NCLEX Practice Quiz On Obstetrical Nursing

1. The nurse is aware than an adaptation of pregnancy is an increased blood supply to the pelvic region that results in a purplish discoloration of the vaginal mucosa. which is known as:

Ladin’s sign

Hegar’s sign

Goodell’s sign

Chadwick’s sign

A purplish color results from the increased vascularity and blood vessel engorgement of the vagina.

Explanation

A purplish color results from the increased vascularity and blood vessel engorgement of the vagina.

2. The pituitary hormone that stimulates the secretion of milk from the mammary glands is:

Prolactin

Oxytocin

Estrogen

Progesterone

Prolactin is a hormone produced by the pituitary gland that stimulates milk production in the mammary glands. It plays a crucial role in lactation, enabling mothers to breastfeed their infants. Oxytocin, also produced by the pituitary gland, stimulates the release of milk from the mammary glands during breastfeeding.

Explanation

Prolactin is a hormone produced by the pituitary gland that stimulates milk production in the mammary glands. It plays a crucial role in lactation, enabling mothers to breastfeed their infants. Oxytocin, also produced by the pituitary gland, stimulates the release of milk from the mammary glands during breastfeeding.

3. When involved in prenatal teaching. the nurse should advise the clients that an increase in vaginal secretions during pregnancy is called leukorrhea and is caused by increased:

Metabolic rates

Production of estrogen

Functioning of the Bartholin glands

Supply of sodium chloride to the cells of the vagina

The increase of estrogen during pregnancy causes hyperplasia of the vaginal mucosa. which leads to increased production of mucus by the endocervical glands. The mucus contains exfoliated epithelial cells.

Explanation

The increase of estrogen during pregnancy causes hyperplasia of the vaginal mucosa. which leads to increased production of mucus by the endocervical glands. The mucus contains exfoliated epithelial cells.

4. During a prenatal examination. the nurse draws blood from a young Rh negative client and explain that an indirect Coombs test will be performed to predict whether the fetus is at risk for:

Acute hemolytic disease

Respiratory distress syndrome

Protein metabolic deficiency

Physiologic hyperbilirubinemia

When an Rh negative mother carries an Rh positive fetus there is a risk for maternal antibodies against Rh-positive blood

Explanation

When an Rh negative mother carries an Rh positive fetus there is a risk for maternal antibodies against Rh-positive blood

5. A 26-year old multigravida is 14 weeks' pregnant and is scheduled for an alpha-fetoprotein test. She asks the nurse. "What does the alpha-fetoprotein test indicate?" The nurse bases a response on the knowledge that this test can detect:

Kidney defects

Cardiac defects

Neural tube defects

Urinary tract defects

The alpha-fetoprotein test detects neural tube defects and Down syndrome.

Explanation

The alpha-fetoprotein test detects neural tube defects and Down syndrome.

6. An expected cardiopulmonary adaptation experienced by most pregnant women is:

Tachycardia

Dyspnea at rest

Progression of dependent edema

Shortness of breath on exertion

This is an expected cardiopulmonary adaptation during pregnancy

Explanation

This is an expected cardiopulmonary adaptation during pregnancy

7. Nutritional planning for a newly pregnant woman of average height and weighing 145 pounds should include:

A decrease of 200 calories a day

An increase of 300 calories a day

An increase of 500 calories a day

A maintenance of her present caloric intake per day

This is the recommended caloric increase for adult women to meet the increased metabolic demands of pregnancy.

Explanation

This is the recommended caloric increase for adult women to meet the increased metabolic demands of pregnancy.

8. At a prenatal visit at 36 weeks' gestation. a client complains of discomfort with irregularly occurring contractions. The nurse instructs the client to:

Lie down until they stop

Walk around until they subside

Time contraction for 30 minutes

Take 10 grains of aspirin for the discomfort

Ambulation relieves Braxton Hicks.

Explanation

Ambulation relieves Braxton Hicks.

9. The nurse teaches a pregnant woman to avoid lying on her back. The nurse has based this statement on the knowledge that the supine position can:

Unduly prolong labor

Cause decreased placental perfusion

Lead to transient episodes of hypotension

Interfere with free movement of the coccyx

This is because the impedance of venous return by the gravid uterus. which causes hypotension and decreased systemic perfusion.

Explanation

This is because the impedance of venous return by the gravid uterus. which causes hypotension and decreased systemic perfusion.

10. A pregnant client is making her first Antepartum visit. She has a two year old son born at 40 weeks. a 5 year old daughter born at 38 weeks. and 7 year old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. Using the GTPAL format. the nurse should identify that the client is:

G4 T3 P2 A1 L4

G5 T2 P1 A1 L4

G4 T3 P1 A1 L4

G5 T2 P2 A1 L4

In the GTPAL format:

G (Gravida) represents the total number of pregnancies, including the current one.

T (Term) represents the number of pregnancies carried to term (delivered at 37 weeks gestation or later).

P (Preterm) represents the number of pregnancies delivered before 37 weeks gestation.

A (Abortions) represents the number of pregnancies that ended before 20 weeks gestation (excluding the current pregnancy, if applicable).

L (Living) represents the number of living children.

When counting pregnancies for the GTPAL format, each pregnancy, including twins or multiple gestations, counts as one under the "G" category. Therefore, the client's history includes:

4 total pregnancies (Gravida)

3 pregnancies carried to term (Term)

1 preterm pregnancy (Preterm)

1 spontaneous abortion (Abortions)

4 living children (Living)

Explanation

In the GTPAL format:

G (Gravida) represents the total number of pregnancies, including the current one.

T (Term) represents the number of pregnancies carried to term (delivered at 37 weeks gestation or later).

P (Preterm) represents the number of pregnancies delivered before 37 weeks gestation.

A (Abortions) represents the number of pregnancies that ended before 20 weeks gestation (excluding the current pregnancy, if applicable).

L (Living) represents the number of living children.

When counting pregnancies for the GTPAL format, each pregnancy, including twins or multiple gestations, counts as one under the "G" category. Therefore, the client's history includes:

4 total pregnancies (Gravida)

3 pregnancies carried to term (Term)

1 preterm pregnancy (Preterm)

1 spontaneous abortion (Abortions)

4 living children (Living)