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Example Questions
Example Question #71 : Obstetrics And Gynecological Conditions
Which of the following conditions can be triggered by Rh incompatibility between mother and fetus?
Preeclampsia
Postpartum hemorrhage
Gestational diabetes
Hyperemesis gravidarum
Hemolytic disease of the newborn
Hemolytic disease of the newborn
Of the conditions listed, the only one that is associated with Rh incompatibility between mother and fetus is hemolytic disease of the newborn (otherwise known as hemolytic disease of the fetus and newborn). In this condition, antibodies from the mother's blood attack the blood of the fetus. This is a major cause of fetal and newborn mortality and morbidity.
Example Question #1041 : Nclex
Which of the following maternal/fetal blood types can lead to hemolytic disease of the newborn?
Rh negative mother, Rh negative fetus
Rh positive mother, Rh negative fetus
Rh positive mother, Rh positive fetus
Rh negative mother, Rh positive fetus
Rh negative mother, Rh positive fetus
Hemolytic disease of the newborn occurs when an Rh negative mother is carrying an Rh positive fetus. The mother must have previously carried an Rh positive fetus and become sensitized to Rh-D antigen during miscarriage, pregnancy (due to placental rupture), or during delivery. Then, during a second pregnancy, anti-RhD antibodies from the mother's immune system can cross the placenta and attack the blood cells of the fetus, causing hemolytic anemia.
Example Question #73 : Obstetrics And Gynecological Conditions
What treatment can prevent the development of sensitization to Rh-D antigen in an Rh negative mother carrying an Rh positive fetus?
Short-course immunosuppressant treatment
Therapeutic abortion
Rho(D) immune globulin
Rh-D fetal serum injections
Rho(D) immune globulin
Rh sensitization can be prevented by treatment of an Rh negative mother with Rho(D) immunoglobulin at 28 weeks, then again within 72 hours of delivery. This is a solution of IgG antibody to Rh-D, which is able to destroy any fetal red blood cells that enter the mother's bloodstream before her own immune system is able to form develop a sensitization.
Example Question #1044 : Nclex
A nurse working in labor and delivery is caring for a client that has been diagnosed with an incompetent cervix. The client has been informed by the physician she is now at risk for a spontaneous abortion. The client asks the nurse about possible interventions.
The nurse is aware the procedure performed for an incompetent cervix is called __________.
McReynold's procedure
tubal ligation
dilation and curettage
colporrhaphy
a Shirodkar procedure
a Shirodkar procedure
A Shirodkar procedure involves sewing a suture in and around the cervix to hold it closed. This is usually performed within the first trimester and later removed when the risk of miscarriage has lessened.
Example Question #1045 : Nclex
A pregnant woman at 43 weeks gestation is having labor augmented with oxytocin infusion. Which of the following best categorizes this particular drug?
Erythropoietin
Prolactin
Anti-diuretic hormone
Growth hormone
Thyroid-stimulating hormone
Anti-diuretic hormone
Oxytocin is often used to help augment labor by inducing contractions. This hormone is naturally made in the body and works as an anti-diuretic hormone (thus promotes the excretion of water). In labor, this hormone also works to stimulate uterine contractiity.
Example Question #1042 : Nclex
You are the nurse taking care of a 76-year old female who complains of vaginal dryness that is occasionally painful during intercourse. She is diagnosed with vulvovaginal atrophy. Which of the following is the best initial treatment?
Topical estrogen
Diphenhydramine
Oxybutinin
Systemic estrogen
Propranolol
Topical estrogen
The correct answer is "Topical estrogen."
In a patient with atrophic vulvovaginitis, a condition that causes thinning of the vaginal and vulvar tissue, resulting in inflammation, diminished lubrication, and subsequent pain, the best initial treatment option if the condition is distressing to the patient is application of topical estrogen. Atrophic vulvovaginitis is a common condition in post-menopausal women as the level of circulating estrogen decreases, and therefore estrogen-mediated effects on female tissues are diminished. With the significant decrease in estrogen to the vagina and vulva, inflammatory and painful symptoms may occur, as in this patient. By applying a topical estrogen cream to the affected tissues, this allows the patient to supplement the estrogen that was lost following menopause, while not exposing the patient to the potentially negative effects (e.g. cardiovascular) of systemic estrogen supplementation.
Propranolol is a beta-adrenergic antagonist and has no role in the treatment of atrophic vulvovaginitis.
Oxybutinin is an anti-cholinergic medication that is used to treat spastic bladder, among other conditions. It has no role in the treatment of atrophic vulvovaginitis.
Diphenhydramine is an anti-histamine medication that has a wide variety of uses, but none known to treat atrophic vulvovaginitis.
Example Question #1046 : Nclex
You are the nurse taking care of a 28-year old G3P2 who is at 33 weeks gestation. She goes into labor, and the physician orders administration of a tocolytic medication. Which of the following medications is a tocolytic?
Furosemide
Sertraline
Lisinopril
Terbinafine
Terbutaline
Terbutaline
The correct answer is "Terbutaline." This is the correct answer, as terbutaline, a beta-2-adrenergic agonist, is the only medication listed that has tocolytic, or labor-repressing (anti-contraction) properties. It is one of the most common medications used for tocolysis in pregnant women. Another commonly used tocolytic agent is nifedipine, a calcium-channel blocker.
The other choices are incorrect. Lisinopril is an angiotensin-converting enzyme inhibitor (ACE-I) that is commonly used to treat hypertension, among other conditions. It has no reported use as a tocolytic. Furosemide is a loop diuretic that is commonly used in the treatment of hypertension. It has no reported tocolytic properties. Sertraline is a selective serotonin reuptake inhibitor medication used to treat a number of conditions including major depressive disorder and generalized anxiety disorder, among others. Terbinafine is an allylamine anti-fungal medication used to treat conditions such as tinea corporis or tinea cruris.
Example Question #72 : Obstetrics And Gynecological Conditions
Basal body temperature is determined by __________.
taking the temperature mid-morning
taking the temperature in the afternoon
taking the temperature before rising
taking the temperature in the evening
taking the temperature before bed
taking the temperature before rising
The basal body temperature is a method many women use to determine when ovulation occurs. To take a basal body temperature, one must use a basal thermometer (which is more sensitive) and take their body temperature before getting out of bed (or even sitting up) each morning. This method is utilized the best if a woman wakes up and takes her temperature at the same time daily.
Example Question #73 : Obstetrics And Gynecological Conditions
A nursing student is participating in clinical practice on a labor and delivery unit. He is learning how to measure contractions. He knows that contractions are measured by frequency, duration, and intensity. Which timeframe correctly describes how the student should measure the frequency of contractions?
The increment of the first contraction to the decrement of the second
The increment of the first contraction to the decrement of the first
The increment of the first contraction to the increment of the second
The increment of the first contraction to the acme of the second
The acme of the first contraction to the acme of the second
The increment of the first contraction to the increment of the second
Increment is the beginning or rise of the contraction. Acme is the peak of the contraction. Decrement is the fall of the contraction. Frequency is measured from the beginning of one contraction to the beginning of another, so it should be measured from the increment of the first contraction to the increment of the second contraction.
Example Question #1043 : Nclex
While caring for a laboring patient, the nurse is called into the room because her patient felt a "gush" of fluid. Which of the following should be the nurse's next action?
Turn the mother to her right side
Alert the physician
Change the sheets
Inform the mother of what she should expect next
Assess fetal heart rate
Assess fetal heart rate
The nurse must suspect rupture of the membranes (amniotic sac). Assess fetal heart rate if rupture of the membranes may have occurred. With rupture comes the potential for cord prolapse. Assess fetal heart rate for baseline variability. Marked variability may be cause for concern and the nurse should monitor the patient for signs of infection.
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