OB unit 2 skills Exam Questions with
Complete Solutions
A patient is admitted to the labor and delivery unit. The fetal monitor is applied, and the
patient moves into a supine position for the assessment. During the examination, the
nurse notes that the FHR is 124 bpm with moderate variability and that the patient's
fundus is soft on palpation. Vital signs reveal blood pressure of 86/40, pulse of 96 bpm,
respiratory rate of 20 per minute, and temperature of 36.8°C (98.2°F). After a few
minutes of monitoring, the nurse notices that the FHR variability is minimal. What should
the nurse do first? - ANS-Reposition the patient so that she is not supine.
A patient delivered her first child 3 years ago. A year later she had a spontaneous
abortion at 12 weeks' gestation. She presents to the antepartum unit at 38 weeks'
gestation reporting rupture of membranes 1 hour ago, but she is not having
contractions. What is the nurse's calculation of the patient's gravidity and parity? - ANS-
Gravida 3, para 1
While assessing an antepartum patient, the nurse hears a loud moan coming from the
hallway. The nurse steps outside the room and sees a pregnant patient arriving on a
stretcher accompanied by a nurse from the emergency department. What is the first
priority for the nurse from the labor and delivery department? - ANS-Assess if delivery is
imminent.
A patient is being admitted for early labor at 40 weeks' gestation. She is gravida 2, para
1. When asked if she is leaking fluid or having bloody show, the patient mentions having
had a gush of fluid about 2 hours ago. What important question does the nurse then ask
the patient? - ANS-"Did you notice what color the fluid was?"
A 22-year-old African-American patient is being admitted to the labor unit for induction
of labor. She is gravida 1, para 0, and currently at 40 5/7 weeks' gestation. She is 150
cm (4 ft 11 in) tall and weighs 50 kg (110 lb). She admits to smoking two or three
cigarettes per day but denies use of alcohol or illegal substances. Her prenatal
laboratory tests show a hemoglobin level of 10 gm/dl and a hematocrit level of 30.6%.
Her blood type is O negative, and the serologic test for syphilis is nonreactive. Other
than coming to the unit for outpatient nonstress tests twice over the past week, she has
not been hospitalized during this pregnancy. The FHR today is 100 bpm with an
irregular rhythm; there are late decelerations. The patient's blood pressure is 144/86;
pulse, 88 bpm; respirations, 16 per minute; and temperature, 36.8°C (98.2°F). The
patient denies having pain. Which cluster of factors indicates an increased r - ANS-
Nonwhite race, height, smoking, anemia, category II (indeterminate) FHR
characteristics, and elevated blood pressure
, A 32-year-old pregnant patient is being admitted to the labor and delivery unit. She is
gravida 4, para 2, and at 39 weeks' gestation. While auscultating the lung and heart
sounds, the nurse notices a thin, yellowish discharge from the patient's right nipple. The
patient also notices it and comments, "I don't know what that is, but I have noticed it for
the last couple of months." What is the best way for the nurse to respond? - ANS-"It is
most likely colostrum, indicating your breasts are getting ready for the baby."
During the labor admission assessment, the nurse asks the patient if she has used
illegal drugs or herbal preparations. The patient glances at her family members and
then quickly denies using anything illegal. The patient becomes quiet, responding to the
nurse's questions with short answers. She begins to appear tense. What does this
behavior tell the nurse? - ANS-Sensitive questions should be asked while the patient is
alone.
1. A laboring gravida 2, para 1 is being cared for on the family birth unit. Her cervix is
currently 5 cm dilated and 100% effaced. The fetus is at -2 station and cephalic in a left
occiput anterior position. The patient calls the nurse to the room and reports a large
gush of fluid with her most recent contraction. The nurse assesses that the patient's
membranes are ruptured and that the amniotic fluid is green and watery. What is the
most important nursing intervention at this time? - ANS-Assess FHR to check for any
change in baseline or any abnormal patterns.
A 17-year-old primigravida is admitted in early labor. Her cervix is 2 to 3 cm dilated and
100% effaced. The fetus is cephalic, and the presenting part is at -1 station. The
patient's membranes are intact. The patient is holding her boyfriend's hand tightly and
breathing rapidly with each contraction. She tells the nurse in a shaky voice, "I'm so
nervous. I've never been in a hospital before. I don't know anything about labor or if I
can do this." What is an appropriate nursing diagnosis for this patient? - ANS-Anxiety
related to unfamiliar environment and lack of birth preparation
A primigravida at 40 weeks' gestation is admitted to the labor unit in latent labor. Her
prenatal history does not indicate any risk factors. Her initial vital signs are temperature
of 37.1°C (98.8°F); pulse, 86 bpm; respirations, 20; and blood pressure, 114/68 mm Hg.
She has been connected to external electronic monitoring for 1 hour. FHR baseline is
145 with moderate variability, the presence of accelerations, and absence of
decelerations. She is having contractions every 3 to 4 minutes, each lasting 40 to 60
seconds, mild to palpation, and with soft resting tone. What is an appropriate nursing
intervention at this point? - ANS-A. Encourage the patient to ambulate within the labor
unit.
4. The laboring patient has progressed to 5 cm dilation, and the fetal presenting part is
at +1 station. The patient is experiencing contractions every 3 minutes, lasting 60 to 90
seconds, and palpating moderate to strong with soft resting tone. The FHR pattern
demonstrates normal characteristics indicative of fetal well-being. The patient is having
difficulty relaxing between contractions and reports low back pain. She further states
Complete Solutions
A patient is admitted to the labor and delivery unit. The fetal monitor is applied, and the
patient moves into a supine position for the assessment. During the examination, the
nurse notes that the FHR is 124 bpm with moderate variability and that the patient's
fundus is soft on palpation. Vital signs reveal blood pressure of 86/40, pulse of 96 bpm,
respiratory rate of 20 per minute, and temperature of 36.8°C (98.2°F). After a few
minutes of monitoring, the nurse notices that the FHR variability is minimal. What should
the nurse do first? - ANS-Reposition the patient so that she is not supine.
A patient delivered her first child 3 years ago. A year later she had a spontaneous
abortion at 12 weeks' gestation. She presents to the antepartum unit at 38 weeks'
gestation reporting rupture of membranes 1 hour ago, but she is not having
contractions. What is the nurse's calculation of the patient's gravidity and parity? - ANS-
Gravida 3, para 1
While assessing an antepartum patient, the nurse hears a loud moan coming from the
hallway. The nurse steps outside the room and sees a pregnant patient arriving on a
stretcher accompanied by a nurse from the emergency department. What is the first
priority for the nurse from the labor and delivery department? - ANS-Assess if delivery is
imminent.
A patient is being admitted for early labor at 40 weeks' gestation. She is gravida 2, para
1. When asked if she is leaking fluid or having bloody show, the patient mentions having
had a gush of fluid about 2 hours ago. What important question does the nurse then ask
the patient? - ANS-"Did you notice what color the fluid was?"
A 22-year-old African-American patient is being admitted to the labor unit for induction
of labor. She is gravida 1, para 0, and currently at 40 5/7 weeks' gestation. She is 150
cm (4 ft 11 in) tall and weighs 50 kg (110 lb). She admits to smoking two or three
cigarettes per day but denies use of alcohol or illegal substances. Her prenatal
laboratory tests show a hemoglobin level of 10 gm/dl and a hematocrit level of 30.6%.
Her blood type is O negative, and the serologic test for syphilis is nonreactive. Other
than coming to the unit for outpatient nonstress tests twice over the past week, she has
not been hospitalized during this pregnancy. The FHR today is 100 bpm with an
irregular rhythm; there are late decelerations. The patient's blood pressure is 144/86;
pulse, 88 bpm; respirations, 16 per minute; and temperature, 36.8°C (98.2°F). The
patient denies having pain. Which cluster of factors indicates an increased r - ANS-
Nonwhite race, height, smoking, anemia, category II (indeterminate) FHR
characteristics, and elevated blood pressure
, A 32-year-old pregnant patient is being admitted to the labor and delivery unit. She is
gravida 4, para 2, and at 39 weeks' gestation. While auscultating the lung and heart
sounds, the nurse notices a thin, yellowish discharge from the patient's right nipple. The
patient also notices it and comments, "I don't know what that is, but I have noticed it for
the last couple of months." What is the best way for the nurse to respond? - ANS-"It is
most likely colostrum, indicating your breasts are getting ready for the baby."
During the labor admission assessment, the nurse asks the patient if she has used
illegal drugs or herbal preparations. The patient glances at her family members and
then quickly denies using anything illegal. The patient becomes quiet, responding to the
nurse's questions with short answers. She begins to appear tense. What does this
behavior tell the nurse? - ANS-Sensitive questions should be asked while the patient is
alone.
1. A laboring gravida 2, para 1 is being cared for on the family birth unit. Her cervix is
currently 5 cm dilated and 100% effaced. The fetus is at -2 station and cephalic in a left
occiput anterior position. The patient calls the nurse to the room and reports a large
gush of fluid with her most recent contraction. The nurse assesses that the patient's
membranes are ruptured and that the amniotic fluid is green and watery. What is the
most important nursing intervention at this time? - ANS-Assess FHR to check for any
change in baseline or any abnormal patterns.
A 17-year-old primigravida is admitted in early labor. Her cervix is 2 to 3 cm dilated and
100% effaced. The fetus is cephalic, and the presenting part is at -1 station. The
patient's membranes are intact. The patient is holding her boyfriend's hand tightly and
breathing rapidly with each contraction. She tells the nurse in a shaky voice, "I'm so
nervous. I've never been in a hospital before. I don't know anything about labor or if I
can do this." What is an appropriate nursing diagnosis for this patient? - ANS-Anxiety
related to unfamiliar environment and lack of birth preparation
A primigravida at 40 weeks' gestation is admitted to the labor unit in latent labor. Her
prenatal history does not indicate any risk factors. Her initial vital signs are temperature
of 37.1°C (98.8°F); pulse, 86 bpm; respirations, 20; and blood pressure, 114/68 mm Hg.
She has been connected to external electronic monitoring for 1 hour. FHR baseline is
145 with moderate variability, the presence of accelerations, and absence of
decelerations. She is having contractions every 3 to 4 minutes, each lasting 40 to 60
seconds, mild to palpation, and with soft resting tone. What is an appropriate nursing
intervention at this point? - ANS-A. Encourage the patient to ambulate within the labor
unit.
4. The laboring patient has progressed to 5 cm dilation, and the fetal presenting part is
at +1 station. The patient is experiencing contractions every 3 minutes, lasting 60 to 90
seconds, and palpating moderate to strong with soft resting tone. The FHR pattern
demonstrates normal characteristics indicative of fetal well-being. The patient is having
difficulty relaxing between contractions and reports low back pain. She further states
