NURSING 3280
CARE OF WOMEN
EXAM Q & A
2024
1. A 25-year-old woman visits the clinic for a routine prenatal checkup at 28
weeks of gestation. She reports feeling well and has no complaints. Her
blood pressure is 120/80 mmHg, pulse is 80 beats/min, and weight is 65 kg.
She has gained 10 kg since the beginning of her pregnancy. The nurse
performs a fundal height measurement and finds it to be 30 cm. What is the
most appropriate action for the nurse to take?
a) Document the finding as normal and reassure the woman.
b) Refer the woman for an ultrasound to rule out intrauterine growth
restriction (IUGR).
c) Advise the woman to increase her calorie intake and monitor her weight
gain.
d) Perform a urine dipstick test to check for proteinuria and glucose.
*Answer: a) Document the finding as normal and reassure the woman.*
Rationale: The fundal height measurement is a simple and reliable method to
assess fetal growth and well-being. It is measured in centimeters from the top
of the pubic bone to the top of the uterus (fundus). The fundal height should
be approximately equal to the number of weeks of gestation, plus or minus 2
cm. In this case, the woman's fundal height is within the normal range for her
gestational age, indicating that her fetus is growing adequately. There is no
1
, need to refer her for an ultrasound, advise her to increase her calorie intake,
or perform a urine test, as these interventions are indicated for women with
suspected fetal growth problems or complications such as preeclampsia or
gestational diabetes.
2. A 32-year-old woman is admitted to the labor and delivery unit with
regular contractions every 5 minutes, lasting 60 seconds each. She is in active
labor and her cervix is dilated to 6 cm. She has a history of cesarean delivery
due to fetal distress in her previous pregnancy. She expresses her desire to
have a vaginal birth after cesarean (VBAC) this time. What are the most
important factors that the nurse should consider when caring for this
woman?
a) The type of uterine incision and the interval between pregnancies.
b) The maternal age and the parity.
c) The fetal position and the presentation.
d) The maternal preference and the informed consent.
*Answer: a) The type of uterine incision and the interval between
pregnancies.*
Rationale: The most important factors that influence the success and safety of
VBAC are the type of uterine incision and the interval between pregnancies.
A low transverse uterine incision (horizontal across the lower segment of the
uterus) has a lower risk of uterine rupture than a classical uterine incision
(vertical along the upper segment of the uterus). A longer interval between
pregnancies (at least 18 months) allows more time for the uterine scar to heal
and reduces the risk of uterine rupture. The maternal age, parity, fetal
position, presentation, preference, and informed consent are also relevant
factors, but they are not as critical as the type of uterine incision and the
interval between pregnancies.
3. A 28-year-old woman delivers a healthy baby girl vaginally after an
uncomplicated labor. The placenta is delivered intact and there is no
excessive bleeding. The nurse performs a physical assessment of the woman
and finds that her uterus is firm, midline, and at the level of the umbilicus.
Her lochia is moderate, rubra, and without clots. Her perineum is intact, with
minimal edema and ecchymosis. Her vital signs are stable and she reports
feeling well. What is the most appropriate nursing diagnosis for this woman?
a) Risk for infection related to vaginal delivery.
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CARE OF WOMEN
EXAM Q & A
2024
1. A 25-year-old woman visits the clinic for a routine prenatal checkup at 28
weeks of gestation. She reports feeling well and has no complaints. Her
blood pressure is 120/80 mmHg, pulse is 80 beats/min, and weight is 65 kg.
She has gained 10 kg since the beginning of her pregnancy. The nurse
performs a fundal height measurement and finds it to be 30 cm. What is the
most appropriate action for the nurse to take?
a) Document the finding as normal and reassure the woman.
b) Refer the woman for an ultrasound to rule out intrauterine growth
restriction (IUGR).
c) Advise the woman to increase her calorie intake and monitor her weight
gain.
d) Perform a urine dipstick test to check for proteinuria and glucose.
*Answer: a) Document the finding as normal and reassure the woman.*
Rationale: The fundal height measurement is a simple and reliable method to
assess fetal growth and well-being. It is measured in centimeters from the top
of the pubic bone to the top of the uterus (fundus). The fundal height should
be approximately equal to the number of weeks of gestation, plus or minus 2
cm. In this case, the woman's fundal height is within the normal range for her
gestational age, indicating that her fetus is growing adequately. There is no
1
, need to refer her for an ultrasound, advise her to increase her calorie intake,
or perform a urine test, as these interventions are indicated for women with
suspected fetal growth problems or complications such as preeclampsia or
gestational diabetes.
2. A 32-year-old woman is admitted to the labor and delivery unit with
regular contractions every 5 minutes, lasting 60 seconds each. She is in active
labor and her cervix is dilated to 6 cm. She has a history of cesarean delivery
due to fetal distress in her previous pregnancy. She expresses her desire to
have a vaginal birth after cesarean (VBAC) this time. What are the most
important factors that the nurse should consider when caring for this
woman?
a) The type of uterine incision and the interval between pregnancies.
b) The maternal age and the parity.
c) The fetal position and the presentation.
d) The maternal preference and the informed consent.
*Answer: a) The type of uterine incision and the interval between
pregnancies.*
Rationale: The most important factors that influence the success and safety of
VBAC are the type of uterine incision and the interval between pregnancies.
A low transverse uterine incision (horizontal across the lower segment of the
uterus) has a lower risk of uterine rupture than a classical uterine incision
(vertical along the upper segment of the uterus). A longer interval between
pregnancies (at least 18 months) allows more time for the uterine scar to heal
and reduces the risk of uterine rupture. The maternal age, parity, fetal
position, presentation, preference, and informed consent are also relevant
factors, but they are not as critical as the type of uterine incision and the
interval between pregnancies.
3. A 28-year-old woman delivers a healthy baby girl vaginally after an
uncomplicated labor. The placenta is delivered intact and there is no
excessive bleeding. The nurse performs a physical assessment of the woman
and finds that her uterus is firm, midline, and at the level of the umbilicus.
Her lochia is moderate, rubra, and without clots. Her perineum is intact, with
minimal edema and ecchymosis. Her vital signs are stable and she reports
feeling well. What is the most appropriate nursing diagnosis for this woman?
a) Risk for infection related to vaginal delivery.
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