OB Final Exam AQ questions EXAM QUESTIONS AND CORRECT
ANSWERS VERIFIED 100%
A client who is having her labor induced with oxytocin has internal fetal
monitoring in place. Her contractions are occurring every 2 minutes, are
lasting 70 seconds, and are reaching 65 mm Hg on an intrauterine pressure
catheter. The baseline fetal heart rate is 130 to 140 beats/min with variability of
about 15 beats/min. The nurse notices that with the last two contractions the
fetal heart rate began to drop during the peak of the contraction to 110
beats/min, where it remained for about 40 seconds before returning to
baseline. What type of pattern is this?
1. Bradycardia
2. Late decelerations
3. Early decelerations
4. Variable decelerations
2. Late decelerations
Late decelerations begin during the peak of a contraction and continue after the
contraction has ended. Bradycardia is a fetal heart rate slower than 110 beats/min
for 10 minutes. Early decelerations mirror the contraction, beginning at the start of
the contraction and ending when the contraction is over. Variable decelerations fall
and rise abruptly and do not have the uniform appearance noted with early and late
decelerations.
A client who is having a difficult labor is found to have cephalopelvic
disproportion. Which prescription should the nurse question?
1. Maintain nothing by mouth (NPO) status.
2. Start a peripheral intravenous (IV) drip of 25% normal saline.
3. Record fetal heart tones every 15 minutes.
4. Piggyback another 10-unit bag of oxytocin.
,4. Piggyback another 10-unit bag of oxytocin.
When there is cephalopelvic disproportion, a cesarean birth is indicated; infusing
oxytocin at this time could result in fetal compromise and uterine rupture. The NPO
status is appropriate in anticipation of a cesarean birth. A peripheral IV is needed not
only for hydration but also for venous access if IV medications become necessary.
The client probably has an electronic monitor recording the fetal heart rate and
uterine contractions; the findings of these assessments should be documented
regularly in accordance with hospital protocol.
What should be included in a plan of care to limit the development of
hyperbilirubinemia in the breastfed neonate?
1. Encouraging more frequent breastfeeding during the first 2 days
2. Instituting phototherapy for 30 minutes every 6 hours for 3 days
3. Substituting formula feeding for breastfeeding on the second day
4. Supplementing breastfeeding with glucose water during the first day
1. Encouraging more frequent breastfeeding during the first 2 days
More frequent breastfeeding stimulates more frequent evacuation of meconium,
thereby preventing resorption of bilirubin into the circulatory system. Phototherapy is
the treatment for hyperbilirubinemia, and it is maintained continuously; it does not
prevent the development of hyperbilirubinemia. It is not necessary to feed the infant
formula. Early breastfeeding tends to keep the bilirubin level low by stimulating
gastrointestinal activity. Increasing water intake does not limit the development of
hyperbilirubinemia, because only small amounts of bilirubin are excreted by the
kidneys.
The nurse is preparing to discharge a 3-day-old infant who weighed 7 lb (3175
g) at birth. Which finding should be reported immediately to the healthcare
provider?
1. Weight of 6 lb 4 oz (2835 g)
2. Hemoglobin of 16.2 g/dL (162 mmol/L)
3. Three wet diapers over the last 12 hours
4. Total serum bilirubin of 10 mg/dL (171 µmol/L)
, 1. Weight of 6 lb 4 oz (2835 g)
A loss of 12 oz (340 g) since birth, or more than 10%, is higher than the acceptable
figure of 5% to 6%. Hemoglobin of 16.2 g/dL (162 mmol/L), total serum bilirubin of 10
mg/dL (171 µmol/L), and three wet diapers over the last 12 hours are all normal and
expected findings.
Which finding in a newborn whose temperature over the last 4 hours has
fluctuated between 98.0° F (36.7° C) and 97.4° F (36.3° C) would be considered
critical?
1. Respiratory rate of 60 breaths/min
2. White blood count greater than 15,000 mm3
3. Serum calcium level of 8 mg/dL (2 mmol/L)
4. Blood glucose level of 36 mg/dL (3.8 mmol/L)
4. Blood glucose level of 36 mg/dL (3.8 mmol/L)
Instability of the newborn's temperature is an indication of hypoglycemia. A glucose
level below 40 mg/dL (1.7 mmol/L) does not provide enough energy to maintain the
body temperature at a normal level. A serum calcium level of 8 mg/dL (2 mmol/L),
respiratory rate of 60 breaths/min, and a white blood cell count greater than 15,000
mm3 are all normal findings and do not affect body temperature.
The most appropriate method for a nurse to evaluate the effects of the
maternal blood glucose level in the infant of a diabetic mother is by performing
a heel stick blood test on the newborn. What specifically does this test
determine?
1. Blood acidity
2. Glucose tolerance
3. Serum glucose level
4. Glycosylated hemoglobin level
3. Serum glucose level
Obtaining a blood glucose level is a simple, cost-effective method of testing
newborns for suspected hypoglycemia. Although the acidity of the blood will indicate
ANSWERS VERIFIED 100%
A client who is having her labor induced with oxytocin has internal fetal
monitoring in place. Her contractions are occurring every 2 minutes, are
lasting 70 seconds, and are reaching 65 mm Hg on an intrauterine pressure
catheter. The baseline fetal heart rate is 130 to 140 beats/min with variability of
about 15 beats/min. The nurse notices that with the last two contractions the
fetal heart rate began to drop during the peak of the contraction to 110
beats/min, where it remained for about 40 seconds before returning to
baseline. What type of pattern is this?
1. Bradycardia
2. Late decelerations
3. Early decelerations
4. Variable decelerations
2. Late decelerations
Late decelerations begin during the peak of a contraction and continue after the
contraction has ended. Bradycardia is a fetal heart rate slower than 110 beats/min
for 10 minutes. Early decelerations mirror the contraction, beginning at the start of
the contraction and ending when the contraction is over. Variable decelerations fall
and rise abruptly and do not have the uniform appearance noted with early and late
decelerations.
A client who is having a difficult labor is found to have cephalopelvic
disproportion. Which prescription should the nurse question?
1. Maintain nothing by mouth (NPO) status.
2. Start a peripheral intravenous (IV) drip of 25% normal saline.
3. Record fetal heart tones every 15 minutes.
4. Piggyback another 10-unit bag of oxytocin.
,4. Piggyback another 10-unit bag of oxytocin.
When there is cephalopelvic disproportion, a cesarean birth is indicated; infusing
oxytocin at this time could result in fetal compromise and uterine rupture. The NPO
status is appropriate in anticipation of a cesarean birth. A peripheral IV is needed not
only for hydration but also for venous access if IV medications become necessary.
The client probably has an electronic monitor recording the fetal heart rate and
uterine contractions; the findings of these assessments should be documented
regularly in accordance with hospital protocol.
What should be included in a plan of care to limit the development of
hyperbilirubinemia in the breastfed neonate?
1. Encouraging more frequent breastfeeding during the first 2 days
2. Instituting phototherapy for 30 minutes every 6 hours for 3 days
3. Substituting formula feeding for breastfeeding on the second day
4. Supplementing breastfeeding with glucose water during the first day
1. Encouraging more frequent breastfeeding during the first 2 days
More frequent breastfeeding stimulates more frequent evacuation of meconium,
thereby preventing resorption of bilirubin into the circulatory system. Phototherapy is
the treatment for hyperbilirubinemia, and it is maintained continuously; it does not
prevent the development of hyperbilirubinemia. It is not necessary to feed the infant
formula. Early breastfeeding tends to keep the bilirubin level low by stimulating
gastrointestinal activity. Increasing water intake does not limit the development of
hyperbilirubinemia, because only small amounts of bilirubin are excreted by the
kidneys.
The nurse is preparing to discharge a 3-day-old infant who weighed 7 lb (3175
g) at birth. Which finding should be reported immediately to the healthcare
provider?
1. Weight of 6 lb 4 oz (2835 g)
2. Hemoglobin of 16.2 g/dL (162 mmol/L)
3. Three wet diapers over the last 12 hours
4. Total serum bilirubin of 10 mg/dL (171 µmol/L)
, 1. Weight of 6 lb 4 oz (2835 g)
A loss of 12 oz (340 g) since birth, or more than 10%, is higher than the acceptable
figure of 5% to 6%. Hemoglobin of 16.2 g/dL (162 mmol/L), total serum bilirubin of 10
mg/dL (171 µmol/L), and three wet diapers over the last 12 hours are all normal and
expected findings.
Which finding in a newborn whose temperature over the last 4 hours has
fluctuated between 98.0° F (36.7° C) and 97.4° F (36.3° C) would be considered
critical?
1. Respiratory rate of 60 breaths/min
2. White blood count greater than 15,000 mm3
3. Serum calcium level of 8 mg/dL (2 mmol/L)
4. Blood glucose level of 36 mg/dL (3.8 mmol/L)
4. Blood glucose level of 36 mg/dL (3.8 mmol/L)
Instability of the newborn's temperature is an indication of hypoglycemia. A glucose
level below 40 mg/dL (1.7 mmol/L) does not provide enough energy to maintain the
body temperature at a normal level. A serum calcium level of 8 mg/dL (2 mmol/L),
respiratory rate of 60 breaths/min, and a white blood cell count greater than 15,000
mm3 are all normal findings and do not affect body temperature.
The most appropriate method for a nurse to evaluate the effects of the
maternal blood glucose level in the infant of a diabetic mother is by performing
a heel stick blood test on the newborn. What specifically does this test
determine?
1. Blood acidity
2. Glucose tolerance
3. Serum glucose level
4. Glycosylated hemoglobin level
3. Serum glucose level
Obtaining a blood glucose level is a simple, cost-effective method of testing
newborns for suspected hypoglycemia. Although the acidity of the blood will indicate
