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OB Nursing-Q&A
OB Nursing-Q&A
1. You performed the leopold’s maneuver and found the following: breech
presentation, fetal back at the right side of the mother. Based on these
findings, you can hear the fetal heart beat (PMI) BEST in which location?
A. Left lower quadrant
B. Right lower quadrant
C. Left upper quadrant
D. Right upper quadrant
Answer: (B) The fundus of the uterus is high pushing the diaphragm
upwards
From the 32nd week of the pregnancy, the fundus of the enlarged uterus is
pushing the respiratory diaphragm upwards. Thus, the lungs have reduced
space for expansion consequently reducing the oxygen supply.
9. Which of the following findings in a woman would be consistent with a
pregnancy of two months duration?
A. Weight gain of 6-10 lbs. and presence of striae gravidarum
B. Fullness of the breast and urinary frequency
C. Braxton Hicks contractions and quickening
D. Increased respiratory rate and ballottement
13. When a pregnant woman experiences leg cramps, the correct nursing
intervention to relieve the muscle cramps is:
A. Allow the woman to exercise
B. Let the woman walk for a while
C. Let the woman lie down and dorsiflex the foot towards the knees
D. Ask the woman to raise her legs
Answer: (C) Let the woman lie down and dorsiflex the foot towards the
knees
Leg cramps is caused by the contraction of the gastrocnimeus (leg
muscle). Thus, the intervention is to stretch the muscle by dosiflexing the
foot of the affected leg towards the knee.
14. From the 33rd week of gestation till full term, a healthy mother should
have prenatal check up every:
A. week
B. 2 weeks
C. 3 weeks
D. 4 weeks
18. If the LMP is Jan. 30, the expected date of delivery (EDD) is
A. Oct. 7
B. Oct. 24
C. Nov. 7
D. Nov. 8
Answer: (A) The mother may have physiologic anemia due to the increased
need for red blood cell mass as well as the fetal requires about 350-400
mg of iron to grow
About 400 mgs of Iron is needed by the mother in order to produce more
RBC mass to be able to provide the needed increase in blood supply for the
fetus. Also, about 350-400 mgs of iron is need for the normal growth of the
fetus. Thus, about 750-800 mgs iron supplementation is needed by the
mother to meet this additional requirement.
22. The diet that is appropriate in normal pregnancy should be high in
A. Protein, minerals and vitamins
B. Carbohydrates and vitamins
C. Proteins, carbohydrates and fats
D. Fats and minerals
Answer: (C) Drink at least 2 liters of fluid 2 hours before the procedure and
not void until the procedure is done
Drinking at least 2 liters of water 2 hours before the procedure will result
to a distended bladder. A full bladder is needed when doing an abdominal
ultrasound to serve as a “window” for the ultrasonic sound waves to pass
through and allow visualization of the uterus (located behind the urinary
bladder).
27. The nursing intervention to relieve “morning sickness” in a pregnant
woman is by giving
A. Dry carbohydrate food like crackers
B. Low sodium diet
C. Intravenous infusion
D. Antacid
Answer: (A) Dry carbohydrate food like crackers
Morning sickness maybe caused by hypoglycemia early in the morning thus
giving carbohydrate food will help.
Answer: (B) G 5 P 3
Gravida refers to the total number of pregnancies including the current
one. Para refers to the number of pregnancies that have reached viability.
Thus, if the woman has had one abortion, she would be considered Para 3.
Twin pregnancy is counted only as 1.
30. The following are skin changes in pregnancy EXCEPT:
A. Chloasma
B. Striae gravidarum
C. Linea negra
D. Chadwick's sign
Answer: (B) Carbon monoxide binds with the hemoglobin of the mother
reducing available hemoglobin for the fetus
Carbon monoxide is one of the substances found in cigarette smoke. This
substance diminishes the ability of the hemoglobin to bind with oxygen
thus reducing the amount of oxygenated blood reaching the fetus.
35. Which of the following is the most likely effect on the fetus if the
woman is severely anemic during pregnancy?
A. Large for gestational age (LGA) fetus
B. Hemorrhage
C. Small for gestational age (SGA) baby
D. Erythroblastosis fetalis
Answer: (C) Position the mother on her side to allow the secretions to
drain from her mouth and prevent aspiration
Positioning the mother on her side will allow the secretions that may
accumulate in her mouth to drain by gravity thus preventing aspiration
pneumonia. Putting a mouth gag is not safe since during the convulsive
seizure the jaw will immediately lock. The mother may go into labor also
during the seizure but the immediate concern of the nurse is the safety of
the baby. After the seizure, check the perineum for signs of precipitate
labor.
39. A gravido-cardiac mother is advised to observe bedrest primarily to
A. Allow the fetus to achieve normal intrauterine growth
B. Minimize oxygen consumption which can aggravate the condition of the
compromised heart of the mother
C. Prevent perinatal infection
D. Reduce incidence of premature labor
Answer: (A) The internal exam is done only at the delivery under strict
asepsis with a double set-up
Painless vaginal bleeding during the third trimester maybe a sign of
placenta praevia. If internal examination is done in this kind of condition,
this can lead to even more bleeding and may require immediate delivery of
the baby by cesarean section. If the bleeding is due to soft tissue injury in
the birth canal, immediate vaginal delivery may still be possible so the set
up for vaginal delivery will be used. A double set-up means there is a set
up for cesarean section and a set-up for vaginal delivery to accommodate
immediately the necessary type of delivery needed. In both cases, strict
asepsis must be observed.
41. Which of the following signs will distinguish threatened abortion from
imminent abortion?
A. Severity of bleeding
B. Dilation of the cervix
C. Nature and location of pain
D. Presence of uterine contraction
Answer: (C) Lower segment of the uterus with the edges near the internal
cervical os
Placenta marginalis is a type of placenta previa wherein the placenta is
implanted at the lower segment of the uterus thus the edges of the
placenta are touching the internal cervical opening/os. The normal site of
placental implantation is the upper portion of the uterus.
45. In which of the following conditions can the causative agent pass
through the placenta and affect the fetus in utero?
A. Gonorrhea
B. Rubella
C. Candidiasis
D. moniliasis
Answer: (C) To make the delivery effort free and the mother does not need
to push with contractions
Forceps delivery under epidural anesthesia will make the delivery process
less painful and require less effort to push for the mother. Pushing
requires more effort which a compromised heart may not be able to
endure.
56. When giving narcotic analgesics to mother in labor, the special
consideration to follow is:
A. The progress of labor is well established reaching the transitional stage
B. Uterine contraction is progressing well and delivery of the baby is
imminent
C. Cervical dilatation has already reached at least 8 cm. and the station is
at least (+)2
D. Uterine contractions are strong and the baby will not be delivered yet
within the next 3 hours.
Answer: (D) Uterine contractions are strong and the baby will not be
delivered yet within the next 3 hours.
Narcotic analgesics must be given when uterine contractions are already
well established so that it will not cause stoppage of the contraction thus
protracting labor. Also, it should be given when delivery of fetus is
imminent or too close because the fetus may suffer respiratory depression
as an effect of the drug that can pass through placental barrier.
57. The cervical dilatation taken at 8:00 A.M. in a G1P0 patient was 6 cm. A
repeat I.E. done at 10 A.M. showed that cervical dilation was 7 cm. The
correct interpretation of this result is:
A. Labor is progressing as expected
B. The latent phase of Stage 1 is prolonged
C. The active phase of Stage 1 is protracted
D. The duration of labor is normal
Answer: (B) Strongly tugging on the umbilical cord to deliver the placenta
and hasten placental separation
When the placenta is still attached to the uterine wall, tugging on the cord
while the uterus is relaxed can lead to inversion of the uterus. Light
tugging on the cord when placenta has detached is alright in order to help
deliver the placenta that is already detached.
59. The fetal heart rate is checked following rupture of the bag of waters in
order to:
A. Check if the fetus is suffering from head compression
B. Determine if cord compression followed the rupture
C. Determine if there is utero-placental insufficiency
D. Check if fetal presenting part has adequately descended following the
rupture
Answer: (B) Determine if cord compression followed the rupture
After the rupture of the bag of waters, the cord may also go with the water
because of the pressure of the rupture and flow. If the cord goes out of the
cervical opening, before the head is delivered (cephalic presentation), the
head can compress on the cord causing fetal distress. Fetal distress can be
detected through the fetal heart tone. Thus, it is essential do check the
FHB right after rupture of bag to ensure that the cord is not being
compressed by the fetal head.
60. Upon assessment, the nurse got the following findings: 2 perineal pads
highly saturated with blood within 2 hours post partum, PR= 80 bpm,
fundus soft and boundaries not well defined. The appropriate nursing
diagnosis is:
A. Normal blood loss
B. Blood volume deficiency
C. Inadequate tissue perfusion related to hemorrhage
D. Hemorrhage secondary to uterine atony
Answer: (C) The pre-contraction FHR is 130 bpm, FHR during contraction is
118 bpm and FHR after uterine contraction is 126 bpm
The normal range of FHR is 120-160 bpm, strong and regular. During a
contraction, the FHR usually goes down but must return to its pre-
contraction rate after the contraction ends.
62. If the labor period lasts only for 3 hours, the nurse should suspect that
the following conditions may occur:
1.Laceration of cervix
2.Laceration of perineum
3.Cranial hematoma in the fetus
4.Fetal anoxia
A. 1 & 2
B. 2 & 4
C. 2,3,4
D. 1,2,3,4
Answer: (C) Put the tip of the fingers lightly on the fundal area and try to
indent the abdominal wall at the height of the contraction
In monitoring the intensity of the contraction the best place is to place the
fingertips at the fundal area. The fundus is the contractile part of the
uterus and the fingertips are more sensitive than the palm of the hand.
65. To monitor the frequency of the uterine contraction during labor, the
right technique is to time the contraction
A. From the beginning of one contraction to the end of the same
contraction
B. From the beginning of one contraction to the beginning of the next
contraction
C. From the end of one contraction to the beginning of the next contraction
D. From the deceleration of one contraction to the acme of the next
contraction
Answer: (B) From the beginning of one contraction to the beginning of the
next contraction
Frequency of the uterine contraction is defined as from the beginning of
one contraction to the beginning of another contraction.
66. The peak point of a uterine contraction is called the
A. Acceleration
B. Acme
C. Deceleration
D. Axiom
Answer: (A) The beginning of one contraction to the end of the same
contraction
Duration of a uterine contraction refers to one contraction. Thus it is
correctly measure from the beginning of one contraction to the end of the
same contraction and not of another contraction.
68. When the bag of waters ruptures, the nurse should check the
characteristic of the amniotic fluid. The normal color of amniotic fluid is
A. Clear as water
B. Bluish
C. Greenish
D. Yellowish
Answer: (C) Cover the prolapse cord with sterile gauze wet with sterile
NSS and place the woman on trendellenberg position
The correct action of the nurse is to cover the cord with sterile gauze wet
with sterile NSS. Observe strict asepsis in the care of the cord to prevent
infection. The cord has to be kept moist to prevent it from drying. Don’t
attempt to put back the cord into the vagina but relieve pressure on the
cord by positioning the mother either on trendellenberg or sims position
70. The fetal heart beat should be monitored every 15 minutes during the
2nd stage of labor. The characteristic of a normal fetal heart rate is
A. The heart rate will decelerate during a contraction and then go back to
its pre-contraction rate after the contraction
B. The heart rate will accelerate during a contraction and remain slightly
above the pre-contraction rate at the end of the contraction
C. The rate should not be affected by the uterine contraction.
D. The heart rate will decelerate at the middle of a contraction and remain
so for about a minute after the contraction
Answer: (A) The heart rate will decelerate during a contraction and then
go back to its pre-contraction rate after the contraction
The normal fetal heart rate will decelerate (go down) slightly during a
contraction because of the compression on the fetal head. However, the
heart rate should go back to the pre-contraction rate as soon as the
contraction is over since the compression on the head has also ended.
Answer: (A) Suction the nose and mouth to remove mucous secretions
Suctioning the nose and mouth of the fetus as soon as the head is
delivered will remove any obstruction that maybe present allowing for
better breathing. Also, if mucus is in the nose and mouth, aspiration of the
mucus is possible which can lead to aspiration pneumonia. (Remember
that only the baby’s head has come out as given in the situation.)
74. When doing perineal care in preparation for delivery, the nurse should
observe the following EXCEPT
A. Use up-down technique with one stroke
B. Clean from the mons veneris to the anus
C. Use mild soap and warm water
D. Paint the inner thighs going towards the perineal area
Answer: (D) Paint the inner thighs going towards the perineal area
Painting of the perineal area in preparation for delivery of the baby must
always be done but the stroke should be from the perineum going
outwards to the thighs. The perineal area is the one being prepared for the
delivery and must be kept clean
75. What are the important considerations that the nurse must remember
after the placenta is delivered?
1.Check if the placenta is complete including the membranes
2.Check if the cord is long enough for the baby
3.Check if the umbilical cord has 3 blood vessels
4.Check if the cord has a meaty portion and a shiny portion
A. 1 and 3
B. 2 and 4
C. 1, 3, and 4
D. 2 and 3
77. The passageway in labor and deliver of the fetus include the following
EXCEPT
A. Distensibility of lower uterine segment
B. Cervical dilatation and effacement
C. Distensibility of vaginal canal and introitus
D. Flexibility of the pelvis
80. The second stage of labor begins with ___ and ends with __?
A. Begins with full dilatation of cervix and ends with delivery of placenta
B. Begins with true labor pains and ends with delivery of baby
C. Begins with complete dilatation and effacement of cervix and ends with
delivery of baby
D. Begins with passage of show and ends with full dilatation and
effacement of cervix
Answer: (C) Begins with complete dilatation and effacement of cervix and
ends with delivery of baby
Stage 2 of labor and delivery process begins with full dilatation of the
cervix and ends with the delivery of baby. Stage 1 begins with true labor
pains and ends with full dilatation and effacement of the cervix.
81. The following are signs that the placenta has detached EXCEPT:
A. Lengthening of the cord
B. Uterus becomes more globular
C. Sudden gush of blood
D. Mother feels like bearing down
Answer: (B) Oxytocin can make the cervix close and thus trap the placenta
inside
The action of oxytocin is to make the uterus contract as well make the
cervix close. If it is given prior to placental delivery, the placenta will be
trapped inside because the action of the drug is almost immediate if given
parentally.
88. In a gravido-cardiac mother, the first 2 hours postpartum (4th stage of
labor and delivery) particularly in a cesarean section is a critical period
because at this stage
A. There is a fluid shift from the placental circulation to the maternal
circulation which can overload the compromised heart.
B. The maternal heart is already weak and the mother can die
C. The delivery process is strenuous to the mother
D. The mother is tired and weak which can distress the heart
Answer: (A) There is a fluid shift from the placental circulation to the
maternal circulation which can overload the compromised heart.
During the pregnancy, there is an increase in maternal blood volume to
accommodate the need of the fetus. When the baby and placenta have
been delivered, there is a fluid shift back to the maternal circulation as
part of physiologic adaptation during the postpartum period. In cesarean
section, the fluid shift occurs faster because the placenta is taken out right
after the baby is delivered giving it less time for the fluid shift to gradually
occur.
89. The drug usually given parentally to enhance uterine contraction is:
A. Terbutalline
B. Pitocin
C. Magnesium sulfate
D. Lidocaine
99. The placenta should be delivered normally within ___ minutes after the
delivery of the baby.
A. 5 minutes
B. 30 minutes
C. 45 minutes
D. 60 minutes
A. 1.0 cm
B. 2.0 cm
C. 2.5 cm
D. 3.0 cm
Answer: (B) Prevent the mother from producing antibodies against the
Rh(+) antigen that she may have gotten when she delivered to her Rh(+)
baby
In Rh incompatibility, an Rh(-) mother will produce antibodies against the
fetal Rh (+) antigen which she may have gotten because of the mixing of
maternal and fetal blood during labor and delivery. Giving her RhoGam
right after birth will prevent her immune system from being permanently
sensitized to Rh antigen.
105. To enhance milk production, a lactating mother must do the following
interventions EXCEPT:
A. Increase fluid intake including milk
B. Eat foods that increases lactation which are called galactagues
C. Exercise adequately like aerobics
D. Have adequate nutrition and rest
Answer: (C) Exercise adequately like aerobics
All the above nursing measures are needed to ensure that the mother is in
a healthy state. However, aerobics does not necessarily enhance lactation.
106. The nursing intervention to relieve pain in breast engorgement while
the mother continues to breastfeed is
A. Apply cold compress on the engorged breast
B. Apply warm compress on the engorged breast
C. Massage the breast
D. Apply analgesic ointment
Answer: (A) Breast feed the baby on self-demand day and night
Feeding on self-demand means the mother feeds the baby according to
baby’s need. Therefore, this means there will be regular emptying of the
breasts, which is essential to maintain adequate lactation.
109. An appropriate nursing intervention when caring for a postpartum
mother with thrombophlebitis is:
A. Encourage the mother to ambulate to relieve the pain in the leg
B. Instruct the mother to apply elastic bondage from the foot going
towards the knee to improve venous return flow
C. Apply warm compress on the affected leg to relieve the pain
D. Elevate the affected leg and keep the patient on bedrest
Answer: (D) Elevate the affected leg and keep the patient on bedrest
If the mother already has thrombophlebitis, the nursing intervention is
bedrest to prevent the possible dislodging of the thrombus and keeping the
affected leg elevated to help reduce the inflammation.
110. The nurse should anticipate that hemorrhage related to uterine atony
may occur postpartally if this condition was present during the delivery:
A. Excessive analgesia was given to the mother
B. Placental delivery occurred within thirty minutes after the baby was
born
C. An episiotomy had to be done to facilitate delivery of the head
D. The labor and delivery lasted for 12 hours
Answer: (C) Massage the fundus vigorously for 15 minutes until contracted
Massaging the fundus of the uterus should not be vigorous and should only
be done until the uterus feel firm and contracted. If massaging is vigorous
and prolonged, the uterus will relax due to over stimulation.
120. The following are nursing interventions to relieve episiotomy wound
pain EXCEPT
A. Giving analgesic as ordered
B. Sitz bath
C. Perineal heat
D. Perineal care
Answer: (A) The fetal lungs are non-functioning as an organ and most of
the blood in the fetal circulation is mixed blood.
The fetal lungs is fluid-filled while in utero and is still not functioning. It
only begins to function in extra uterine life. Except for the blood as it
enters the fetus immediately from the placenta, most of the fetal blood is
mixed blood.
123. The normal respiration of a newborn immediately after birth is
characterized as:
A. Shallow and irregular with short periods of apnea lasting not longer
than 15 seconds, 30-60 breaths per minute
B. 20-40 breaths per minute, abdominal breathing with active use of
intercostals muscles
C. 30-60 breaths per minute with apnea lasting more than 15 seconds,
abdominal breathing
D. 30-50 breaths per minute, active use of abdominal and intercostal
muscles
Answer: (A) Shallow and irregular with short periods of apnea lasting not
longer than 15 seconds, 30-60 breaths per minute
A newly born baby still is adjusting to xtra uterine life and the lungs are
just beginning to function as a respiratory organ. The respiration of the
baby at this time is characterized as usually shallow and irregular with
short periods of apnea, 30-60 breaths per minute. The apneic periods
should be brief lasting not more than 15 seconds otherwise it will be
considered abnormal.
124. The anterior fontanelle is characterized as:
A. 3-4 cm antero-posterior diameter and 2-3 cm transverse diameter,
diamond shape
B. 2-3 cm antero-posterior diameter and 3-4 cm transverse diameter and
diamond shape
C. 2-3 cm in both antero-posterior and transverse diameter and diamond
shape
D. none of the above
127. Right after birth, when the skin of the baby’s trunk is pinkish but the
soles of the feet and palm of the hands are bluish this is called:
A. Syndactyly
B. Acrocyanosis
C. Peripheral cyanosis
D. Cephalo-caudal cyanosis
128. The minimum birth weight for full term babies to be considered
normal is:
A. 2,000gms
B. 1,500gms
C. 2,500gms
D. 3,000gms
In basal body temperature (BBT) technique, the sign that ovulation has
occurred is an elevation of body temperature by
Answer: (B) The mother breastfeeds exclusively and regularly during the
first 6 months without giving supplemental feedings
A mother who breastfeeds exclusively and regularly during the first 6
months benefits from lactation amenorrhea. There is evidence to support
the observation that the benefits of lactation amenorrhea lasts for 6
months provided the woman has not had her first menstruation since
delivery of the baby.
134. Intra-uterine device prevents pregnancy by the ff. mechanism EXCEPT
A. Endometrium inflames
B. Fundus contracts to expel uterine contents
C. Copper embedded in the IUD can kill the sperms
D. Sperms will be barred from entering the fallopian tubes
Answer: (D) Sperms will be barred from entering the fallopian tubes
An intrauterine device is a foreign body so that if it is inserted into the
uterine cavity the initial reaction is to produce inflammatory process and
the uterus will contract in order to try to expel the foreign body. Usually
IUDs are coated with copper to serve as spermicide killing the sperms
deposited into the female reproductive tract. But the IUD does not
completely fill up the uterine cavity thus sperms which are microscopic is
size can still pass through.
135. Oral contraceptive pills are of different types. Which type is most
appropriate for mothers who are breastfeeding?
A. Estrogen only
B. Progesterone only
C. Mixed type- estrogen and progesterone
D. 21-day pills mixed type
1. Mittelschmerz;
2. Spinnabarkeit;
3. Thin watery cervical mucus;
4. Elevated body temperature of 4.0 degrees centigrade
A. 1 & 2
B. 1, 2, & 3
C. 3 & 4
D. 1, 2, 3, 4
Answer: (B) It may occur between 14-16 days before next menstruation
Not all menstrual cycles are ovulatory. Normal ovulation in a woman
occurs between the 14th to the 16th day before the NEXT menstruation. A
common misconception is that ovulation occurs on the 14th day of the
cycle. This is a misconception because ovulation is determined NOT from
the first day of the cycle but rather 14-16 days BEFORE the next
menstruation.
140. If a couple would like to enhance their fertility, the following means
can be done:
A. 1 only
B. 1 & 4
C. 1,2,4
D. 1,2,3,4
142. The following are important considerations to teach the woman who
is on low dose (mini-pill) oral contraceptive EXCEPT:
A. The pill must be taken everyday at the same time
B. If the woman fails to take a pill in one day, she must take 2 pills for
added protection
C. If the woman fails to take a pill in one day, she needs to take another
temporary method until she has consumed the whole pack
D. If she is breast feeding, she should discontinue using mini-pill and use
the progestin-only type
Answer: (B) If the woman fails to take a pill in one day, she must take 2
pills for added protection
If the woman fails to take her usual pill for the day, taking a double dose
does not give additional protection. What she needs to do is to continue
taking the pills until the pack is consumed and use at the time another
temporary method to ensure that no pregnancy will occur. When a new
pack is started, she can already discontinue using the second temporary
method she employed.
143. To determine if the cause of infertility is a blockage of the fallopian
tubes, the test to be done is
A. Huhner’s test
B. Rubin’s test
C. Postcoital test
D. None of the above
Answer: (A) Thin watery mucus which can be stretched into a long strand
about 10 cm
At the midpoint of the cycle when the estrogen level is high, the cervical
mucus becomes thin and watery to allow the sperm to easily penetrate and
get to the fallopian tubes to fertilize an ovum. This is called spinnabarkeit.
And the woman feels “wet”. When progesterone is secreted by the ovary,
the mucus becomes thick and the woman will feel “dry”.
146. Vasectomy is a procedure done on a male for sterilization. The organ
involved in this procedure is
A. Prostate gland
B. Seminal vesicle
C. Testes
D. Vas deferens
Answer: (B) Any day of the month as long it is regularly observed on the
same day every month
Menopausal women still need to do self examination of the breast
regularly. Any day of the month is alright provided that she practices it
monthly on the same day that she has chosen. The hormones estrogen and
progesterone are already diminished during menopause so there is no
need to consider the time to do it in relation to the menstrual cycle.