NCLEX : Obstetrics and Gynecological Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #41 : Obstetrics And Gynecological Conditions

A 24 year old primigravida client has just given birth to a Rh positive child and she herself is Rh negative. The nurse recognizes this situation can lead to future problems in terms of future pregnancies due to this blood type mismatch. 

All of the following are associated with Rh factor incompatibility except __________.

Possible Answers:

Kernicterus is a potentially serious effect due to pathological jaundice that can have long lasting neurological effects on the child if not prevented. 

A major effect of Rh incompatibility is an increased risk of blood clotting and thrombosis in the fetus during subsequent pregnancies

The mother will form IgG and IgM antibodies in response to being exposed to a fetus' incompatible blood type. 

May lead to fetal anemia and lead to an acceleration of red blood cell production if the mother is not given Rho-D immune globulin to prevent antibodies from destroying fetal blood cells.

The mixing of fetal blood with maternal blood may occur during an amniocentesis or early seperation of the placenta during birth. 

Correct answer:

A major effect of Rh incompatibility is an increased risk of blood clotting and thrombosis in the fetus during subsequent pregnancies

Explanation:

Blood clots are not a common effect in the fetus due to Rh incompatibility. A disorder known as erythroblastosis fetalis is a type of hemolytic disease that occurs in the fetus due to an immune reaction of the Rh negative mother and an Rh positive fetus. All other choices are associated with this type of incompatibility.

Example Question #41 : Obstetrics And Gynecological Conditions

Which type of abortion is associated with sepsis, cramping, abdominal tenderness and an open cervical os?

Possible Answers:

Inevitable abortion

Spontaneous abortion

Missed abortion

Threatened abortion

Complete abortion

Correct answer:

Missed abortion

Explanation:

A missed abortion is marked by the death of the fetus in utero but is not expelled from the uterus. If left untreated can lead to infection in the womb, it is marked by foul odor and bleeding as well as an elevated temperture and sepsis. 

Example Question #43 : Obstetrics And Gynecological Conditions

Which of the following statements is true about a hydatidiform molar pregnancy?

Possible Answers:

A hydatidiform molar pregnancy is reported to cause malignancy in approximately 60% of cases. 

A molar pregnancy can proceed without incident once Rho-D immune globulin is administered to the mother. 

The cause of a molar pregnancy is due multiple ovum becoming fertized and coalescing to form a cluster of atypical cells containing a haploid number of chromosomes. 

An ultraound usually reveals a mass resembling a "cluster of grapes", and a blood test will reveal a positive pregnancy result due to elevated HCG (human chorionic gonadotropin) hormone.

A molar pregnancy is a type of ectopic pregnancy in need of dilation and curratage to prevent internal hemorrhaging or possible hysterectomy.

Correct answer:

An ultraound usually reveals a mass resembling a "cluster of grapes", and a blood test will reveal a positive pregnancy result due to elevated HCG (human chorionic gonadotropin) hormone.

Explanation:

A hydatidiform molar pregnancy is mostly a benign process that may occur due to an abnormal ovum becoming fertilized and growing into collection of cells in a cluster like formation. They are benign over 80% of the time. Rho-D immune globulin is a medication administered to an Rh negative mother that will give birth to a second Rh positive child to prevent an immune reaction that may harm the child. 

Example Question #1 : Causes And Treatments Of Ob/Gyn Conditions

A woman is hospitalized for preeclampsia. Which medication may the nurse administer to prevent the occurrence of seizures?

Possible Answers:

Nubain

Calcium gluconate

Magnesium sulfate

Pitocin

Zolpidem

Correct answer:

Magnesium sulfate

Explanation:

Magnesium sulfate is used to prevent seizures in women with severe preeclampsia. Calcium gluconate is the antidote if magnesium toxicity is assessed. It should be readily available when a woman is receiving magnesium sulfate. Pitocin is used to stimulate the uterus, often to induce labor. Nubain is an opioid that can be given to women during labor to treat pain. Zolpidem (Ambien) is a sleep aid. 

Example Question #1 : Causes And Treatments Of Ob/Gyn Conditions

Jean is a 33-year-old woman who has previously had regular periods but has not gotten her period for six months. Which of the following would the nurse rule out as the cause? 

Possible Answers:

Kidney disease

Cross country running five times per week

Poor eating habits

Yoga once per week

Antidepressant use

Correct answer:

Yoga once per week

Explanation:

Yoga once per week (light exercise) is the least likely of the above to cause a change in regular menstruation. Cross country or long distance running (vigorous exercise) is more likely to cause changes to a woman's cycle. Poor lifestyle choices such as eating habits and health issues such as kidney disease can also cause irregular menstruation. Likewise, pharmaceuticals can have the same effect.

Example Question #2 : Causes And Treatments Of Ob/Gyn Conditions

Sandy is 29 years old and experiences bleeding between periods. The nurse marks which of the following on sandy's medical chart? 

Possible Answers:

Polymenorrhea

Oligomenorrhea

Menometrorrhagia

Metrorrhagia

Menorrhagia

Correct answer:

Metrorrhagia

Explanation:

Metrorrhagia is bleeding between periods. Menorrhagia refers to excessively heavy periods. Oligomenorrhea refers to light, scattered periods (typically spaced by greater than 35 days). Polymenorrhea is used to describe short cycles of equal to or less than 21 days. Menometrorrhagia is used to describe periods that are heavier, sporadic, and more frequent than normal periods. 

Example Question #2 : Causes And Treatments Of Ob/Gyn Conditions

A patient tells the nurse that she is practicing fertility awareness. The nurse tells the patient that the "unsafe period" can range from __________.

Possible Answers:

seven days before and seven days after ovulation

two days before and one day after ovulation

one day before and two days after ovulation

one day before and one day after ovulation

two days before and two days after ovulation

Correct answer:

seven days before and seven days after ovulation

Explanation:

According to the family planning method of contraception, the period in which conception can occur and one should refrain from intercourse is up to 7 days before and 7 days after ovulation. Some references show that sperm can live for up to five to seven days inside the female reproductive system. An unfertilized egg can live from between 12-24 hours. This greatly increases the window in which conception can occur. 

Example Question #1 : Causes And Treatments Of Ob/Gyn Conditions

Which of the following is false regarding oral contraceptives? 

Possible Answers:

They may decrease the severity of menstrual cramps

They may decrease the risk of breast cancer

They may reduce the risk of uterine cancer

They may heighten the risk of depression

They may increase the risk of developing a blood clot

Correct answer:

They may decrease the risk of breast cancer

Explanation:

Oral contraceptives may increase the risk of breast cancer, increase the risk of depression, and increase the risk of developing a blood clot (higher in women who smoke cigarettes). They can reduce the risk of uterine cancer and are frequently used in women with primary dysmenorrhea. Primary dysmenorrhea refers to painful menstrual cycles without an underlying cause. 

Example Question #2 : Causes And Treatments Of Ob/Gyn Conditions

A 51-year-old female arrives at her doctor's office because she has not had any periods for 12 months. The nurse should suspect __________.

Possible Answers:

pregnancy

polycystic ovarian syndrome

pelvic inflammatory disease

endometriosis

menopause

Correct answer:

menopause

Explanation:

Amenorrhea is the complete absence of a period. There are many different causes for amenorrhea. One of the most frequent causes of amenorrhea for women in the fifth decade of life, is menopause. Menopause is the most likely  cause of amenorrhea in this particular patient because she has not been experiencing periods for 12 months and is 51-years-old. While pregnancy is possible, the nurse would suspect menopause first. Pelvic inflammatory disease (PID) is a pelvic infection usually resulting in severe pain. Endometriosis is a condition in which uterine tissue inappropriately grows in areas such as the rectum or ovary, also typically causing severe pain. Polycystic ovarian syndrome is a condition causing hormone imbalance. It can cause amenorrhea. This question requires the use of strategy to answer. There are several choices that could be responsible for amenorrhea, but which one is the most correct?  

Example Question #4 : Causes And Treatments Of Ob/Gyn Conditions

Jody is a 40-year-old woman seeking care for dysmenorrhea for the first time. Which would not be considered an appropriate treatment? 

Possible Answers:

Lifestyle modifications

Naproxen

Ibuprofen

Oxycodone/acetaminophen

Oral contraceptives

Correct answer:

Oxycodone/acetaminophen

Explanation:

There are many different ways to treat painful periods (dysmenorrhea). Ibuprofen and naproxen are anti-inflammatory agents that do not require a prescription and can be very effective. They have relatively few side effects. Lifestyle modification (such as exercise) is another good alternative. The use of oral contraceptives are also frequently used to give women lighter and milder periods. Percocet is not generally used because it is an opioid analgesic and not recommended for long term use because they carry potential for addiction.

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