OB CMS EXAM NGN / CMS OB EXAM WITH NGN
LATEST ACTUAL EXAM
The is assisting a patient who just delivered a healthy baby boy weighing 7 pounds.
Upon cord traction of placenta, she notices a sudden gushing of a large amount of
blood and the fundus is no longer palpable in the abdomen. What are useful nursing
interventions if uterine inversion is suspected?
1. Administering oxytocic
2. Assess vital signs
3. Discontinue uterotonic drugs
4. Do not attempt to remove the placenta
5. Establish IV access and fluids - ANSWER: 2. Assess vital signs
3. Discontinue uterotonic drugs
4. Do not attempt to remove the placenta
5. Establish IV access and fluids
Rationale: Never attempt to remove the placenta if it is still attached, because this
will only create a larger surface area for bleeding. When an inversion occurs a large
amount of blood suddenly gushes from the vagina. The fundus is not palpable in the
abdomen. If the loss of blood continues unchecked, the woman will immediately
show signs of blood loss. Uterine inversion may occur after the birth if traction is
applied to the umbilical cord too soon or if the pressure is applied to the uterine
fundus when the uterus is not contracted. Administering an oxytocic drug only
compounds the inversion. Uterotonic drugs should be discontinued to allow uterine
relaxation for replacement. IV fluids should be commenced to support blood
pressure.
A nurse is reviewing her assignments. Which patient should she assess first?
1. A 12-hour infant who is small for gestational age.
2. Four hour infant with a cardiac defect.
3. 9 hour old infant who has not voided
4. 3 day old infant waiting for discharge - ANSWER: 2. Four hour infant with a
cardiac defect
Rationale: The infant with a cardiac defect is at the most risk for complications and
should be assessed first.
At 32 weeks' gestation a 15-year-old primigravid client who is 5'2", has gained 20 lbs,
with a 1 lb weight gain in the last 2 weeks. Urinalysis reveals negative glucose and a
trace of protein. The nurse should advise the client that which of the following
factors increases her risk for preeclampsia?
1. Total weight gain
2. Short stature
3. Adolescent age group
4. Proteinuria - ANSWER: 3. Adolescent age group
Rationale: Client's with increased risk for preeclampsia include primigravid clients
younger than 20 years or older than 40 years, clients with 5 or more pregnancies,
, women of color, women with multifetal pregnancies, women with diabetes or
heart issues. A total weight gain of 20 lbs in the at 32 weeks gestation with a 1 lb
weight gain in the last 2 weeks is within normal limits. Trace amounts of protein in
the urine is common during pregnancy but amounts of +1 or more may be
pregnancy induced hypertension.
A patient has meconium-stained amniotic fluid. Fetal scalp sampling indicates a
blood pH of 7.12 and fetal bradycardia is present. Based on these findings, the nurse
should take which action?
1. Administer amnioinfusion.
2. Prepare for cesarean section.
3. Reposition the patient.
4. Start IV as prescribed. - ANSWER: 2. Prepare for cesarean section.
Rationale: Infants with meconium-stained amniotic fluid may have respiratory
difficulties and bradycardia at birth. Based on this assessment, fetal metabolic
acidosis is present. These findings pose a great threat to the newborn's well-being.
A cesarean section is required. Amnioinfusion is an infusion of sterile isotonic
solution into the uterine cavity during labor to reduce umbilical cord compression.
This is also done to dilute meconium in the amniotic fluid, reducing the risk that
the infant will aspirate thick meconium at birth. The procedure is not sufficient in
this scenario neither is the IV.
What is premature rupture of membranes? - ANSWER: Premature rupture of the
membranes is spontaneous rupture of the amniotic membrane before the onset of
labor. When the rupture of membranes is before term infection becomes a risk.
What hormones are secreted by the corpus luteum? - ANSWER: The corpus luteum
secretes estrogen and progesterone during the remaining 14 days of the cycle.
What is the normal intrauterine fetal attitude? - ANSWER: It is the relationship of
the fetal body parts to one another. The normal intrauterine attitude is flexion, in
which the fetal back is rounded, the head is forward on the chest, and the arms
and legs are folded in against the body.
Absence of menses for 6 months or more in a client with prior normal menses is
known as? - ANSWER: Secondary amenorrhea
What is the postpartum period? - ANSWER: The postpartum period starts
immediately after delivery and is usually completed by week 6 after delivery.
What is the rooting reflex? - ANSWER: Touching the newborn's lip, cheek, or corner
of the mouth with a nipple causes the newborn to turn the head toward the nipple
and open mouth. The newborn takes hold of the nipple and sucks. The rooting
reflex usually disappears 3 to 4 months.
What are the interventions for the contraction stress test? - ANSWER: The external
fetal monitor is applied to the client and a 20-minute baseline strip is recorded.
LATEST ACTUAL EXAM
The is assisting a patient who just delivered a healthy baby boy weighing 7 pounds.
Upon cord traction of placenta, she notices a sudden gushing of a large amount of
blood and the fundus is no longer palpable in the abdomen. What are useful nursing
interventions if uterine inversion is suspected?
1. Administering oxytocic
2. Assess vital signs
3. Discontinue uterotonic drugs
4. Do not attempt to remove the placenta
5. Establish IV access and fluids - ANSWER: 2. Assess vital signs
3. Discontinue uterotonic drugs
4. Do not attempt to remove the placenta
5. Establish IV access and fluids
Rationale: Never attempt to remove the placenta if it is still attached, because this
will only create a larger surface area for bleeding. When an inversion occurs a large
amount of blood suddenly gushes from the vagina. The fundus is not palpable in the
abdomen. If the loss of blood continues unchecked, the woman will immediately
show signs of blood loss. Uterine inversion may occur after the birth if traction is
applied to the umbilical cord too soon or if the pressure is applied to the uterine
fundus when the uterus is not contracted. Administering an oxytocic drug only
compounds the inversion. Uterotonic drugs should be discontinued to allow uterine
relaxation for replacement. IV fluids should be commenced to support blood
pressure.
A nurse is reviewing her assignments. Which patient should she assess first?
1. A 12-hour infant who is small for gestational age.
2. Four hour infant with a cardiac defect.
3. 9 hour old infant who has not voided
4. 3 day old infant waiting for discharge - ANSWER: 2. Four hour infant with a
cardiac defect
Rationale: The infant with a cardiac defect is at the most risk for complications and
should be assessed first.
At 32 weeks' gestation a 15-year-old primigravid client who is 5'2", has gained 20 lbs,
with a 1 lb weight gain in the last 2 weeks. Urinalysis reveals negative glucose and a
trace of protein. The nurse should advise the client that which of the following
factors increases her risk for preeclampsia?
1. Total weight gain
2. Short stature
3. Adolescent age group
4. Proteinuria - ANSWER: 3. Adolescent age group
Rationale: Client's with increased risk for preeclampsia include primigravid clients
younger than 20 years or older than 40 years, clients with 5 or more pregnancies,
, women of color, women with multifetal pregnancies, women with diabetes or
heart issues. A total weight gain of 20 lbs in the at 32 weeks gestation with a 1 lb
weight gain in the last 2 weeks is within normal limits. Trace amounts of protein in
the urine is common during pregnancy but amounts of +1 or more may be
pregnancy induced hypertension.
A patient has meconium-stained amniotic fluid. Fetal scalp sampling indicates a
blood pH of 7.12 and fetal bradycardia is present. Based on these findings, the nurse
should take which action?
1. Administer amnioinfusion.
2. Prepare for cesarean section.
3. Reposition the patient.
4. Start IV as prescribed. - ANSWER: 2. Prepare for cesarean section.
Rationale: Infants with meconium-stained amniotic fluid may have respiratory
difficulties and bradycardia at birth. Based on this assessment, fetal metabolic
acidosis is present. These findings pose a great threat to the newborn's well-being.
A cesarean section is required. Amnioinfusion is an infusion of sterile isotonic
solution into the uterine cavity during labor to reduce umbilical cord compression.
This is also done to dilute meconium in the amniotic fluid, reducing the risk that
the infant will aspirate thick meconium at birth. The procedure is not sufficient in
this scenario neither is the IV.
What is premature rupture of membranes? - ANSWER: Premature rupture of the
membranes is spontaneous rupture of the amniotic membrane before the onset of
labor. When the rupture of membranes is before term infection becomes a risk.
What hormones are secreted by the corpus luteum? - ANSWER: The corpus luteum
secretes estrogen and progesterone during the remaining 14 days of the cycle.
What is the normal intrauterine fetal attitude? - ANSWER: It is the relationship of
the fetal body parts to one another. The normal intrauterine attitude is flexion, in
which the fetal back is rounded, the head is forward on the chest, and the arms
and legs are folded in against the body.
Absence of menses for 6 months or more in a client with prior normal menses is
known as? - ANSWER: Secondary amenorrhea
What is the postpartum period? - ANSWER: The postpartum period starts
immediately after delivery and is usually completed by week 6 after delivery.
What is the rooting reflex? - ANSWER: Touching the newborn's lip, cheek, or corner
of the mouth with a nipple causes the newborn to turn the head toward the nipple
and open mouth. The newborn takes hold of the nipple and sucks. The rooting
reflex usually disappears 3 to 4 months.
What are the interventions for the contraction stress test? - ANSWER: The external
fetal monitor is applied to the client and a 20-minute baseline strip is recorded.
