HIGH RISK OB REAL EXAM COMPLETE
QUESTIONS AND ANSWERS.
Some factors contributing to the birth of SGA newborns include maternal age of 20 or
35 years old, low socioeconomic status, preeclampsia with increased BP. - ANSWER-
Review the significance of TORCH to pregnancy.-this is a panel of tests that show
certain antibodies to specific infections that pose a risk to the fetus
Toxoplasmosis
Other (gonorrhea, hep B, syphilic, Group B streptococcus, varicella-zoster, HIV,
Parvovirus B19)
Rubella
Cytomegalovirus
Herpes
*A contributor to Hyperbilirubemia - ANSWER-
Which of the following findings on a prenatal visit at 10 weeks might lead the nurse to
suspect a hydatidiform mole?
A) Complaint of frequent mild nausea
B) Blood pressure of 120/84 mm Hg
C) History of bright red spotting 6 weeks ago
D) Fundal height measurement of 18 cm - ANSWER-D
Findings with gestational trophoblastic disease (hydatidiform mole) may include uterine
size larger than expected.
Which of the following data on a client's health history would the nurse identify as
contributing to the client's risk for an ectopic pregnancy?
A) Use of oral contraceptives for 5 years
B) Ovarian cyst 2 years ago
C) Recurrent pelvic infections
D) Heavy, irregular menses - ANSWER-C
In the general population, most cases of ectopic pregnancy are the result of tubal
scarring secondary to pelvic inflammatory disease.
Which of the following findings would the nurse interpret as suggesting a diagnosis of
gestational trophoblastic disease?
A) Elevated hCG levels, enlarged abdomen, quickening
B) Vaginal bleeding, absence of FHR, decreased hPL levels
C) Visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen
D) Gestational hypertension, hyperemesis gravidarum, absence of FHR - ANSWER-D
Gestational trophoblastic disease may be manifested by early development of
preeclampsia (gestational hypertension), severe morning sickness due to high hCG
levels, and absence of fetal heart rate or activity.
,A nurse is providing care to several pregnant women at the clinic. The nurse would
screen for group B streptococcus infection in a client at:
A) 16 weeks' gestation
B) 28 week' gestation
C) 32 weeks' gestation
D) 36 weeks' gestation - ANSWER-D
According to the CDC guidelines, all pregnant women should be screened for group B
streptococcus infection at 35 to 37 weeks' gestation.
A group of nursing students are preparing a presentation for their class about measures
to prevent toxoplasmosis. Which of the following would the students be least likely to
include? Select all that apply.
A) Washing raw fruits and vegetables before eating them
B) Cooking all meat to an internal temperature of 140° F
C) Wearing gardening gloves when working in the soil
D) Avoiding contact with a cat's litter box. - ANSWER-B
Meats should be cooked to an internal temperature of 160° F. Other measures to
prevent toxoplasmosis include peeling or thoroughly washing all raw fruits and
vegetables before eating them, wearing gardening gloves when in contact with outdoor
soil, and avoiding the emptying or cleaning of a cat's litter box.
A nurse is preparing an inservice education program for a group of nurses about
dystocia involving problems with the passenger. Which of the following would the nurse
most likely include as the most common problem?
A) Macrosomia
B) Breech presentation
C) Persistent occiput posterior position
D) Multifetal pregnancy - ANSWER-C
Common problems involving the passenger include occiput posterior position, breech
presentation, multifetal pregnancy, excessive size (macrosomia) as it relates to
cephalopelvic disproportion (CPD), and structural anomalies. Of these, persistent
occiput posterior is the most common malposition, occurring in about 15% of laboring
women.
Acquired Disorder typically occur at or soon after birth. The may result from problems or
conditions experienced by the woman during her pregnancy or at birth, such as
diabetes, maternal infections, or substance abuse, or conditions associated with labor
and birth, such as prolonged rupture of membranes or fetal distress - ANSWER-
A client experienced prolonged labor with prolonged premature rupture of membranes.
The nurse would be alert for which of the following in the mother and the newborn?
A) Infection
B) Hemorrhage
C) Trauma
D) Hypovolemia - ANSWER-A
, Although hemorrhage, trauma, and hypovolemia may be problems, the prolonged labor
with the prolonged premature rupture of membranes places the client at high risk for a
postpartum infection. The rupture of membranes removes the barrier of amniotic fluid,
so bacteria can ascend.
The nurse is teaching a pregnant woman with type 1 diabetes about her diet during
pregnancy. Which client statement indicates that the nurse's teaching was successful?
A) "I'll basically follow the same diet that I was following before I became pregnant."
B) "Because I need extra protein, I'll have to increase my intake of milk and meat."
C) "Pregnancy affects insulin production, so I'll need to make adjustments in my diet."
D) "I'll adjust my diet and insulin based on the results of my urine tests for glucose." -
ANSWER-C
A nurse is developing a program for pregnant women with diabetes about reducing
complications. Which factor would the nurse identify as being most important in helping
to reduce the maternal/fetal/neonatal complications associated with pregnancy and
diabetes?
A) Stability of the woman's emotional and psychological status
B) Degree of glycemic control achieved during the pregnancy
C) Evaluation of retinopathy by an ophthalmologist
D) Blood urea nitrogen level (BUN) within normal limits - ANSWER-B
Therapeutic management for the woman with diabetes focuses on tight glucose control,
thereby minimizing the risks to the mother, fetus, and neonate. In pregnancy, placental
hormones cause insulin resistance at a level that tends to parallel growth of the
fetoplacental unit. Nutritional management focuses on maintaining balanced glucose
levels. Thus, the woman will probably need to make adjustments in her diet. Blood
glucose monitoring results typically guide therapy. Evaluating for long-term diabetic
complications such as retinopathy or nephropathy, as evidenced by laboratory testing
such as BUN levels, is an important aspect of preconception care to ensure that the
mother enters the pregnancy in an optimal state.
A woman with preterm labor is receiving magnesium sulfate. Which finding would
require the nurse to intervene immediately?
A) Respiratory rate of 16 breaths per minute
B) Diminished deep tendon reflexes
C) Urine output of 45 mL/hour
D) Alert level of consciousness - ANSWER-B
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate.
Which finding would the nurse interpret as indicating a therapeutic level of medication?
A) Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendons reflexes 2+
D) Difficulty in arousing - ANSWER-C
QUESTIONS AND ANSWERS.
Some factors contributing to the birth of SGA newborns include maternal age of 20 or
35 years old, low socioeconomic status, preeclampsia with increased BP. - ANSWER-
Review the significance of TORCH to pregnancy.-this is a panel of tests that show
certain antibodies to specific infections that pose a risk to the fetus
Toxoplasmosis
Other (gonorrhea, hep B, syphilic, Group B streptococcus, varicella-zoster, HIV,
Parvovirus B19)
Rubella
Cytomegalovirus
Herpes
*A contributor to Hyperbilirubemia - ANSWER-
Which of the following findings on a prenatal visit at 10 weeks might lead the nurse to
suspect a hydatidiform mole?
A) Complaint of frequent mild nausea
B) Blood pressure of 120/84 mm Hg
C) History of bright red spotting 6 weeks ago
D) Fundal height measurement of 18 cm - ANSWER-D
Findings with gestational trophoblastic disease (hydatidiform mole) may include uterine
size larger than expected.
Which of the following data on a client's health history would the nurse identify as
contributing to the client's risk for an ectopic pregnancy?
A) Use of oral contraceptives for 5 years
B) Ovarian cyst 2 years ago
C) Recurrent pelvic infections
D) Heavy, irregular menses - ANSWER-C
In the general population, most cases of ectopic pregnancy are the result of tubal
scarring secondary to pelvic inflammatory disease.
Which of the following findings would the nurse interpret as suggesting a diagnosis of
gestational trophoblastic disease?
A) Elevated hCG levels, enlarged abdomen, quickening
B) Vaginal bleeding, absence of FHR, decreased hPL levels
C) Visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen
D) Gestational hypertension, hyperemesis gravidarum, absence of FHR - ANSWER-D
Gestational trophoblastic disease may be manifested by early development of
preeclampsia (gestational hypertension), severe morning sickness due to high hCG
levels, and absence of fetal heart rate or activity.
,A nurse is providing care to several pregnant women at the clinic. The nurse would
screen for group B streptococcus infection in a client at:
A) 16 weeks' gestation
B) 28 week' gestation
C) 32 weeks' gestation
D) 36 weeks' gestation - ANSWER-D
According to the CDC guidelines, all pregnant women should be screened for group B
streptococcus infection at 35 to 37 weeks' gestation.
A group of nursing students are preparing a presentation for their class about measures
to prevent toxoplasmosis. Which of the following would the students be least likely to
include? Select all that apply.
A) Washing raw fruits and vegetables before eating them
B) Cooking all meat to an internal temperature of 140° F
C) Wearing gardening gloves when working in the soil
D) Avoiding contact with a cat's litter box. - ANSWER-B
Meats should be cooked to an internal temperature of 160° F. Other measures to
prevent toxoplasmosis include peeling or thoroughly washing all raw fruits and
vegetables before eating them, wearing gardening gloves when in contact with outdoor
soil, and avoiding the emptying or cleaning of a cat's litter box.
A nurse is preparing an inservice education program for a group of nurses about
dystocia involving problems with the passenger. Which of the following would the nurse
most likely include as the most common problem?
A) Macrosomia
B) Breech presentation
C) Persistent occiput posterior position
D) Multifetal pregnancy - ANSWER-C
Common problems involving the passenger include occiput posterior position, breech
presentation, multifetal pregnancy, excessive size (macrosomia) as it relates to
cephalopelvic disproportion (CPD), and structural anomalies. Of these, persistent
occiput posterior is the most common malposition, occurring in about 15% of laboring
women.
Acquired Disorder typically occur at or soon after birth. The may result from problems or
conditions experienced by the woman during her pregnancy or at birth, such as
diabetes, maternal infections, or substance abuse, or conditions associated with labor
and birth, such as prolonged rupture of membranes or fetal distress - ANSWER-
A client experienced prolonged labor with prolonged premature rupture of membranes.
The nurse would be alert for which of the following in the mother and the newborn?
A) Infection
B) Hemorrhage
C) Trauma
D) Hypovolemia - ANSWER-A
, Although hemorrhage, trauma, and hypovolemia may be problems, the prolonged labor
with the prolonged premature rupture of membranes places the client at high risk for a
postpartum infection. The rupture of membranes removes the barrier of amniotic fluid,
so bacteria can ascend.
The nurse is teaching a pregnant woman with type 1 diabetes about her diet during
pregnancy. Which client statement indicates that the nurse's teaching was successful?
A) "I'll basically follow the same diet that I was following before I became pregnant."
B) "Because I need extra protein, I'll have to increase my intake of milk and meat."
C) "Pregnancy affects insulin production, so I'll need to make adjustments in my diet."
D) "I'll adjust my diet and insulin based on the results of my urine tests for glucose." -
ANSWER-C
A nurse is developing a program for pregnant women with diabetes about reducing
complications. Which factor would the nurse identify as being most important in helping
to reduce the maternal/fetal/neonatal complications associated with pregnancy and
diabetes?
A) Stability of the woman's emotional and psychological status
B) Degree of glycemic control achieved during the pregnancy
C) Evaluation of retinopathy by an ophthalmologist
D) Blood urea nitrogen level (BUN) within normal limits - ANSWER-B
Therapeutic management for the woman with diabetes focuses on tight glucose control,
thereby minimizing the risks to the mother, fetus, and neonate. In pregnancy, placental
hormones cause insulin resistance at a level that tends to parallel growth of the
fetoplacental unit. Nutritional management focuses on maintaining balanced glucose
levels. Thus, the woman will probably need to make adjustments in her diet. Blood
glucose monitoring results typically guide therapy. Evaluating for long-term diabetic
complications such as retinopathy or nephropathy, as evidenced by laboratory testing
such as BUN levels, is an important aspect of preconception care to ensure that the
mother enters the pregnancy in an optimal state.
A woman with preterm labor is receiving magnesium sulfate. Which finding would
require the nurse to intervene immediately?
A) Respiratory rate of 16 breaths per minute
B) Diminished deep tendon reflexes
C) Urine output of 45 mL/hour
D) Alert level of consciousness - ANSWER-B
A client is diagnosed with gestational hypertension and is receiving magnesium sulfate.
Which finding would the nurse interpret as indicating a therapeutic level of medication?
A) Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendons reflexes 2+
D) Difficulty in arousing - ANSWER-C
