Inpatient Obstetric Nursing Exam Quiz
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Do you know the special precautions being taken during pregnancy? If you are preparing for an inpatient obstetric nursing exam, take this quiz and see how well you know. This quiz will help you understand various situations and cases that you may encounter during your professional career. If you know all the answers, it will be the best practice test for you. But, if you miss out on something, just check the answer, and update your knowledge. All the best!
- 1.
The patient in triage is diagnosed with PTL. The nurse should expect that the physician will order.
- A.
Betamethasone 12 mg IM
- B.
Discharge with orders to be off from work
- C.
Magnesium Sulfate IV and Procardia po
- D.
All of the above
Correct Answer
A. Betamethasone 12 mg IMExplanation
The correct answer is Betamethasone 12 mg IM. PTL stands for preterm labor, which is when a woman goes into labor before 37 weeks of pregnancy. Betamethasone is a corticosteroid that is commonly used to accelerate fetal lung maturation in cases of preterm labor. It helps to reduce the risk of respiratory distress syndrome in premature infants. Therefore, it is expected that the physician will order Betamethasone 12 mg IM for the patient in triage with PTL.Rate this question:
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- 2.
The new patient in triage is a 32-week 18yo G3P01110 African American woman. She presents with a complaint of intermittent lower back pain. You are awaiting the fetal Fibronectin results. What may other historical factors be contributing?
- A.
Further obstetrical history details
- B.
Non-gynecological surgical history
- C.
6-week ultrasound result from the ER
- D.
None of the above
Correct Answer
A. Further obstetrical history detailsExplanation
The correct answer suggests that obtaining further obstetrical history details may contribute to understanding the patient's complaint of intermittent lower back pain. This information could provide insights into any previous pregnancies, complications, or conditions that may be relevant to her current symptoms. It could help in assessing the potential causes of the pain and determining the appropriate course of action for the patient's care.Rate this question:
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- 3.
The tocolytic that is contraindicated in the diabetic woman is
- A.
Magnesium Sulfate
- B.
Nifedipine (Procardia)
- C.
Terbutaline (Beta-mimetics)
- D.
None of the above
Correct Answer
C. Terbutaline (Beta-mimetics)Explanation
Terbutaline (Beta-mimetics) is contraindicated in diabetic women as it can cause hyperglycemia, which can worsen their diabetic condition. Beta-mimetics like terbutaline can stimulate the release of glucose from the liver and decrease insulin sensitivity, leading to elevated blood sugar levels. Therefore, it is not recommended for use as a tocolytic in diabetic women. Magnesium sulfate and nifedipine do not have the same contraindications in diabetic women.Rate this question:
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- 4.
A woman receives magnesium sulfate during labor for gestational hypertension. What effect can this have on the newborn?
- A.
Elevated cortisol levels
- B.
Hyperglycemia
- C.
Muscle weakness
- D.
None of the above
Correct Answer
C. Muscle weaknessExplanation
Magnesium sulfate can cause muscle weakness in the newborn. This is because magnesium acts as a muscle relaxant and can affect the neuromuscular transmission. When given to the mother during labor for gestational hypertension, magnesium sulfate can cross the placenta and affect the baby's muscles, leading to weakness. Elevated cortisol levels and hyperglycemia are not associated with the administration of magnesium sulfate during labor.Rate this question:
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- 5.
In comparing early and late decelerations, a distinguishing factor between the two is:
- A.
Onset time to the nadir of the deceleration
- B.
The number of decelerations that occur
- C.
Timing in relation to the contractions
- D.
None of the above
Correct Answer
C. Timing in relation to the contractionsExplanation
The distinguishing factor between early and late decelerations is their timing in relation to the contractions. Early decelerations occur in response to the start of a contraction and mirror the contraction pattern, while late decelerations occur after the peak of the contraction and are associated with uteroplacental insufficiency. Therefore, the timing of the deceleration in relation to the contractions helps differentiate between the two types.Rate this question:
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- 6.
A postpartum woman's prenatal history shows a quad screen with a maternal serum alpha-fetoprotein (MSAFP) lower than normal and a higher than normal HCG and Inhibin A. The nurse can expect the diagnosis of the newborn.
- A.
Neurotube defect
- B.
Trisomy 21
- C.
Underestimates gestational age
- D.
None of the above
Correct Answer
B. Trisomy 21Explanation
Based on the prenatal history provided, a quad screen with a lower than normal maternal serum alpha-fetoprotein (MSAFP) and higher than normal HCG and Inhibin A suggests the diagnosis of Trisomy 21 (Down syndrome). Trisomy 21 is a genetic disorder caused by the presence of an extra copy of chromosome 21. The abnormal levels of these markers in the quad screen are indicative of the condition.Rate this question:
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- 7.
A postpartum patient on her 2nd day is concerned she has been voiding too much. Her output is 3000cc. The appropriate response of the nurse is to:
- A.
Contact her care provider for an antibiotic order
- B.
Explain that this is a normal physiologic response to delivery
- C.
Obtain a clean catch urine
- D.
None of the above
Correct Answer
B. Explain that this is a normal pHysiologic response to deliveryExplanation
On the second day postpartum, it is normal for a patient to have increased urine output. This is because during pregnancy, the body retains extra fluid, and after delivery, the body starts to eliminate this excess fluid. Therefore, it is important for the nurse to reassure the patient that increased urine output is a normal response to delivery, rather than contacting the care provider for an antibiotic order or obtaining a urine sample.Rate this question:
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- 8.
Subsequent to a massive hemorrhage after delivery of a macerated fetus, a woman appears to stabilize. Suddenly, at one hour postpartum, her respirations become rapid and shallow. She states she feels cold and begins to lose consciousness. Some laboratory tests are available and reveal: Hematocrit- 34% Fibrinogen- 350mg/dl Platelet count- 125,000/ mm3. The most appropriate management includes the administration of
- A.
Blood products
- B.
Epinephrine
- C.
Heparin
- D.
All of the above
Correct Answer
A. Blood productsExplanation
The given scenario suggests that the woman is experiencing postpartum hemorrhage, which is evident from her symptoms of rapid and shallow respirations, feeling cold, and losing consciousness. The laboratory tests indicate a low hematocrit level and a normal fibrinogen level, suggesting blood loss. The platelet count is slightly low, which may be due to dilutional effects. Therefore, the most appropriate management would be the administration of blood products, such as packed red blood cells, to replenish the lost blood volume and improve oxygen-carrying capacity. Epinephrine and heparin are not indicated in this situation.Rate this question:
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- 9.
A patient diagnosed with a postpartum infection states she does not have any pain but seems confused and agitated. Her vital signs are as follows: BP 98/50; Pulse 125; and output is decreased. The most likely diagnosis is
- A.
A pulmonary embolism
- B.
Septic shock
- C.
Thromboembolism
- D.
None of the above
Correct Answer
B. Septic shockExplanation
The patient's symptoms of confusion, agitation, low blood pressure, increased heart rate, and decreased urine output suggest a systemic infection that has progressed to septic shock. Septic shock occurs when an infection leads to a severe inflammatory response, causing widespread organ dysfunction. The patient's lack of pain is not consistent with a pulmonary embolism, which typically presents with chest pain and shortness of breath. Thromboembolism is also unlikely as the patient's symptoms are more indicative of an infection rather than a blood clot. Therefore, septic shock is the most likely diagnosis based on the given information.Rate this question:
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- 10.
A postpartum patient is diagnosed with Sheehan's Syndrome, which is caused by
- A.
Gestational hypertension
- B.
Hyperglycemia following delivery
- C.
Postpartum necrosis
- D.
None of the above
Correct Answer
C. Postpartum necrosisExplanation
Sheehan's Syndrome is a condition that occurs when the pituitary gland is damaged due to severe blood loss during childbirth, leading to inadequate hormone production. This damage is caused by postpartum necrosis, which refers to the death of tissues in the pituitary gland. Gestational hypertension and hyperglycemia following delivery are not directly related to the development of Sheehan's Syndrome.Rate this question:
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- 11.
A woman 4 hours postpartum reports sudden, excruciating vulvar pain and severe rectal pressure. This patient is likely exhibiting symptoms of
- A.
Bartholin gland cyst
- B.
Vulvar edema
- C.
Vulvar hematoma
- D.
None of the above
Correct Answer
C. Vulvar hematomaExplanation
The correct answer is vulvar hematoma. This is because the woman is experiencing sudden, excruciating vulvar pain and severe rectal pressure, which are common symptoms of a vulvar hematoma. A vulvar hematoma occurs when there is bleeding into the tissues of the vulva, usually as a result of trauma during childbirth. This can cause significant pain and discomfort for the woman. Bartholin gland cyst and vulvar edema do not typically present with the same symptoms described in the question.Rate this question:
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- 12.
Functional closure of the ductus arteriosus occurs as a result of:
- A.
Fibrosis of the ductal muscle
- B.
Increased arterial oxygen tension
- C.
Increased left atrial pressure
- D.
None of the above
Correct Answer
B. Increased arterial oxygen tensionExplanation
Increased arterial oxygen tension leads to functional closure of the ductus arteriosus. The ductus arteriosus is a blood vessel that connects the pulmonary artery to the aorta in a fetus. During fetal development, the ductus arteriosus allows blood to bypass the lungs since the fetus receives oxygen from the placenta. However, after birth, when the baby starts breathing on its own, the increased arterial oxygen tension signals the ductus arteriosus to close. This closure is essential for proper circulation and oxygenation of blood in the body.Rate this question:
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- 13.
A woman with hydramnios is experiencing abdominal pain and dyspnea. The treatment with indomethacin will:
- A.
Decrease fetal lung liquid absorption
- B.
Decrease fetal urine productions
- C.
Promote diuresis
- D.
None of the above
Correct Answer
B. Decrease fetal urine productionsExplanation
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that can be used to treat hydramnios, a condition characterized by excessive amniotic fluid. The excessive amniotic fluid can put pressure on the abdomen, causing pain, and also on the lungs, leading to difficulty in breathing (dyspnea). Indomethacin works by inhibiting the production of prostaglandins, which are responsible for maintaining fetal kidney function and urine production. Therefore, the use of indomethacin in the treatment of hydramnios would decrease fetal urine production, helping to reduce the excessive amniotic fluid.Rate this question:
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- 14.
A pregnant woman on a continuous infusion of Magnesium Sulfate for preeclampsia exhibits the following: respiratory rate: 14 per minute and deep tendon reflexes are decreased with clonus absent.
- A.
Decrease the infusion rate
- B.
Discontinue the infusion
- C.
Maintain the infusion rate
- D.
None of the above
Correct Answer
C. Maintain the infusion rateExplanation
The given symptoms indicate that the pregnant woman's respiratory rate is within the normal range and her deep tendon reflexes are decreased with clonus absent. These findings suggest that the Magnesium Sulfate infusion is effectively managing her preeclampsia without causing any adverse effects. Therefore, it is appropriate to maintain the infusion rate to continue providing the necessary treatment and ensure the well-being of both the mother and the baby.Rate this question:
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- 15.
A woman with a BMI of 18 gains 25 pounds during her pregnancy. This pregnancy is at increased risk for:
- A.
Cesarean delivery
- B.
Delivery of a low birthweight infant
- C.
Preeclampsia
- D.
None of the above
Correct Answer
D. None of the aboveExplanation
A woman with a BMI of 18 who gains 25 pounds during her pregnancy is not necessarily at increased risk for any of the listed complications (cesarean delivery, low birthweight infant, or preeclampsia) based solely on her weight gain. A BMI of 18 is considered underweight, and a weight gain of 25 pounds during pregnancy may be within the recommended range for a woman with this initial BMI, depending on her individual needs and circumstances. It is essential for pregnant women to have regular prenatal care, including monitoring weight gain and overall health, to ensure the best possible outcomes for both the mother and baby. Potential risks and complications during pregnancy can be influenced by various factors, and healthcare providers will consider the woman's unique situation when providing guidance and care.Rate this question:
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- 16.
A pregnant woman was diagnosed with varicella-zoster at 32 weeks gestation. She is now in labor and delivery in active labor at 40 weeks gestation. The nurse would expect which of the following would be appropriate in order to ensure the health of the newborn.
- A.
Administer zoster immunoglobulin to the newborn at delivery
- B.
Administer zoster immunoglobulin to the patient prior to delivery
- C.
The mother's antibodies will be protective, so no action is needed
- D.
None of the above
Correct Answer
C. The mother's antibodies will be protective, so no action is neededExplanation
The correct answer is that the mother's antibodies will be protective, so no action is needed. When a pregnant woman is diagnosed with varicella-zoster, she develops antibodies that can be passed on to the fetus through the placenta. These antibodies provide passive immunity to the newborn, protecting them from varicella-zoster infection. Therefore, there is no need to administer zoster immunoglobulin to the newborn or the patient prior to delivery.Rate this question:
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- 17.
Within the first 2 days after birth, progesterone levels fall, causing what acid-base change?
- A.
Increased PaCO2
- B.
Decreased PaCO2
- C.
Decreased PaO2
- D.
Increased PaO2
Correct Answer
B. Decreased PaCO2Explanation
Within the first 2 days after birth, the fall in progesterone levels causes a decreased PaCO2. This occurs because progesterone stimulates respiratory drive during pregnancy, so its reduction after birth leads to a transient decrease in respiratory drive, resulting in lower levels of carbon dioxide exhalation.Rate this question:
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- 18.
Compared to the value in the third trimester, an increase in which of the following values happens postpartum.
- A.
BUN
- B.
Creatinine clearance
- C.
Proteinuria
- D.
All of the above
Correct Answer
A. BUNExplanation
BUN stands for Blood Urea Nitrogen, which is a measure of the amount of nitrogen in the blood that comes from urea, a waste product of protein metabolism. During pregnancy, the BUN levels tend to decrease due to increased blood volume and increased renal blood flow. However, after giving birth, BUN levels tend to increase due to the decrease in blood volume and the body's adjustment to normal non-pregnant state. Therefore, an increase in BUN happens postpartum.Rate this question:
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- 19.
A woman who is 4 hours postpartum asks the nurse how much weight she might have lost with delivery. The nurse would know to tell her that the average weight loss at birth is:
- A.
10 lbs
- B.
12 lbs
- C.
14 lbs
- D.
20 lbs
Correct Answer
B. 12 lbsExplanation
The average weight loss at birth is 12 lbs. This is because during childbirth, a woman typically loses the weight of the baby, the placenta, and amniotic fluid, which can amount to around 12 lbs.Rate this question:
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- 20.
A patient in preterm labor at 30 weeks received indomethacin (Indocin). The newborn should be observed for:
- A.
Duodenal Atresia
- B.
Hirschsprung Disease
- C.
Necrotizing Enterocolitis (NEC)
- D.
None of the above
Correct Answer
C. Necrotizing Enterocolitis (NEC)Explanation
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to delay preterm labor. However, one of the potential side effects of indomethacin is the increased risk of developing necrotizing enterocolitis (NEC) in the newborn. NEC is a serious condition characterized by inflammation and damage to the intestines, particularly in premature infants. Therefore, it is important to closely observe the newborn for signs and symptoms of NEC after the mother has received indomethacin to ensure early detection and prompt treatment if necessary.Rate this question:
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- 21.
The most important nursing action following the administration of epidural anesthesia is to:
- A.
Administer oxytocin to counteract the effect of the epidural
- B.
Maintain the patient in a flat position to avoid post-anesthesia headache
- C.
Monitor the blood pressure for possible hypotension
- D.
None of the above
Correct Answer
C. Monitor the blood pressure for possible hypotensionExplanation
Following the administration of epidural anesthesia, it is important to monitor the patient's blood pressure for possible hypotension. Epidural anesthesia can cause a decrease in blood pressure, and monitoring is necessary to identify and address any hypotensive episodes promptly. This is crucial to prevent complications such as decreased perfusion to vital organs and potential harm to the patient. Administering oxytocin or maintaining the patient in a flat position to avoid post-anesthesia headache are not the most important nursing actions following the administration of epidural anesthesia.Rate this question:
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- 22.
The cause of the sudden late onset of postpartum hemorrhage secondary to retained placental fragments is due to:
- A.
Increased uterine contraction activity
- B.
Necrotic tissue separation from the uterus
- C.
Weakness in the uterine musculature
- D.
All of the above
Correct Answer
B. Necrotic tissue separation from the uterusExplanation
The correct answer is necrotic tissue separation from the uterus. This is because retained placental fragments can lead to necrosis, or tissue death, which can cause separation of the tissue from the uterus. This can result in sudden late onset of postpartum hemorrhage. Increased uterine contraction activity and weakness in the uterine musculature may contribute to postpartum hemorrhage, but they are not the primary cause in this scenario.Rate this question:
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- 23.
The insulin requirements for most diabetic breastfeeding women is:
- A.
Decreased
- B.
Increased
- C.
The same as for bottle feeding diabetics
- D.
None of the above
Correct Answer
A. DecreasedExplanation
Breastfeeding women with diabetes generally have decreased insulin requirements compared to bottle feeding diabetics. This is because breastfeeding helps to naturally lower blood glucose levels in the mother. Breastfeeding stimulates the release of hormones that increase insulin sensitivity and promote glucose uptake by the muscles. As a result, the mother's insulin needs are reduced. It is important for diabetic breastfeeding women to monitor their blood sugar levels closely and adjust their insulin dosage accordingly to maintain stable blood glucose levels.Rate this question:
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- 24.
A patient reports painful nipples. The nurse knows that:
- A.
A lack of nipple preparation can result in pain
- B.
Nursing too long can cause pain
- C.
Specific areas of pain can have a specific cause
- D.
None of the above
Correct Answer
C. Specific areas of pain can have a specific causeExplanation
The nurse knows that specific areas of pain can have a specific cause. This means that the pain in the patient's nipples may be caused by a specific issue or condition, such as an infection, injury, or breastfeeding problem. It suggests that the nurse should assess the patient's nipples and surrounding areas to determine the specific cause of the pain and provide appropriate treatment or interventions.Rate this question:
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- 25.
You are caring for a new mother in the recovery room who was delivered by cesarean at 35 weeks gestation. She has a personal history of tetralogy of Fallot. Your nursing care must include:
- A.
Vital signs including ling sounds and assessment of pedal edema
- B.
Knowledge of her cardiac status prior to and during her pregnancy
- C.
Counseling regarding the significant increased risk of heart defects in her newborn
- D.
None of the above
Correct Answer
A. Vital signs including ling sounds and assessment of pedal edemaExplanation
The correct answer is vital signs including lung sounds and assessment of pedal edema. This is because the patient has a personal history of tetralogy of Fallot, which is a congenital heart defect. Monitoring vital signs, especially lung sounds and pedal edema, can help assess her cardiac status and detect any signs of complications or worsening of her condition. This is crucial in ensuring the patient's safety and well-being during the recovery period.Rate this question:
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- 26.
The greatest risk of herpes simplex virus (HSV) transmission to a newborn who is delivered vaginally occurs with:
- A.
An active recurrent (secondary) HSV outbreak at the time of the delivery
- B.
A history of a primary HSV outbreak early in pregnancy without active disease at the time of delivery
- C.
An active primary HSV outbreak at the time of delivery
- D.
None of the above
Correct Answer
C. An active primary HSV outbreak at the time of deliveryExplanation
An active primary HSV outbreak at the time of delivery poses the greatest risk of transmission to a newborn. This is because during a primary outbreak, the mother has a high viral load and may shed the virus more easily. In addition, the newborn's immune system is not fully developed, making them more susceptible to infection. In contrast, an active recurrent outbreak or a history of a primary outbreak early in pregnancy without active disease at the time of delivery may still pose a risk, but it is lower compared to an active primary outbreak.Rate this question:
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- 27.
The parameter of fetal heart monitoring that is most predictive of fetal compromise is:
- A.
Baseline fetal tachycardia
- B.
Minimal or absent fetal heart rate variability
- C.
Variable decelerations
- D.
None of the above
Correct Answer
B. Minimal or absent fetal heart rate variabilityExplanation
Minimal or absent fetal heart rate variability is the most predictive parameter of fetal compromise. Fetal heart rate variability refers to the normal fluctuations in the fetal heart rate, which indicate a healthy autonomic nervous system. When there is minimal or no variability, it suggests that the fetus is experiencing stress or compromise, as the autonomic nervous system is not functioning properly. This can be a sign of fetal distress and may require further monitoring or intervention to ensure the well-being of the fetus.Rate this question:
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- 28.
Women who experience precipitous labor are at increased risk for:
- A.
Perineal lacerations
- B.
Preeclampsia
- C.
Urinary retention
- D.
All of the above
Correct Answer
A. Perineal lacerationsExplanation
Women who experience precipitous labor, which is defined as labor that progresses very quickly, are at an increased risk for perineal lacerations. This is because the rapid descent and birth of the baby can put excessive pressure on the perineum, causing tears or lacerations. Preeclampsia, a condition characterized by high blood pressure and organ damage, and urinary retention are not directly related to precipitous labor, so they are not the correct answer in this case.Rate this question:
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- 29.
An Rh-negative mother delivers an Rh-positive infant, and alloimmunization (production of Rh antibodies in the mother) occurs. In this case, the risk of hemolytic disease is greatest in
- A.
Subsequent Rh-Negative fetuses
- B.
The current Rh-positive infant
- C.
Subsequent Rh-positive fetuses
- D.
None of the above
Correct Answer
C. Subsequent Rh-positive fetusesExplanation
When an Rh-negative mother delivers an Rh-positive infant, there is a risk of alloimmunization, which means the mother's immune system produces Rh antibodies in response to the Rh-positive blood cells of the infant. These antibodies can cross the placenta and attack the red blood cells of subsequent Rh-positive fetuses. This can lead to hemolytic disease of the newborn in subsequent pregnancies, causing destruction of the baby's red blood cells and potentially leading to serious complications. Therefore, the greatest risk of hemolytic disease is in subsequent Rh-positive fetuses.Rate this question:
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- 30.
A patient at 34 weeks gestation in a low-risk pregnancy who reports decreased fetal movement over the preceding hour should be instructed to:
- A.
Report to her primary medical provider for immediate assessment
- B.
Have something to eat and drink, lie on her left side, and count fetal movements over the next 1-2 hour
- C.
Increase her physical activity
- D.
None of the above
Correct Answer
B. Have something to eat and drink, lie on her left side, and count fetal movements over the next 1-2 hourExplanation
A patient at 34 weeks gestation in a low-risk pregnancy who reports decreased fetal movement over the preceding hour should be instructed to have something to eat and drink, lie on her left side, and count fetal movements over the next 1-2 hours. This is because decreased fetal movement can be a sign of potential fetal distress, and these instructions are commonly recommended to stimulate fetal movement. If the fetal movements do not increase or if the patient has any concerns, she should then report to her primary medical provider for further assessment.Rate this question:
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Jul 11, 2024Quiz Edited by
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Nov 02, 2014Quiz Created by
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