lasting 50-60 seconds. The fetus is in LOA position
12. The nurse’s first action should be to:
a.Check the FHR
b.Call the physician
c. Check the vaginal discharge with nitrazine paper
d.Admit Mrs. Calamares to the delivery area
13. When asked to describe the amniotic fluid, Mrs. Calamares states that it is
“brown-tinged”. This indicates that:
a. The fetus had infection
b. At some point, the
fetus experienced oxygen deprivation
c. The fetus is in distress and should be delivered immediately
d. The fetus is not experiencing any undue stress
14. The nurse established an IV line, and then connects Calamares to an
electronic fetal monitor. The fetal monitoring strip shows FHR deceleration
occurring about 30 sec after each contraction begins; the FHR returns to
baseline after the contraction is over. This type of deceleration is caused by:
a. Fetal head compression
b. Umbilical cord compression
c. Utero-placental
insufficiency
d. Cardiac anomalies
15. With this type of deceleration, the nurse’s first action should be to:
a. Do nothing, this is a normal occurrence
b. Call the physician
c. Position the patient
on her left side
d. Continue monitoring the FHR
16. Which of the following methods would be avoided for a woman who is 38 years
old, has 3 children and smokes a pack of cigarette per day?
a. Oral contraceptives
b. Cervical cap
c. Diaphragm
d. IUD (Intra-uterine device)
17. A woman using diaphragm for contraception should be instructed to leave it
in place for at least how long after intercourse?
a. 1 hour
b. 6 hours
c. 12 hours
d. 28 hours
18. When assessing the adequacy of sperm for conception to occur, which of the
following is the most helpful criterion?
a. sperm count
b. sperm motility
c. Sperm maturity
d. Semen volume
19. A couple with one child had been trying, without success for several years
to have another child. Which of the following terms would describe the
situation?
a. Primary Infertility
b. Secondary Infertility
c. Irreversible infertility
d. Sterility
Situation: Melanie a 33y/o G1P0 at 32 weeks AOG is admitted to the Hospital
with the diagnosis of PIH.
20. Magnesium Sulfate is ordered per IV. Which of the following should prompt
the nurse to refer to the obstetricians prior to administration of the drug?
a. BP= 180/100
b. Urine output is 40 ml/hr
c. RR=12 bpm
d. (+) 2 deep tendon reflex
21. The nurse knows that Melanie is knowledgeable about the occurrence of PIH
when she remarks:
a. “It usually appears anytime during the pregnancy”
b. “Its similar to cardio-vascular disease”
c. “PIH occurs during the 1st trimester”
d. “PIH occurs after the
20th wks AOG”
22. After several hours of MgSO4 administration to Melanie, she should be
observed for clinical manifestations of:
a. Hyperkalemia
b. Hypoglycemia
c. Hypermagnesemia
d. Hypercalcemia
23. The nurse instructs Melanie to report prodromal symptoms of seizures
associated with PIH. Which of the following will she likely identify?
a. Urine output of 15ml/hr
b. (-) deep tendon reflex
c. sudden increase in BP
d. Epigastric pain
Situation: The following questions pertain to intrapartum complications:
24. Which of the following may happen if the uterus becomes over stimulated by
oxytocin during induction of labor?
a. Weak contractions prolonged to more than 70 sec
b. Titanic contractions
prolonged for more than 90 sec
c. Increased pain with bright red vaginal bleeding
d. Increased restlessness
25. Which of the following factors is the underlying cause of dystocia?
a. Nutritional
b. Environmental
c. Mechanical
d. Medical
26. When Umbilical cord is inserted at the edge of the placenta is termed:
a. Central insertion
b. Battledore insertion
c. Velamentous insertion
d. Lateral insertion
27. When fetal surface of the placenta presents a central depression surrounded
by a thickened grayish white ring, the condition is known as:
a. Placenta succenturiata
b. Placenta marginata
c. Fenestrated placenta
d. Placenta
Circumvallata
28. Which of the following is derived form mesoderm?
a. lining of the GI tract
b. liver
c. brain
d. skeletal system
29. The average length of the umbilical cord in human is:
a. 35 cm
b. 55 cm
c. 65 cm
d. 45 cm
30. Urinary excretion of HCG is maximal between which days of gestation?
50-60
40-50
60-70
30-40
31. Which of the following is not a part of conceptus?
a. deciduas
b. amniotic fluid
c. fetus
d. membranes
32. Protection of the fetus against syphilis during the 1st trimester is
attributed to:
a. amniotic fluid
b. langhan’s layer
c. syncitiothrophoblast
d. placenta
Situation: Diane is pregnant with her first baby. She went to the clinic for
check up.
33. To determine the clients EDC, which day of the menstrual period will you
ask?
a. first
b. last
c. third
d. second
34. According to Diane, her LMP is November 15, 2002, using the Naegle’s rule
what is her EDC?
a. August 22, 2003
b. August 18, 2003
c. July 22, 2003
d. February 22, 2003
35. She complained of leg cramps, which usually occurs at night. To provide
relief, the nurse tells Diane to:
a. Dorsiflex the foot
while extending the knee when the cramps occur
b. Dorsiflex the foot while flexing the knee when the cramps occurs
c. Plantar flex the foot while flexing the knee when the cramps occur
d. Plantar flex the foot while extending the knee when the cramp occur
Situation: Marita is a nurse working in a STD clinic (question 36-45)
36. The main symptom of gonorrhea in male is:
a. Maculopapular rash
b. Jaundice
c. Urinary retention
d. Urethral discharge
37. In providing education to your clients, you should take into account the
fact that the most effective method known to control the spread of HIV
infection is:
a. Premarital serological screening
b. Prophylactic treatment of exposed person
c. On going sex
education about preventive behaviors
d. Laboratory screening of pregnant woman
38. You counseled one of your clients who developed herpes genitalis concerning
follow up care. Women who have developed the disease are at risk of developing:
a. Heart and CNS damage
b. Cervical cancer
c. Infant Pneumonia and eye infection
d. Sterility
39. Cremasteric, 19 y/o states that he has Gonorrhea. In performing assessment,
the nurse should expect to identify which of the following symptoms?
a. Lesion on the palms and soles
b. A pinpoint rash on the penis
c. Urinary dribbling
d. Dysuria
40. The nurse should explain to Rhone, 15 y/o that untreated Gonorrhea in the
female frequently leads to:
a. Obstruction of the
Fallopian tubes
b. Ovarian cysts
c. Ulceration of the cervix
d. Endometrial polyps
41. Diane, a 16 y/o female high school student has syphilis. Treatment is
initiated. Before the client leaves the clinic, which of the following actions
is essential for the nurse to take?
a. Advice the client to avoid sexual contact for 2 months
b. Ask the client to identify
her sexual contacts
c. Arrange for the client to have hearing and vision screening
d. Have the client to return to the clinic weekly for blood test
42. Kris complains of fishy smelling, white cheeslike vaginal discharge with
pruritus. You suspect that Kris may have:
a. Moniliasis
b. Trichomoniasis
c. Syphilis
d. Gonorrhea
43. Demi who has history of repeated Trichomonas infections was advised to have
Pap-smear by her physician. She asked you what the test is for. Your
appropriate response is:
a. It’s a screening for
cervical cancer
b. It’s a screening test for presence of cancer in the female reproductive
tract
c. It is a diagnostic test for the presence of Trichomonas infection
d. It is a test that will show if she has cervical cancer or not.
44. The result of the pap-test is class II. This means that:
a. Presence of malignant cells
b. Presence of benign or possible malignancy
c. Normal finding
d. Possible inflammation
or infections
45. You should be aware that a major difficulty in preventing spread of
gonorrhea is that many women who have the disease:
a. Is un aware that they
have it
b. Have milder form of the disease than most men
c. Are more reluctant to seek health care than men
d. Acquire the disease without having sexual contact
Situation: Mrs. Rhona Mahilum was admitted to the hospital with signs and
symptoms of pre-eclampsia
46. Because of the possibility of convulsive seizures, which of the following
should the nurse have available at the client’s bed side?
a. Oxygen and
nasopharyngeal suction
b. leather restraints
c. cardiac monitor
d. venous cutdown set
47. One morning, Rhona tells the nurse that she think she is having
contractions. Which of the following approaches should the nurse use to fully
assess the presence of uterine co tractions?
a. Place the hand on opposite side of the upper part of the abdomen, and curve
them somewhat around the uterine fundus.
b. Place the heel of the hand on the abdomen just above the umbilicus firmly
c. Place the hand flat
on the abdomen over the uterine fundus, with the fingers apart and press
lightly
d. Place the hand in the middle of the upper abdomen and then move hand several
times to different parts of the abdomen
48. Exposure of a woman pregnant of a female offspring to which of the following
substance increases the risk of the offspring during reproductive years to
cervical and uterine cancer
steroids
thalidomides
diethylstilbestrol
tetracyclines
49. In which of the following conditions is vaginal rugae most prominent?
a. multiparous women
b. before menopause
c. after menopause
d. nulliparous waman
50. The deepest part o the perineal body surrounding the urethra, vagina and
rectum that when damaged can result to cystocele, rectocele and urinary stress
incontinence is the?
a. Pubococcygeus muscle
b. Spinchter of urethra and anus
c. Bulbocavernous muscle
d. Ischiocavernous muscle
Situation: Review of concepts of parturition was made by the clinical
instructor to a group of nursing students preliminary to their assignment to
Labor and delivery room
51. Which plays an important role in the initiation of labor?
a. maternal adrenal cortex
b. fetal adrenal cortex
c. fetal adrenal medulla
d. maternal adrenal medulla
52. Which is not considered an uteroronin?
a. Prostaglandin
b. Endothelin-1
c. Oxytocin
d. Relaxin
53. Which is a primary power of labor?
a. uterine contractions
b. pushing of the mother
c. intrathoracic pressure
d. abdominal contraction
54. The lower uterine segment is formed from the:
a. cervix
b. isthmus and cervix
c. body of the uterus
d. isthmus
55. Ripening of the cervix occurs during the:
a. first stage
b. second stage
c. third stage
d. fourth stage
56. In the second stage of labor, uterine contraction last:
a. 20 seconds
b. 30 seconds
c. 60 seconds
d. 120 seconds
57. The time between uterine contractions is:
a. intensity
b. interval
c. duration
d. frequency
58. Midpelvic capacity may be precisely determined by:
a. imaging studies
b. clinical measurement of the sidewall convergence
c. clinical measurement of the ischial spine prominence
d. sub pubic angel measurement
59. The inanimate bone of the pelvis is not composed of the:
a. sacrum
b. ilium
c. Pubis
d. Ischium
60. Which does not refer to the transverse diameter of the pelvic outlet?
a. Bi-ischial diameter
b. Bi-spinous diameter
c. Bi-tuberous diameter
d. Intertuberous diameter
61. The Antero-posterior diameter of the pelvic inlet where the fetus will
likely most difficulty during labor is the:
a. Diagonal conjugate
b. True conjugate
c. conjugate Vera
d. obstetric conjugate
62. The true conjugate can be measured by subtracting ______ to the diagonal
conjugate?
a. 2.5 – 3 cm
b. 3.5 – 4 cm
c. 3 – 4 cm
d. 1.5 – 2 cm
63. The most important muscle of the pelvic floor is the:
a. levator ani muscle
b. ischiocavernous
c. bulbocavernous
d. pubococcygeous
64. Which pelvic shape has the poorest prognosis fro vaginal delivery?
a. platypelloid
b. anthropoid
c. android
d. gynecoid
65. The two pubic bones meet anteriorly at the:
a. symphysis pubis
b. coccyx
c. sacrococcygeal
d. sacro-illiac joint
66. In the second stage of labor, expulsion of the fetus from birth canal
depends on which important factor?
a. Maternal bearing down
b. Cervical dilatation
c. Uterine contractions
d. Adequate pelvic size
67. In what presentation is the head in extreme flexion?
a. sinciput
b. brow
c. vertex
d. face
Situation: a 26 y/o primigravida admitted to the hospital. Vaginal exam reveals
that her cervix is 5cm dilated, 80% effaced and the presenting part in zero
station, membranes still intact, occiput is in posterior position
68. Due to fetal position, the nurse caring for her would be correct in telling
her that:
a. she will not have the urge to bear down when she becomes fully dilated
b. she can expect to
have more back discomfort than most woman in labor
c. the position of baby’s head is optimum for passing through the pelvis
d. a caesarian section may be necessary to deliver the baby in thin position
69. Upon IE, you noted that the cervix ix ¼ its original length. This mean that
effacement is:
a. 25%
b. 75%
c. 100%
d. 50%
70. Because of the position of the fetus, an episiotomy has to be performed to
enlarge the birth canal. Which of the following is an advantage of episiotomy
over lacerations?
a. it is more difficult to repair than laceration
b. it is more painful than laceration
c. it involve a more blood loss than laceration
d. heals more faster
than laceration
71. Supporting the perenium at the time of crowning will facilitate:
a. flexion of the fetal head
b. external rotation
c. extension of the
fetal head
d. expulsion
72. When the bi-parietal diameter of the fetal head passes through the pelvic
inlet, this is referred as:
a. descent
b. flexion
c. engagement
d. extension
73. Sudden gush of blood or lengthening of the cord after the delivery of
infant should warn the nurse of:
a. placenta acrreta
b. placental separation
c. placental retention
d. abruption placenta
Situation: Nurse Tsunade is a staff nurse in the OB ward of Konoha Medical
Hospital
74. When separation begins at the center of the placenta and slides down the
birth canal like a folded umbrella this is referred as:
a. Duncan mechanism
b. Shultz mechanism
c. Brandt Andrews mechanism
d. Ritgen’s maneuver
75. Which of the following is not true regarding the third stage of labor?
a. Care should be taken
in the administration of bolus of oxytocin because it can cause hypertension
b. Signs of placental separation are lengthening of the cord, sudden gush of
blood and sudden change in shape of the uterus
c. It ranges from the time of expulsion of the fetus to the delivery of the
placenta
d. The placenta is delivered approximately 5-15 minutes after delivery of the
baby
76. In the immediate postpartum period the action of methylegonovine is to:
a. cause sustained
uterine contractions
b. causes intermittent uterine contractions
c. relaxes the uterus
d. induces sleep so that the mother can rest after an exhausting labor
77. Rhina is a primipara hospitalized due to preeclampsia. The doctor decided
to perform NST. The nurse should apply the fetal transducer over the fetus:
a. chest
b. back
c. head
d. buttocks
78. Marisse, a newly delivered multipara complains of heavy and painful breast
accompanied by fever. The nurse tells Gina that it is normal breast engorgement
as the fever is characterized by
a. More than 38 degrees
b. Does not last more
than 24 hours
c. Caused by infection
d. Needs to be treated with antibiotic
79. Postpartum depression occurs during which time frame?
a. within weeks after
delivery
b. within 12 weeks
c. within 16 weeks
d. within 24 hours
80. Demi, a 38 y/o multipara is admitted with a tentative diagnosis of femoral
thrombophlebitis. The nurse assesses the patient with:
a. burning on urination
b. leg pain
c. abdominal pain
d. increased lochial flow
81. Fever, foul lochial discharge and subinvolution of the uterus are signs of:
a. puerperal psychosis
b. puerperal sepsis
c. postpartum hemorrhage
d. hypertensive disorder
82. Which is most important when caring for a high risk postpartum clients?
a. discussing hygiene and nutrition
b. referring the mother to others for emotional support
c. discussing complications and treatment
d. promoting
mother-newborn contact
83. A direct cause of mis-management of the third stage of labor is:
a. inversion of the
uterus
b. cord prolapse
c. prolonged labor
d. all of these
84. Rachel, a diabetic woman at 36 weeks gestation is scheduled for biophysical
profile in order to:
a. ascertain correct gestational age
b. determine fetal lung maturity
c. determine fetal well
being
d. determine fetal size and obvious congenital anomaly
85. In a primigravida, the following demotes contracted pelvis except:
a. absence of quickening
b. absence of lightening
c. absence of engagement
d. none of these
86. Which of the following changes in Diane’s BP would nurse Tsunade not
expect?
a. it tends to be highest in sitting
b. BP may increase a little in the 2nd tri
c. It should be taken at every visit at the clinic
d. It is normal for
blood pressure to increase as much as 33 in systolic in the 3rd tri when a
woman is near delivery
87. Nurse Tsunade referred to Diane to an Obstetrician. At 8 months she was
orderd for a contraction stress test and the result is negative. Diane asked
when she should be back for her next check up?
a. Monthly
b. Within 24-hours
c. Within a week
d. Weekly for 2 weeks then monthly
89. Diane wants to know how many fetal movements per hour is normal. The
correct response of Nurse tsunade is:
a. twice
b. thrice
c. four times
d. 10-12 times
90. Which of the following statement about L/S ratio in amniotic fluid is
correct?
a. a slight variation in technique does not significantly affect the accuracy
of result
b. a L/S ratio of 2:1 is incompatible with life
c. a L/S ratio of less than 1:0 is compatible with fetal survival
d. when L/S ratio is 2:1
below, majority of infants develop respiratory distress
91. Every
visit, you obtain the pregnant woman’s fundic height.. At what age of gestion
does the fundic height in cm strongly correlates with gestational age in wks?
a. 20-24 wks
b. 18-24 wks
c. 18-32 wks
d. 12-38 wks
92. Which is not an indication of amniocentesis?
a. previous pregnancy with chromosomal abnormal fetus
b. down syndrome in siblings
c. pregnancies in women over 35 y/o
d. at 8 wks gestation
for chromosomal study
Situation: Erica is 24 y/o Filipina married to an American. She is pregnant for
the second time and now at 8 weeks AOG. She is RH (-) with blood type B
93. Erica gave birth to a term baby with yellowish skin and sclera. The baby is
placed on phototherapy. The treatment is effective when blood test shows:
a. Low serum bilirubin
b. O2 level of 99%
c. Normal RBC and WBC count
d. Low platelet count
94. Because of rapidly rising bilirubin level, exchange transfusion was
performed on Erica’s NB. The nurse understands that the blood to be transfused
to the baby should be:
a. Type B, RH +
b. Type O, RH –
c. ABO compatible, RH –
d. Type B, RH –
95. Immediately after delivery of Erica’s Baby, the nurse should remember to:
a. delay clamping of the cord to previde the newborn with more blood
b. cut immediately after
birth of the baby
c. administer RHoGam to the NB immediately on the 3rd stage of labor
d. place the NB in an isolette for phototherapy
96. The doctor ordered Kleihauer-Betke. The nurse know which of the following
to be wrong about the test:
a. it is used to identify the amount of antibodies in the maternal serum
b. it is used to
determine presence of fetal blood
c. it is used to asses whether the mother is RH – or RH +
d. It is used to determine fetal blood type and RH factor
97. Which of the following findings in Erica’s history would identify a need
for her to receive RHo (d) immune globulin?
a. Rh -, coombs +
b. Rh -, Coombs –
c. Rh +, Coombs –
d. Rh +, Coombs +
98. The portion of the placenta overlying the blastocyst
a. decidua capsularis
b. decidua vera
c. decidua basalis
d. decidua parietalis
99. The cardinal function of deciduas is
a. Immune resonse
b. Production of hormones
c. Maintenance of
pregnancy
d. None of the above
100. O2 and Co2 are exchanged in the placenta through the process of:
a. pinocytosis
b. diffusion
c. facilitated diffusion
d. active transport
No comments:
Post a Comment