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OB Final Review

Total questions: 75

Worksheet time: 53mins

Name
Class
Date
1.

Which of the following is the priority assessment immediately after the rupture of membranes?

a)

Fetal heart rate

b)

Maternal temperature

c)

Degree of dilation

d)

Frequency of contractions

2.

A nurse is caring for a client at 30 weeks gestation with signs of preterm labor. Which medication might be given to promote fetal lung maturity?

a)

Oxytocin

b)

Betamethasone

c)

Magnesium sulfate

d)

Misoprostol

3.

Which fetal position is most favorable for vaginal delivery?

a)

Occiput posterior

b)

Occiput anterior

c)

Breech

d)

Transverse

4.

What is the purpose of Leopold's maneuvers?

a)

To assess cervical dilation

b)

To determine fetal presentation and position

c)

To measure uterine contractions

d)

To assess amniotic fluid levels

5.

Which signs and symptoms are associated with preeclampsia?

a)

Proteinuria

b)

Headache

c)

Hypotension

d)

Blurred vision

e)

Epigastric pain

6.

What should the nurse include in postpartum education for a client after a C-section?

a)

Encourage ambulation

b)

Avoid lifting more than 10 lbs

c)

No driving for 2 weeks

d)

Report signs of infection

e)

Begin abdominal exercises immediately

7.

Which are signs of true labor?

a)

Cervical change

b)

Contractions that go away with rest

c)

Contractions felt in the back and abdomen

d)

Membrane rupture

e)

Fundal height increase

8.

At what gestational age does the fundus typically reach the umbilicus?

a)

12 weeks

b)

16 weeks

c)

20 weeks

d)

24 weeks

9.

Which milestones are matched with the correct gestational weeks? (SATA)

a)

Fetal heart tones heard with Doppler at 10-12 weeks

b)

Quickening felt around 28 weeks

c)

Viability usually considered at 24 weeks

d)

Neural tube closes by 12 weeks

e)

Surfactant production begins around 28 weeks

10.

How much folic acid should a woman of childbearing age consume daily to prevent neural tube defects?

a)

100 mcg

b)

200 mcg

c)

400 mcg

d)

800 mcg

11.

Which foods should be avoided during pregnancy due to risk of listeria or high mercury? (SATA)

a)

Sushi

b)

Unpasteurized cheese

c)

Cooked eggs

d)

Swordfish

e)

Deli meats

12.

Which test is done between 11-14 weeks to detect Down Syndrome and other trisomy disorders (13. 18, 21)?

a)

Non-stress test

b)

Group B strep swab

c)

Nuchal Translucent Testing

d)

Chorionic villus sampling

13.

Which are components of a Biophysical Profile? (SATA)

a)

Fetal tone

b)

Amniotic fluid volume

c)

Placental location

d)

Fetal movement

e)

Fetal breathing

14.

Which are common signs of gestational diabetes? (SATA)

a)

Polyuria

b)

Headache

c)

Polydipsia

d)

Glucosuria

e)

Weight loss

15.

Group B strep is screened at 35–37 weeks gestation.

a)

True

b)

False

16.

A woman with preeclampsia is admitted. Which orders would you anticipate? (SATA)

a)

Magnesium sulfate

b)

Continuous fetal monitoring

c)

Seizure precautions

d)

High-sodium diet

e)

Vital signs q4h

17.

Which signs suggest that a woman is in the transition phase of labor? (SATA)

a)

Cervical dilation 8–10 cm

b)

Strong urge to push

c)

Mild contractions every 10 minutes

d)

Nausea and vomiting

e)

Irritability

18.

What is the normal range for a newborn's Apgar score at 1 minute?

a)

0–2

b)

4–6

c)

7–10

d)

10–12

19.

When should Rho(D) immune globulin (RhoGAM) be administered? (SATA)

a)

Within 72 hours postpartum if baby is Rh+ and mom is Rh–

b)

At 28 weeks gestation for Rh– mothers

c)

After miscarriage or trauma

d)

Only if the mother is Rh+

e)

Given to all mothers regardless of blood type

20.

Which of the following are normal findings in a newborn? (SATA)

a)

Acrocyanosis

b)

Mottled skin

c)

Meconium within 24–48 hours

d)

Bilateral clear breath sounds

e)

A positive Babinski reflex

21.

A firm, midline uterus is a sign of uterine atony.

a)

True

b)

False

22.

Which hormone is responsible for maintaining the endometrial lining in early pregnancy?

a)

Estrogen

b)

Progesterone

c)

hCG

d)

Oxytocin

23.

Human chorionic gonadotropin (hCG) is primarily produced by the:

a)

Pituitary gland

b)

Corpus luteum

c)

Placenta

d)

Hypothalamus

24.

Which hormones increase joint laxity and prepare the pelvis for labor? (SATA)

a)

Relaxin

b)

Estrogen

c)

Oxytocin

d)

Prolactin

e)

Progesterone

25.

Which of the following are presumptive signs of pregnancy? (SATA)

a)

Amenorrhea

b)

Chadwick’s sign

c)

Quickening

d)

Positive pregnancy test

e)

Breast tenderness

26.

Which of the following are positive signs of pregnancy? (SATA)

a)

Fetal movement felt by the mother

b)

Fetal heart tones on Doppler

c)

Visualization of fetus via ultrasound

d)

Braxton Hicks contractions

e)

Palpation of fetal movement by examiner

27.

A woman’s last menstrual period was July 10. What is her estimated due date using Naegele’s Rule?

a)

March 10

b)

April 3

c)

April 17

d)

May 3

28.

Which test measures the nuchal translucency to assess chromosomal abnormalities in the first trimester?

a)

Amniocentesis

b)

Chorionic villus sampling (CVS)

c)

Nuchal translucency test (NTT)

d)

Alpha-fetoprotein

29.

The biophysical profile (BPP) includes which of the following components? (SATA)

a)

Non-stress test

b)

Amniotic fluid volume

c)

Fetal tone

d)

Umbilical cord pH

e)

Fetal breathing movements

30.

Which of the following is true about contraction stress testing (CST)?

a)

A positive CST means fetal well-being

b)

Oxytocin or nipple stimulation is used

c)

It is preferred over the non-stress test

d)

It is done before 20 weeks gestation

31.

Which are accurate descriptions of amniocentesis? (SATA)

a)

Performed between 15–20 weeks for genetic testing

b)

Assesses fetal lung maturity in third trimester

c)

Involves removal of amniotic fluid

d)

Done via cervical approach

e)

Associated with risk of miscarriage

32.

Chorionic villus sampling (CVS) differs from amniocentesis in that:

a)

It is done later in pregnancy

b)

It has no risk of limb defects

c)

It samples placental tissue

d)

It is used to assess lung maturity

33.

PUBS (Percutaneous Umbilical Blood Sampling) is most often used to:

a)

Check for gestational diabetes

b)

Monitor fetal blood gases and infections

c)

Screen for Down syndrome

d)

Measure fetal heart rate

34.

An elevated maternal serum alpha-fetoprotein (MSAFP) may indicate: (SATA)

a)

Neural tube defects

b)

Down syndrome

c)

Multiple gestation

d)

Fetal demise

e)

Ectopic pregnancy

35.

Variable is defined as fluctuations in the fetal heart rate.

a)

True

b)

False

36.

Which are true about maternal serum alpha-fetoprotein (MSAFP)? (SATA)

a)

Ideally done between 16–18 weeks

b)

It is diagnostic

c)

Abnormal results require follow-up

d)

It screens for trisomy 18 and 21

37.

Which are signs of a placenta previa? (SATA)

a)

Bright red vaginal bleeding

b)

Painless bleeding

c)

Uterine tenderness

d)

Soft, relaxed uterus

e)

Bleeding after 20 weeks

38.

Which statement about abruptio placentae is correct?

a)

It causes painless bleeding

b)

It’s always managed expectantly

c)

It presents with a firm, tender uterus

d)

It occurs in the first trimester

39.

What are common complications of hyperemesis gravidarum? (SATA)

a)

Dehydration

b)

Electrolyte imbalance

c)

Fetal macrosomia

d)

Ketosis

e)

Weight loss

40.

What medication is commonly used to treat hyperemesis gravidarum around the clock?

a)

Diclegis

b)

Ondansetron

c)

Oxytocin

d)

Magnesium sulfate

41.

Which are characteristics of uterine tachysystole? (SATA)

a)

More than 5 contractions in 10 minutes

b)

Increased fetal variability

c)

May be caused by Pitocin

d)

Leads to fetal hypoxia

e)

Requires immediate C-section

42.

Although a fetus is relatively protected in the mother’s womb, a number of different toxins can harm the fetus. These include lead, mercury, illegal drugs, and many other substances. How do toxins usually reach the developing fetus?

a)

by diffusion across the placental membrane

b)

by osmosis across the placental membrane

c)

by blood flow from the mother to the fetus

d)

Through the umbilical cord

43.

In weeks 29-36 of pregnancy the woman should expect prenatal visits to occur:

a)

Every week

b)

Every 2 weeks

c)

Every 4 weeks

44.

Oxytocin: first-line use for post partum bleeding and or hemorrhage

a)

False

b)

True

45.

A client is about 16 weeks pregnant and is concerned because she feels her abdomen contracting. She calls the primary care providers office and speaks to the nurse. What is the most appropriate response to this clients concern?

a)

What you are feeling are called Braxton Hicks contractions. They are considered practice contractions during pregnancy.

b)

You need to report to the emergency room immediately

c)

Are you experiencing any bleeding, or discharge?

d)

Have you been exposed to any STI's?

46.

During an examination a client at 32 weeks pregnant becomes dizzy, light headed, and pale while supine. What is the priority action of the nurse?

a)

Raise the head of the bed to 30 degrees

b)

Assess the clients vital signs

c)

Turn patient on left side

47.

A pregnant client reports an increase in a thick whitish vaginal discharge. Which response by the nurse would be most appropriate?

a)

Ask the client if there is a possibility of an STI

b)

Inform the client that the provider will need to do a vaginal exam.

c)

Inform the client that this discharge is normal during pregnancy

48.

A client in her 2nd trimester of pregnancy is anxious about the blotchy, brown pigmentation appearing on her forehead and cheeks. She also reports increased pigmentation on her breasts and genitalia. Which statement by the nurse is most appropriate?

a)

You need to adjust your skin care routine during pregnancy.

b)

This is called facial melasma (chloasma) and should fade after birth.

c)

Use hypoallergenic soap and lotions to reduce the discolorations.

49.

Meconium-stained amniotic fluid is always an emergency.

a)

True

b)

False

50.

The height of the clients fundus is 24 cm. Approximately how many weeks pregnant would this client be?

a)

20 weeks

b)

22 weeks

c)

24 weeks

d)

30 weeks

51.

SATA

Which are POSITIVE signs of pregnancy?

a)

A softened cervix

b)

Electronic device detects fetal heart rate.

c)

Ultra Sound detects baby

d)

Fetal movement palpated by Dr. or Nurse.

e)

A softened cervix

52.

Early decelerations:

a)

An abrupt decrease in fetal hear rate below the baseline with the onset to the lowest point lasting less than 30seconds

b)

A gradual decrease in fetal heart rate with an onset to the lowest point that is greater than or equal to 30 seconds with a return to baseline associated with a contraction.

53.

Accelerations are reassuring and means the baby is well oxygenated.

a)

True

b)

False

54.

Magnesium sulfate is used to stop contractions during preterm labor and prevent seizures in preeclampsia.

a)

True

b)

False

55.

A reactive non-stress test includes at least 2 fetal heart rate accelerations in 20 minutes.

a)

True

b)

False

56.

Lochia rubra should last up to 2 weeks postpartum.

a)

True

b)

False

57.

A hypotonic labor pattern is best described as:

a)

Strong contractions with no dilation

b)

Infrequent, weak contractions

c)

A medical emergency

d)

Frequent, painful contractions with rapid dilation

58.

Which drugs are used as tocolytics? (SATA)

a)

Terbutaline

b)

Nifedipine

c)

Magnesium sulfate

d)

Oxytocin

59.

Which are diagnostic criteria for preeclampsia? (SATA)

a)

BP ≥ 140/90 after 20 weeks

b)

Proteinuria or signs of organ damage

c)

Seizures

d)

Edema in ankles

60.

Eclampsia differs from preeclampsia in that the patient has:

a)

elevated liver enzymes

b)

hypertension

c)

proteinuria

d)

seizures

61.

Which are components of HELLP syndrome? (SATA)

a)

Hemolysis

b)

Elevated liver enzymes

c)

Low platelets

d)

Hyperglycemia

e)

Hyponatremia

62.

ABO incompatibility usually affects infants with which maternal blood type?

a)

Type AB

b)

Type A

c)

Type B

d)

Type O

63.

TORCH infections include: (SATA)

a)

Toxoplasmosis

b)

Osteomyelitis

c)

Rubella

d)

Cytomegalovirus

e)

Herpes simplex virus

64.

Which TORCH infection is associated with cat litter exposure and can cause hydrocephalus and chorioretinitis?

a)

Rubella

b)

Cytomegalovirus

c)

Toxoplasmosis

d)

HSV

65.

Which factors affect the "Passenger" in labor? (SATA)

a)

fetal attitude

b)

fetal presentation

c)

fetal station

d)

uterine contractions

e)

fetal lie

66.

Which pelvic type is most favorable for vaginal delivery?

a)

Android

b)

Antropoid

c)

Platypelloid

d)

Gynecoid

67.

True signs of labor include: (SATA)

a)

Cervical effacement and dilation

b)

Irregular contractions

c)

Bloody show

d)

Contractions that stop with rest

e)

Rupture of membranes

68.

A fetal station of 0 means the fetal head is at the:

a)

uterine fundus

b)

pelvic inlet

c)

ischial spines

d)

perineum

69.

List the Stage number for each following event: Delivery of placenta, Recovery period, onset of labor to 10cm, 10cm to delivery of baby (separate numbers by commas)

(a)  

70.

A second-degree laceration involves:

a)

Only vaginal mucosa

b)

Perineal skin and muscle

c)

Anal sphincter

d)

Rectal wall

71.

Which are true regarding external fetal monitoring (EFM)? (SATA)

a)

Uses ultrasound transducer

b)

Can measure contraction intensity

c)

Noninvasive

d)

Cannot detect baseline variability

e)

Used in intermittent or continuous formats

72.

Internal monitoring includes which methods? (SATA)

a)

Fetal scalp electrode (FSE)

b)

Intrauterine pressure catheter (IUPC)

c)

Tocotransducer

d)

External cephalic version

e)

Requires ruptured membranes

73.

External cephalic version is used to:

a)

Turn breech baby to vertex

b)

Flip posterior baby to anterior

c)

Start labor

d)

Manage shoulder dystocia

74.

Which Bishop score indicates the cervix is favorable for induction?

a)

<4

b)

5–6

c)

≥8

d)

3

75.

Which are common indications for C-section? (SATA)

a)

Placenta previa

b)

Fetal distress

c)

Active genital herpes

d)

Cephalopelvic disproportion (CPD)

e)

Preeclampsia with stable BP