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Obstetrics and Gynecology Multiple Choice Questions and Answers, Exams of Nursing

Western Washington University (WWU)Nursing

A series of multiple choice questions and answers related to obstetrics and gynecology, focusing on topics such as gestational trophoblastic disease, gestational hypertension, spontaneous abortion, ectopic pregnancy, rh isoimmunization, preeclampsia, hyperemesis gravidarum, and hellp syndrome. each question is followed by the correct answer and a detailed rationale, making it a valuable resource for students and professionals in the field. The questions cover a range of complexities, from basic definitions to more nuanced clinical scenarios.

Typology: Exams

2024/2025

Available from 05/02/2025

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RICCI CHAPTER 19 - TEST BANK - 4TH EDITION
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES
1. After teaching a woman who has had an evacuation for gestational trophoblastic disease
(hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the
nurse's teaching was successful?
A. "I will be sure to avoid getting pregnant for at least 1 year."
B. "My intake of iron will have to be closely monitored for 6 months."
C. "My blood pressure will continue to be increased for about 6 more months."
D. "I won't use my birth control pills for at least a year or two."
Answer: A
Rationale: After evacuation of trophoblastic tissue (hydatiform mole), long-term follow-up is
necessary to make sure any remaining trophoblastic tissue does not become malignant. Serial
hCG levels are monitored closely for 1 year, and the client is urged to avoid pregnancy for 1 year
because it can interfere with the monitoring of hCG levels. Iron intake and blood pressure are not
important aspects of follow up after evacuation of a hydatiform mole. Use of a reliable
contraceptive is strongly recommended so that pregnancy is avoided.
2. A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. The
nurse determines that the medication is at a therapeutic level based on which finding?
A. urinary output of 20 mL per hour
B. respiratory rate of 10 breaths/minute
C. deep tendons reflexes 2+
D. difficulty in arousing
Answer: C
Rationale: With magnesium sulfate, deep tendon reflexes of 2+ would be considered normal and
therefore a therapeutic level of the drug. Urinary output of less than 30 mL, a respiratory rate of
less than 12 breaths/minute, and a diminished level of consciousness would indicate magnesium
toxicity.
3. Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the
client crying. Which response by the nurse would be most appropriate?
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Download Obstetrics and Gynecology Multiple Choice Questions and Answers and more Exams Nursing in PDF only on Docsity!

RICCI CHAPTER 19 - TEST BANK - 4TH EDITION

QUESTIONS AND CORRECT ANSWERS WITH

RATIONALES

  1. After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful? A. "I will be sure to avoid getting pregnant for at least 1 year." B. "My intake of iron will have to be closely monitored for 6 months." C. "My blood pressure will continue to be increased for about 6 more months." D. "I won't use my birth control pills for at least a year or two." Answer: A Rationale: After evacuation of trophoblastic tissue (hydatiform mole), long-term follow-up is necessary to make sure any remaining trophoblastic tissue does not become malignant. Serial hCG levels are monitored closely for 1 year, and the client is urged to avoid pregnancy for 1 year because it can interfere with the monitoring of hCG levels. Iron intake and blood pressure are not important aspects of follow up after evacuation of a hydatiform mole. Use of a reliable contraceptive is strongly recommended so that pregnancy is avoided.
  2. A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. The nurse determines that the medication is at a therapeutic level based on which finding? A. urinary output of 20 mL per hour B. respiratory rate of 10 breaths/minute C. deep tendons reflexes 2+ D. difficulty in arousing Answer: C Rationale: With magnesium sulfate, deep tendon reflexes of 2+ would be considered normal and therefore a therapeutic level of the drug. Urinary output of less than 30 mL, a respiratory rate of less than 12 breaths/minute, and a diminished level of consciousness would indicate magnesium toxicity.
  3. Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which response by the nurse would be most appropriate?

A. "Why are you crying?" B. "Will a pill help your pain?" C. "I'm sorry you lost your baby." D. "A baby still wasn't formed in your uterus." Answer: C Rationale: Telling the client that the nurse is sorry for the loss acknowledges the loss to the woman, validates her feelings, and brings the loss into reality. Asking why the client is crying is ineffective at this time. Offering a pill for the pain ignores the client's feelings. Telling the client that the baby was not formed is inappropriate and discounts any feelings or beliefs that the client has.

  1. A nurse is reviewing a client's history and physical examination findings. Which information would the nurse identify as contributing to the client's risk for an ectopic pregnancy? A. use of oral contraceptives for 5 years B. ovarian cyst 2 years ago C. recurrent pelvic infections D. heavy, irregular menses Answer: C Rationale: In the general population, most cases of ectopic pregnancy are the result of tubal scarring secondary to pelvic inflammatory disease. Oral contraceptives, ovarian cysts, and heavy, irregular menses are not considered risk factors for ectopic pregnancy.
  2. A client is suspected of having a ruptured ectopic pregnancy. Which assessment would the nurse identify as the priority? A. hemorrhage B. jaundice C. edema D. infection Answer A Rationale: With a ruptured ectopic pregnancy, the woman is at high risk for hemorrhage. Jaundice, edema, and infection are not associated with a ruptured ectopic pregnancy.
  3. It is determined that a client's blood Rh is negative and her partner's is Rh positive. To help prevent Rh isoimmunization, the nurse would expect to administer Rho(D) immune globulin at which time? A. at 32 weeks' gestation and immediately before discharge

C. nothing by mouth D. administration of labetalol Answer: C Rationale: Typically, on admission, the woman with hyperemesis has oral food and fluids withheld to rest the gut and receives parenteral fluids to rehydrate and reduce the symptoms. Once the condition stabilizes, oral intake is gradually increased. Total parenteral nutrition may be used if the client's condition does not improve with several days of bed rest, gut rest, IV fluids, and antiemetics. Labetalol is an antihypertensive agent that may be used to treat gestational hypertension, not hyperemesis.

  1. A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? A. hyperglycemia B. elevated platelet count C. disseminated intravascular coagulation (DIC) D. elevated liver enzymes Answer: D Rationale: HELLP is an acronym for hemolysis, elevated liver enzymes, and low platelets. Hyperglycemia is not a part of this syndrome. HELLP may increase the woman's risk for DIC but it is not an assessment finding.
  2. A client with severe preeclampsia is receiving magnesium sulfate as part of the treatment plan. To ensure the client's safety, which compound would the nurse have readily available? A. calcium gluconate B. potassium chloride C. ferrous sulfate D. calcium carbonate Answer: A Rationale: The woman is at risk for magnesium toxicity. The antidote for magnesium sulfate is calcium gluconate, and this should be readily available in case the woman has signs and symptoms of magnesium toxicity.
  3. A nurse is conducting an assessment of a woman who has experienced PROM. Which amniotic fluid finding would lead the nurse to suspect infection as the cause of a client's PROM? A. yellow-green fluid B. blue color on Nitrazine testing

C. ferning D. foul odor Answer: D Rationale: A foul odor of the amniotic fluid indicates infection. Yellow-green fluid would suggest meconium. A blue color on Nitrazine testing and ferning indicate the presence of amniotic fluid.

  1. The nurse is reviewing the laboratory test results of a pregnant client. Which finding would alert the nurse to the development of HELLP syndrome? A. hyperglycemia B. elevated platelet count C. leukocytosis D. elevated liver enzymes Answer: D Rationale: HELLP is an acronym for hemolysis, elevated liver enzymes, and low platelets. Hyperglycemia or leukocytosis is not a part of this syndrome.
  2. While assessing a pregnant woman, the nurse suspects that the client may be at risk for hydramnios. Which information would the nurse use to support this suspicion? Select all that apply. A. history of diabetes B. reports of shortness of breath C. identifiable fetal parts on abdominal palpation D. difficulty obtaining fetal heart rate E. fundal height below that for expected gestational age Answer: A, B, D Rationale: Factors such as maternal diabetes or multiple gestations place the woman at risk for hydramnios. In addition, there is a discrepancy between fundal height and gestational age, such that a rapid growth of the uterus is noted. Shortness of breath may result from overstretching of the uterus due to the increased amount of amniotic fluid. Often, fetal parts are difficult to palpate and fetal heart rate is difficult to obtain because of the excess fluid present.
  3. A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion. The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first trimester abortions?

Answer: C Rationale: The woman with preterm prelabor rupture of membranes should monitor her baby's activity by performing fetal kick counts daily, check her temperature and report any increases to the health care provider, not insert anything into her vagina or vaginal area, such as tampons or vaginal intercourse, and avoid sitting in a tub bath.

  1. A nurse is assessing a pregnant woman with gestational hypertension. Which finding would lead the nurse to suspect that the client has developed severe preeclampsia? A. urine protein 300 mg/24 hours B. blood pressure 150/96 mm Hg C. mild facial edema D. hyperreflexia Answer: D Rationale: Severe preeclampsia is characterized by blood pressure over 160/110 mm Hg, urine protein levels greater than 500 mg/24 hours, and hyperreflexia. Mild facial edema is associated with mild preeclampsia.
  2. A nurse suspects that a pregnant client may be experiencing a placental abruption based on assessment of which finding? Select all that apply. A. dark red vaginal bleeding B. insidious onset C. absence of pain D. rigid uterus E. absent fetal heart tones Answer: A, D, E Rationale: Assessment findings associated with a placental abruption include a sudden onset with concealed or visible dark red bleeding, constant pain or uterine tenderness on palpation, firm to rigid uterine tone, and fetal distress or absent fetal heart tones.
  3. The health care provider prescribes PGE2 for a woman to help evacuate the uterus following a spontaneous abortion. Which action would be most important for the nurse to do? A. Use clean technique to administer the drug. B. Keep the gel cool until ready to use. C. Maintain the client supine for 30 minutes after administration. D. Administer intramuscularly into the deltoid area. Answer: C Rationale: When PGE2 is prescribed, the gel should come to room temperature before

administering it. Sterile technique should be used, and the client should remain supine for 30 minutes after administration. Rho(D) immune globulin is administered intramuscularly into the deltoid area.

  1. A nurse is reviewing an article about preterm prelabor rupture of membranes. Which factors would the nurse expect to find placing a woman at high risk for this condition? Select all that apply. A. high body mass index B. urinary tract infection C. low socioeconomic status D. single gestations E. smoking Answer: B, C, E Rationale: High-risk factors associated with prelabor rupture of membranes (PROM) include low socioeconomic status, multiple gestation, low body mass index, tobacco use, preterm labor history, placenta previa, abruptio placenta, urinary tract infection, vaginal bleeding at any time in pregnancy, cerclage, and amniocentesis.
  2. A woman with placenta previa is being treated with expectant management. The woman and fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that home care might be inappropriate? A. "My mother lives next door and can drive me here if necessary." B. "I have a toddler and preschooler at home who need my attention." C. "I know to call my health care provider right away if I start to bleed again." D. "I realize the importance of following the instructions for my care." Answer: B Rationale: Having a toddler and preschooler at home needing attention suggest that the woman would have difficulty maintaining bed rest at home. Therefore, expectant management at home may not be appropriate. Expectant management is appropriate if the mother and fetus are both stable, there is no active bleeding, the client has readily available access to reliable transportation, and can comprehend instructions.
  3. A woman with hyperemesis gravidarum asks the nurse about suggestions to minimize nausea and vomiting. Which suggestion would be most appropriate for the nurse to make? A. "Make sure that anything around your waist is quite snug." B. "Try to eat three large meals a day with less snacking."

B. "I will weigh myself once a week." C. "I should complete a fetal kick count each day." D. "I will check my urine for protein four times a day." E. "I'll call my health care provider if I have burning when I urinate." Answer: A, C, E Rationale: The client should take her blood pressure twice daily, check and record weight daily, perform urine dipstick checks for protein twice daily, record the number of fetal kicks daily, and notify her health care provider if she experiences burning on urination.

  1. A client comes to the emergency department with moderate vaginal bleeding. She says, "I have had to change my pad about every 2 hours and it looks like I may have passed some tissue and clots." The woman reports that she is 9 weeks' pregnant. Further assessment reveals the following:
  • Cervical dilation
  • Strong abdominal cramping
  • Low human chorionic gonadotropin (hCG) levels
  • Ultrasound positive for products of conception The nurse suspects that the woman is experiencing which type of spontaneous abortion? A. Threatened B. Inevitable C. Incomplete D. Complete Answer: B Rationale: Based on the assessment findings, the woman is likely experiencing an inevitable abortion characterized by vaginal bleeding, rupture of membranes, cervical dilation, strong abdominal cramping, possible passage of products of conception, and ultrasound and hCG levels indicating pregnancy loss. A threatened abortion is characterized by slight vaginal bleeding, no cervical dilation or cange in cervical consistency, mild abdominal cramping, close cervical os, and no passage of fetal tissue. An incomplete abortion is characterized by intense abdominal cramping, heavy vaginal bleeding and cervical dilation with passage of some products of conception. A complete abortion is characterized by a history of vaginal bleeding and abdominal pain along with passage of tissue and subsequent decrease in pain and decrease in bleeding.
  1. A pregnant client with preeclampsia is being treated with intravenous magnesium sulfate. The nurse assesses the client's deep tendon reflexes and grades them as 4+. The nurse notifies the health care provider about this finding, describing them using which term to ensure accurate communication? A. Absent

B. Average C. Brisk D. Clonus Answer: D Rationale: The National Institute of Neurological Disorders and Stroke, a division of the National Institutes of Health, published a scale in the early 1990s that, though subjective, is used widely today. It grades reflexes from 0 to 4+. Grades 2+ and 3+ are considered normal, and grades 0 which indicates an absent reflex and 4 which indicates clonus may indicate pathology. Because these are subjective assessments, to improve communication of reflex results, condensed descriptor categories such as absent, average, brisk, or clonus should be used rather than numeric codes. A 4+ grade indicates clonus which is the presence of rhythmic involuntary contractions, most often at the foot or ankle. Sustained clonus confirms central nervous system involvement.

  1. A client who has experienced an incomplete abortion is prescribed mifepristone to assist in removing the retained products of conception. Which medication would the nurse expect to adminster if prescribed before administering mifepristone? A. Opioid analgesic for relief of cramping B. Antiemetic to minimize nausea C. VItamin K to reduce bleeding D. Diuretic to promote fluid loss Answer: B Rationale: For the client receiving mifepristone, the nurse would anticipate administering an antiemetic beforehand to reduce nausea and vomiting. Acetaminophen would be useful for pain relief, not an opioid. VItamin K or a diuretic would not be appropriate when administering mifepristone. Vitamin K would be used to counteract bleeding such as that associated with heparin administration. A diuretic would be appropriate to promote fluid excretion with fluid overload.
  2. A client at 33 weeks' gestation comes to the emergency department with vaginal bleeding. Assessment reveals the following:
  • Onset of slight vaginal bleeding at 29 weeks with spontaneous cessation
  • Recent onset of bright red vaginal bleeding, more than with previous episode
  • No uterine contractions at present
  • Fetal heart rate within normal range
  • Uterus soft and nontender Based on the assessment findings, which condition would the nurse likely suspect? A. Placental abruption