Obstetrical Nursing – Antepartum – NCLEX Quiz 3

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Obstetrical Nursing  Antepartum  NCLEX Quiz 3 - Quiz

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Questions and Answers
  • 1. 

    Rho (D) immune globulin (RhoGAM) is prescribed for a woman following delivery of a newborn infant and the nurse provides information to the woman about the purpose of the medication. The nurse determines that the woman understands the purpose of the medication if the woman states that it will protect her next baby from which of the following?

    • A.

      Being affected by Rh incompatibility

    • B.

      Having Rh-positive blood

    • C.

      Developing a rubella infection

    • D.

      Developing physiological jaundice

    Correct Answer
    A. Being affected by Rh incompatibility
    Explanation
    Rh incompatibility can occur when an Rh-negative mom becomes sensitized to the Rh antigen. Sensitization may develop when an Rh-negative woman becomes pregnant with a fetus who is Rh positive. During pregnancy and at delivery. some of the baby’s Rh positive blood can enter the maternal circulation. causing the woman’s immune system to form antibodies against Rh-positive blood. Administration of Rho(D) immune globulin prevents the woman from developing antibodies against Rh-positive blood by providing passive antibody protection against the Rh antigen.

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  • 2. 

    A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is experiencing toxicity from the medication if which of the following is noted on assessment?

    • A.

      Presence of deep tendon reflexes

    • B.

      Serum magnesium level of 6 mEq/L

    • C.

      Proteinuria of +3

    • D.

      Respirations of 10 per minute

    Correct Answer
    D. Respirations of 10 per minute
    Explanation
    Magnesium toxicity can occur from magnesium sulfate therapy. Signs of toxicity relate to the central nervous system depressant effects of the medication and include respiratory depression. loss of deep tendon reflexes. and a sudden drop in the fetal heart rate and maternal heart rate and blood pressure.Option B: Therapeutic levels of magnesium are 4-7 mEq/L.Option C: Proteinuria of +3 would be noted in a client with preeclampsia.

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  • 3. 

    A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned to care for the client determines that the magnesium therapy is effective if:

    • A.

      Ankle clonus in noted

    • B.

      The blood pressure decreases

    • C.

      Seizures do not occur

    • D.

      Scotomas are present

    Correct Answer
    C. Seizures do not occur
    Explanation
    For a client with preeclampsia. the goal of care is directed at preventing eclampsia (seizures).Option A: Ankle clonus indicated hyperreflexia and may precede the onset of eclampsia.Option B: Magnesium sulfate is an anticonvulsant. not an antihypertensive agent. Although a decrease in blood pressure may be noted initially. this effect is usually transient.Option D: Scotomas are areas of complete or partial blindness. Visual disturbances. such as scotomas. often precede an eclamptic seizure.

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  • 4. 

    A nurse is caring for a pregnant client with severe preeclampsia who is receiving IV magnesium sulfate. Select all nursing interventions that apply in the care for the client.

    • A.

      Monitor maternal vital signs every 2 hours

    • B.

      Notify the physician if respirations are less than 18 per minute.

    • C.

      Monitor renal function and cardiac function closely

    • D.

      Keep calcium gluconate on hand in case of a magnesium sulfate overdose

    • E.

      Monitor deep tendon reflexes hourly

    • F.

      Monitor I and O’s hourly

    • G.

      Notify the physician if urinary output is less than 30 ml per hour.

    Correct Answer(s)
    C. Monitor renal function and cardiac function closely
    D. Keep calcium gluconate on hand in case of a magnesium sulfate overdose
    E. Monitor deep tendon reflexes hourly
    F. Monitor I and O’s hourly
    G. Notify the pHysician if urinary output is less than 30 ml per hour.
    Explanation
    When caring for a client receiving magnesium sulfate therapy. the nurse would monitor maternal vital signs. especially respirations. every 30-60 minutes and notify the physician if respirations are less than 12. because this would indicate respiratory depression. Calcium gluconate is kept on hand in case of magnesium sulfate overdose because calcium gluconate is the antidote for magnesium sulfate toxicity. Deep tendon reflexes are assessed hourly. Cardiac and renal function are monitored closely. The urine output should be maintained at 30 ml per hour because the medication is eliminated through the kidneys.

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  • 5. 

    In the 12th week of gestation. a client completely expels the products of conception. Because the client is Rh negative. the nurse must:

    • A.

      Administer RhoGAM within 72 hours

    • B.

      Make certain she receives RhoGAM on her first clinic visit

    • C.

      Not give RhoGAM. since it is not used with the birth of a stillborn

    • D.

      Make certain the client does not receive RhoGAM. since the gestation only lasted 12 weeks.

    Correct Answer
    A. Administer RhoGAM within 72 hours
    Explanation
    RhoGAM is given within 72 hours postpartum if the client has not been sensitized already.

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  • 6. 

    In a lecture on sexual functioning. the nurse plans to include the fact that ovulation occurs when the:

    • A.

      Oxytocin is too high

    • B.

      Blood level of LH is too high

    • C.

      Progesterone level is high

    • D.

      Endometrial wall is sloughed off.

    Correct Answer
    B. Blood level of LH is too high
    Explanation
    It is the surge of LH secretion in mid cycle that is responsible for ovulation.

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  • 7. 

    The chief function of progesterone is the:

    • A.

      Development of the female reproductive system

    • B.

      Stimulation of the follicles for ovulation to occur

    • C.

      Preparation of the uterus to receive a fertilized egg

    • D.

      Establishment of secondary male sex characteristics

    Correct Answer
    C. Preparation of the uterus to receive a fertilized egg
    Explanation
    Progesterone stimulates differentiation of the endometrium into a secretory type of tissue.

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  • 8. 

    The developing cells are called a fetus from the:

    • A.

      Time the fetal heart is heard

    • B.

      Eighth week to the time of birth

    • C.

      Implantation of the fertilized ovum

    • D.

      End of the send week to the onset of labor

    Correct Answer
    B. Eighth week to the time of birth
    Explanation
    In the first 7-14 days. the ovum is known as a blastocyst; the developing cells are then called a fetus until birth.

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  • 9. 

    After the first four months of pregnancy. the chief source of estrogen and progesterone is the:

    • A.

      Placenta

    • B.

      Adrenal cortex

    • C.

      Corpus luteum

    • D.

      Anterior hypophysis

    Correct Answer
    A. Placenta
    Explanation
    When the placental formation is complete. around the 16th week of pregnancy;;;

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  • 10. 

    The nurse recognizes that an expected change in the hematologic system that occurs during the 2nd trimester of pregnancy is:

    • A.

      A decrease in WBC’s

    • B.

      In increase in hematocrit

    • C.

      An increase in blood volume

    • D.

      A decrease in sedimentation rate

    Correct Answer
    C. An increase in blood volume
    Explanation
    The blood volume increases by approximately 40-50% during pregnancy. The peak blood volume occurs between 30 and 34 weeks of gestation. The hematocrit decreases as a result of the increased blood volume.

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  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Sep 08, 2017
    Quiz Created by
    Santepro
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