Antepartum and Intrapartum Period Obstetrics (OB) SCC 4th Quarter Practice Test

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• What is the role of magnesium sulfate in obstetric care?
• A 34-year-old multiparous client at 16 weeks' gestation reports she has already felt the baby move. How should the nurse interpret this finding?
• When is gestational diabetes mellitus screening usually performed?
• What are the essential elements of neonatal transition after birth?
• After an episiotomy, which nursing intervention is essential to perform when caring for the client?
• A primigravid client has just completed a difficult, forceps-assisted birth of a 9-lb neonate. Her labor was unusually long and required oxytocin augmentation. The nurse should stay alert for which postpartum complication?
• During a prenatal visit, a nurse measures a client's fundal height at 19 cm. This measurement indicates that the fetus has reached approximately which gestational age?
• During labor, which assessment finding would prompt the nurse to notify the health care provider?
• A plan for a patient at 34 weeks with premature labor includes which nonpharmacologic intervention to help halt labor?
• A third-trimester patient in labor with a history of a fall presents with bruising but no vaginal bleeding; the Abuse Assessment Screen indicates possible abuse. To which professional should the nurse refer the patient?
• A 16-year-old primigravida at 36 weeks' gestation with no prenatal care experienced a seizure. Upon arrival, what should the nurse do?
• Prostaglandins used to ripen the cervix include:
• In GTPAL 5-2-1-1-2, how many abortions has the patient had?
• What hemoglobin threshold defines anemia during pregnancy?
• At approximately what gestational age are fetal heart sounds audible by Doppler?
• Umbilical cord prolapse occurs after spontaneous rupture of membranes. What should the nurse do immediately?
• An induction with oxytocin shows fetal heart rate accelerations lasting 15 seconds and exceeding baseline with fetal movement. What action should the nurse take?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. Which of the following is a valid result of the test?
• A 27-year-old primigravida with insulin-dependent diabetes at 34 weeks' gestation had a reactive nonstress test. What does this indicate?
• Betamethasone 12 mg IM at 28 weeks is given to do what?
• A laboring client on oxytocin shows contractions every 30 seconds to 2 minutes with an intensity of 90 mm Hg and increasing resting tone. How should the nurse respond?
• An obstetric ultrasound reveals the fetus has spina bifida. The mother becomes tearful and anxious. Which nursing response best supports her?
• Severe back pain during active labor with cervical dilation at 8 cm and complete effacement is most commonly associated with which fetal head position?
• A client at 12 weeks gestation attends a class on fetal development. The nurse anticipates that at 16 weeks' gestation the fetus will have:
• Which action should be included in a unit policy to educate clients before labor induction?
• Which corticosteroids are used to promote fetal lung maturation in threatened preterm birth?
• The nurse should instruct the UAP to notify the nurse if any laboring client shows which finding?
• A nurse assesses a client for signs of ectopic pregnancy. Which assessment finding should the nurse expect?
• Oligohydramnios is defined by an amniotic fluid index less than:
• Which statement best reflects guidance about rubella exposure and vaccination during pregnancy?
• Purplish color to the vagina and cervix at 10 weeks' gestation is an example of which sign?
• A multigravid client at 32 weeks who has had prior hemolytic disease of the newborn should have frequent antibody titer evaluations obtained from which source?
• A 26-year-old primigravida at 34 weeks uses mineral oil for constipation. Which instruction is correct?
• Why is Rh(D) immune globulin given to Rh-negative mothers, and when is it administered?
• In GTPAL 5-2-1-1-2, how many term pregnancies has the patient had?
• During a prenatal visit, a 25-year-old pregnant woman in the third trimester reports frequent constipation. Which nursing suggestion would be most helpful?
• A reactive nonstress test (NST) is defined by:
• Placenta previa classically presents with:
• During an initial prenatal visit, which topic should the nurse ensure is covered with the patient?
• When a multigravida in active labor shows fetal heart rate decelerations that mirror contractions as she begins to push, what should the nurse do?
• Which of the following is a common indication for induction of labor at term?
• After instructing a primigravid client about how preeclampsia can affect the mother and fetus, the patient says preeclampsia can lead to which problem?
• A nurse is caring for a client who has bruises on the face and arms; the husband refuses to leave the bedside and answers questions for the client. Which intervention is most appropriate?
• Placenta accreta spectrum includes abnormal placental attachment to the myometrium; subtypes include which terms?
• A client who is 32 weeks pregnant presents to the emergency department with bright red bleeding and no abdominal pain. A nurse should:
• In a patient receiving IV magnesium sulfate for preeclampsia, which sign would indicate toxicity?
• The Bishop score is calculated using all of the following except:
• In GTPAL 5-2-1-1-2, how many total pregnancies has the patient had?
• How is primary postpartum hemorrhage defined?
• What defines preeclampsia with severe features?
• Which statement indicates understanding about morning sickness management?
• After instructing a primigravid client about placenta function, the nurse finds she believes the placenta produces testosterone. The nurse should recognize this as a need for additional teaching. Which hormone is produced by the placenta?
• During cesarean birth consent, the husband offers to sign because the patient is upset. What should the nurse do?
• A client at 36 weeks who begins labor after an eclamptic seizure. The nurse should assess for which complication?
• An episiotomy is performed to enlarge the vaginal opening and facilitate childbirth. Which statement best describes this procedure?
• How is trial of labor after cesarean (TOLAC) approached in modern practice?
• Which type of fetal heart rate deceleration mirrors contractions and is generally considered benign?
• In neonatal transition, which action is typical when breathing support is required?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. The test can determine the sex of the fetus.
• Which scenario most influences the decision to perform a cesarean delivery in term breech?
• Active labor progression is generally defined by cervical dilation from approximately what centimeter to full dilation with regular contractions?
• What is the first-line uterotonic for postpartum hemorrhage due to uterine atony?
• In breech presentation at term, which factor is considered when deciding on cesarean delivery?
• Accompanied by her partner, a client seeks admission to the labor and delivery area and says she is in labor and attended prenatal care. Which question should the nurse ask her first?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. Which finding can this test identify?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. This test can identify which characteristic?
• A multigravida in active labor is 7 cm dilated. The fetal heart rate baseline is 130 bpm with moderate variability. Variable decelerations occur to 100–110 bpm. What should the nurse do next?
• When preparing a patient for amniocentesis, which pre-procedure instruction is essential?
• Mineral oil interferes with absorption of which vitamins?
• If placenta previa covers the os, what delivery method is often required?
• The baseline fetal heart rate in a reactive NST should be:
• A newly pregnant woman tells the nurse that she hasn't been taking her prenatal vitamins because they make her nauseated. In addition to telling the client how important taking the vitamins are, the nurse should advise her to:
• During admission at 39 weeks, membranes rupture spontaneously with cervix at 5 cm, presenting part at 0 station, and reassuring electronic fetal monitoring. What should the nurse do first?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. Which finding can identify neural tube defects?
• In planning intrapartum analgesia, which complication should be monitored?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. This test can identify which of the following?
• Prior to an amniocentesis, the nurse should instruct the client to void to reduce the risk of bladder puncture. Which option lists this as a pre-procedure instruction?
• A client is being admitted to the labor and childbirth unit. Her GTPAL classification is 5-2-1-1-2. Which statement correctly describes the patient’s obstetric history for shift report?
• Which option best describes appropriate prophylactic antibiotic use during cesarean delivery?
• What is a key step in the management of umbilical cord prolapse when the presenting part cannot be immediately repositioned?
• Which first-trimester screening statement best assesses fetal aneuploidy risk?
• After teaching a pregnant client about potential complications of amniocentesis that must be reported immediately, the nurse determines that the client understands the instruction when she says that she will report:
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. Which finding would indicate neural tube defects?
• What is the purpose of the detailed fetal anatomy ultrasound performed around 18–22 weeks?
• Which of the following is NOT a sign of magnesium toxicity?
• In the first stage of labor with external fetal monitoring, which pattern on the fetal heart tracing suggests adequate uteroplacental-fetal perfusion?
• Which finding would most strongly indicate the need for intervention in hyperemesis gravidarum?
• A multigravid client diagnosed with chronic hypertension is now in preterm labor at 34 weeks' gestation. The HCP has prescribed magnesium sulfate at 3 g/h. Which assessment finding indicates that the intended therapeutic effect has occurred?
• A client who is 7 months pregnant experiences severe leg cramps at night. Which nursing action would be most effective in helping her cope?
• When is the Tdap vaccine recommended during pregnancy?
• What is the best approach when a patient expresses fear about a fetal anomaly?
• A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of her fetus. Her BPP score is 8. What does this score indicate?
• Which client is the best candidate for VBAC?
• When is Apgar scoring performed?
• In a patient at 15 weeks' gestation with dark brown vaginal bleeding, frequent nausea and vomiting, blood pressure 142/98 mm Hg, and fundal height 19 cm, which prescription is most important for the nurse to request from the primary care provider?
• A reactive NST indicates fetal well-being; which of the following statements would align with this result?
• When measuring the fundal height of a primigravid client at 20 weeks' gestation, the nurse will locate the fundal height at which point?
• Placenta accreta spectrum includes abnormal placental attachment to the myometrium; which terms describe the spectrum?
• Two hours ago, a multigravid client was admitted in active labor with her cervix dilated at 5 cm and completely effaced and the fetus at 0 station. Currently, the client is experiencing nausea and vomiting, a slight chill with perspiration beads on her lip, and extreme irritability. The nurse should first:
• During labor, suspected umbilical cord prolapse, what is the initial management?
• Variable decelerations are typically interpreted as a sign of what, and what is the initial management?
• Two hours ago a multigravid in labor without anesthesia showed 5 cm dilation, complete effacement, presenting part at 0 station, membranes intact; now the client is irritable with nausea and one episode of vomiting. Which phase of labor is most likely occurring?
• What is the recommended corticosteroid timing for fetal lung maturation in threatened preterm birth?
• Influenza vaccination during pregnancy should be given in which timeframe?
• A patient at 34 weeks with placenta previa has ongoing vaginal bleeding but normal fetal heart rate and no labor. What is the priority nursing action?
• In placental abruption, which scenario triggers expedited delivery?
• What medication is used as an antifibrinolytic in postpartum hemorrhage?
• A multigravida in active labor is given nalbuphine. The nurse determines the analgesic is effective when the client says
• Placenta accreta spectrum refers to abnormal placental attachment to the myometrium. Which history increases risk?
• After instruction of a primigravid client at 8 weeks' gestation about measures to overcome early morning nausea and vomiting, which client statement indicates the need for additional teaching?
• Which hormone is not produced by the placenta?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. Which finding would indicate neural tube defects?
• Which of the following is a pharmacologic method used to ripen the cervix prior to induction?
• Which of the following is a mechanical method used to ripen the cervix prior to induction?
• A client asks about complementary therapies for relief of discomfort related to pregnancy. Which comfort measure mentioned indicates a need for further teaching?
• During premature rupture of membranes at 30 weeks with cervix 2 cm dilated and 50% effaced, which assessment should the nurse perform next?
• Which fetal heart rate pattern is most concerning for uteroplacental insufficiency?
• Which statement about taking prenatal vitamins with iron is correct?
• A client who is 5 months pregnant was exposed to rubella and asks whether she can be immunized now. How should the nurse respond?
• When tachysystole occurs during labor and fetal status is nonreassuring, what is the recommended initial management?
• A multigravid client at term is admitted for trial labor and possible vaginal birth. After receiving nalbuphine IV, fetal heart rate shows minimal variability at 120 bpm. The decreased variability is most likely caused by which factor?
• During pushing, the fetal head is crowning. To prevent perineal lacerations, the nurse should:
• External cephalic version is considered at term for breech presentation. Which of the following is a contraindication?
• Postpartum care measures help prevent infection after cesarean delivery. Which of the following is included?
• Which finding indicates magnesium toxicity and requires clinical attention?
• How is preeclampsia defined clinically?
• A patient undergoes an amniotomy. Shortly afterward, the nurse detects large variable decelerations in the fetal heart rate on the external monitor. These findings signify:
• A fundal height of 19 cm corresponds most closely to which gestational age?
• What is the primary purpose of a trial labor in a patient with a prior cesarean birth?
• After expelling a hydatidiform mole, which response best addresses the patient’s question about when to try to become pregnant again?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. This test can identify chromosomal defects.
• Which option correctly identifies Chadwick sign?
• An adolescent in labor requests an epidural; the cultural family says 'bite the bullet.' How should the nurse respond to ensure the patient's request is honored?
• Which symptom supports transition phase of labor?
• Which immediate diagnostic step is most important for a patient at 15 weeks' gestation with dark brown vaginal bleeding and high blood pressure?
• What analgesia is commonly used for intrapartum pain management in many settings?
• In preparation for parenting class, how will true labor contractions be described?
• Which previous cesarean incision would be a contraindication for attempting a VBAC?
• If gestational diabetes screening is positive, what is the next step?
• Which action is most effective in relieving nocturnal leg cramps in late pregnancy?
• During a 24-week prenatal visit, a primigravid client is planning a 6-hour automobile trip to visit her parents. Which statement indicates a need for further teaching about precautions during the trip?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. Which of the following is a valid use of this test?
• During labor, a primigravid client receives an epidural anesthesia. Which finding would best suggest an adverse reaction to the anesthesia?
• A pregnant client planning a long car drive asks about travel precautions. Which plan demonstrates appropriate rest during travel?
• For a seizure in a pregnant teenager, which is the appropriate initial action on arrival?
• Initial client assessment shows BP 160/110 mm Hg, pulse 88, respirations 22, reflexes +3/+4 with 2 beat clonus, +3 protein in urine. Based on these findings, which complaints are most likely?
• During a childbirth preparation class, a primigravid client at 36 weeks reports lower back pain. Which exercise would be most helpful?
• A primigravid client in active labor has just received an epidural block. After administration, the nurse should assess for:
• In a multiparous patient, quickening may be felt as early as which gestational age?
• In caring for a patient with a fetal anomaly such as anencephaly who wishes to donate neonatal organs after death, the nurse should
• When explaining to a pregnant client about the need to take supplemental vitamins with iron during her pregnancy, the nurse should instruct the client to take the iron with which liquid to promote maximum absorption?
• What is the recommended total weight gain during pregnancy for a person with a normal pre-pregnancy BMI (18.5–24.9)?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. Which of the following can this test identify?
• A laboring client at -2 station has a spontaneous rupture of the membranes, and a cord immediately protrudes from the vagina. The nurse should first:
• A full-term client is admitted for labor induction with a Bishop score of 10. Which drug would the nurse anticipate administering?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. The test can reveal the sex of the fetus.
• In transition during labor, a primiparous patient who has progressed to 8 cm dilation and +1 station with intense pain is most likely to require which initial assessment by the nurse?
• During a labor assessment, a client at 42 weeks gestation shows fetal tachycardia (190 bpm) for 10 minutes with extremely active fetus and strong contractions. Which finding would indicate fetal hypoxia?
• In a laboring patient with external fetal monitoring, which tracing finding is most consistent with decreased fetal oxygenation due to uteroplacental insufficiency?
• How should the nurse handle a teenage patient’s analgesia request when cultural beliefs are involved?
• For a primigravida in transition phase who is writhing in pain and previously documented as 8 cm dilated with +1 station, what is the highest priority intervention?
• For a client receiving IV magnesium sulfate for severe preeclampsia, which assessment finding would alert to hypermagnesemia?
• A multiparous patient at 16 weeks gestation is diagnosed with a fetus likely having anencephaly. The patient plans to continue the pregnancy and donate neonatal organs after death. The nurse should:
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. The test can reveal the sex of the fetus.
• Postpartum infection prevention after cesarean includes which practice related to technique?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. Which of the following is a correct use of this test?
• The primary rationale for cesarean delivery in term breech when vaginal delivery is high risk is to:
• In GTPAL 5-2-1-1-2, how many preterm births has the patient had?
• A nurse observes vomiting during oxytocin induction and discovers patients lacked instruction and haven't fasted 8 hours. How should the nurse intervene?
• Which parameters should be monitored to detect magnesium toxicity?
• Meconium-stained amniotic fluid during labor indicates an increased risk of which neonatal complication?
• Which of the following is NOT a component of the Bishop score?
• When membranes rupture spontaneously at 5 cm with reassuring fetal status, what is the first assessment the nurse should perform?
• At what gestational age is the detailed fetal anatomy ultrasound typically performed?
• Which set of findings is typical of placental abruption?
• A patient with PROM at 30 weeks without contractions should be evaluated for infection. Which assessment is most important?
• A client in the 13th week of pregnancy develops hyperemesis gravidarum. Which laboratory finding indicates the need for intervention?
• A nurse detects a foul odor in a bathroom and suspects a client is smoking marijuana. What should the nurse do next?
• Which of the following is NOT a potential severe feature of preeclampsia?
• During a scheduled cesarean birth for a primigravid client with a fetus at 39 weeks’ gestation in a breech presentation, a neonatologist is present in the operating room because neonates born by cesarean birth tend to have an increased incidence of which problem?
• When measuring fundal height at around 20 weeks' gestation, which landmark is generally at the level of the fundus?
• A client at 34 weeks with placenta previa is bleeding. The fetal heart sounds are normal and the client is not in labor. Which nursing intervention should the nurse perform?
• In the scenario of third-trimester vaginal bleeding without abdominal pain, what is an appropriate initial assessment?
• An alternative intrapartum analgesia method to an epidural is IV opioids. Which complication should be monitored with this option?
• A laboring patient with epidural anesthesia develops a sudden drop in blood pressure. Which of the following is the most appropriate immediate nursing action?
• Which finding is most consistent with the need to discontinue labor augmentation with oxytocin?
• What is the initial management for placental abruption when there is maternal or fetal compromise?
• Which outcome would be the priority to achieve when planning care for a primigravid 38 weeks with severe preeclampsia on intravenous magnesium sulfate?
• A primigravid client who is 2 months pregnant should expect to feel the fetus move at which time?
• A client who is 15 weeks pregnant comes to the clinic for amniocentesis. Which of the following can amniocentesis determine?
• Which statement about vaccines during pregnancy is accurate?
• A nurse is performing a physical examination of a primigravid client who's 8 weeks pregnant. At this time, the nurse expects to assess:
• A 25-year-old in the first stage of labor receives a continuous lumbar epidural block when the cervix is 6 cm dilated. After administration, which assessment would be most important?
• During a routine prenatal visit in the first trimester, a client says she isn’t sure about becoming a parent. Which response should the nurse offer?