RNC Inpatient Obstetrics Practice Exam III

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RNC Inpatient Obstetrics Practice Exam III - Quiz

Questions and Answers
  • 1. 

    Inpatient obstetric care results in approximately what percentage of malpractice claims in the obstetrics and gynecology?

    • A.

      25

    • B.

      50

    • C.

      75

    Correct Answer
    B. 50
    Explanation
    Inpatient obstetric care results in approximately 50% of malpractice claims in obstetrics and gynecology. This suggests that half of the malpractice claims in this field are related to the care provided during inpatient obstetric procedures. It highlights the significance of ensuring proper care and safety measures are taken during inpatient obstetric care to prevent potential malpractice claims.

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  • 2. 

    Guidance for ethical nursing care is provided by the:

    • A.

      American Nurses Association 'Code of Ethics for Nurses'

    • B.

      American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) 'Guidelines for Perinatal Care'.

    • C.

      American Medical Association 'Code of Medical Ethics'

    Correct Answer
    A. American Nurses Association 'Code of Ethics for Nurses'
    Explanation
    The correct answer is the American Nurses Association 'Code of Ethics for Nurses'. This code provides guidance for ethical nursing care, outlining the principles and values that nurses should uphold in their practice. It addresses various ethical considerations such as patient autonomy, confidentiality, advocating for patients' rights, and maintaining professional boundaries. It serves as a resource for nurses to navigate ethical dilemmas and ensure that they provide safe, compassionate, and patient-centered care. The other options, the American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) 'Guidelines for Perinatal Care' and the American Medical Association 'Code of Medical Ethics', may provide guidance specific to their respective fields but do not encompass the broader scope of nursing ethics.

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  • 3. 

    Disruptive clinician behavior:

    • A.

      Is often directly linked to clinical practice issues

    • B.

      Rarely involves clinical practice issues

    • C.

      Should be handled separately from clinical practice issues

    Correct Answer
    A. Is often directly linked to clinical practice issues
    Explanation
    Disruptive clinician behavior is often directly linked to clinical practice issues because it can stem from factors such as stress, burnout, or dissatisfaction with patient care. These issues can manifest as disruptive behavior towards colleagues, patients, or the healthcare system itself. Addressing the underlying clinical practice issues can help mitigate disruptive behavior and improve overall patient care and workplace dynamics.

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  • 4. 

    The best approach for addressing disruptive clinician behavior is:

    • A.

      Immediate intervention

    • B.

      Monitoring trends

    • C.

      Peer review

    Correct Answer
    A. Immediate intervention
    Explanation
    Immediate intervention is the best approach for addressing disruptive clinician behavior because it allows for prompt action to be taken in order to address and rectify the disruptive behavior. By intervening immediately, the negative impact of the behavior can be minimized and potential harm to patients or colleagues can be prevented. It also sends a clear message that such behavior is not tolerated and helps to maintain a positive and respectful work environment. Monitoring trends and peer review can be effective in identifying patterns and providing feedback, but immediate intervention is necessary to address the behavior in the moment.

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  • 5. 

    Successful defense of malpractice claims is enhanced by following:

    • A.

      Community standards

    • B.

      National professional standards

    • C.

      Trends in practice

    Correct Answer
    B. National professional standards
    Explanation
    Following national professional standards is important for successful defense of malpractice claims because these standards set the expectations and guidelines for professional conduct in a specific field. By adhering to these standards, professionals can demonstrate that they have met the established criteria for their practice, which can help in defending against claims of malpractice. National professional standards also provide a benchmark against which the professional's actions can be evaluated, helping to establish whether the alleged malpractice occurred or not. By aligning with these standards, professionals can strengthen their defense and demonstrate that they have acted in accordance with accepted norms and practices in their field.

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  • 6. 

    When a sentinel event occurs, according to the Joint Commission (TJC):

    • A.

      A root-cause analysis should be conducted

    • B.

      It must be reported to TJC within 60 days

    • C.

      Those involved should be placed on administrative leave pending an investigation

    Correct Answer
    A. A root-cause analysis should be conducted
    Explanation
    When a sentinel event occurs, the Joint Commission (TJC) recommends conducting a root-cause analysis. This analysis helps to identify the underlying causes and contributing factors of the event, allowing for appropriate corrective actions to be implemented. It is an essential step in understanding what went wrong and how to prevent similar events in the future. The analysis involves gathering data, examining processes, and identifying system weaknesses or breakdowns that may have led to the event. It is a proactive approach to improving patient safety and quality of care.

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  • 7. 

    Based on TJC criteria, which of the following clinical situations is a sentinel event?

    • A.

      Any unexplained adverse occurrence

    • B.

      Birth of a baby with previously undiagnosed congenital abnormalities

    • C.

      Unanticipated death of a full-term infant

    Correct Answer
    C. Unanticipated death of a full-term infant
    Explanation
    The correct answer is "Unanticipated death of a full-term infant." According to TJC criteria, a sentinel event is an unexpected occurrence involving death or serious physical or psychological injury. In this case, the unanticipated death of a full-term infant qualifies as a sentinel event because it involves an unexpected death. The other options, such as any unexplained adverse occurrence or the birth of a baby with previously undiagnosed congenital abnormalities, may be concerning but do not meet the criteria for a sentinel event.

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  • 8. 

    The purpose of the root-cause analysis process is to:

    • A.

      Determine fault of the healthcare provider or hospital

    • B.

      Examine institutional liability

    • C.

      Review potentially contributing systems

    Correct Answer
    C. Review potentially contributing systems
    Explanation
    The purpose of the root-cause analysis process is to review potentially contributing systems. This means that the process aims to identify and analyze the underlying factors or systems that may have contributed to a particular incident or problem. It is not focused on determining fault or assigning blame to healthcare providers or hospitals, nor is it primarily concerned with examining institutional liability. Instead, it seeks to understand the broader systems and processes in place that may have played a role in the occurrence of the issue at hand.

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  • 9. 

    Professional nursing liability is most commonly increased by the absence of:

    • A.

      Adequate medical record documentation

    • B.

      Annual competency validation

    • C.

      Current unit policies and procedures

    Correct Answer
    A. Adequate medical record documentation
    Explanation
    Professional nursing liability is most commonly increased by the absence of adequate medical record documentation. This is because thorough and accurate documentation is essential for providing evidence of the care provided to patients. It helps in communication among healthcare professionals, ensures continuity of care, and serves as legal protection in case of any legal disputes or claims. Inadequate documentation can lead to errors, miscommunication, and misunderstandings, increasing the risk of adverse events and potential liability for nurses.

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  • 10. 

    An incident -management program will:

    • A.

      Include "near misses" with potential for adverse outcomes

    • B.

      Identify and discipline those at fault

    • C.

      Increase institutional and nursing liability

    Correct Answer
    A. Include "near misses" with potential for adverse outcomes
    Explanation
    An incident-management program is designed to identify and address potential risks and adverse outcomes in order to prevent them from occurring in the future. By including "near misses" with potential for adverse outcomes, the program can identify areas where mistakes or errors almost occurred and take proactive measures to prevent them from happening again. This approach focuses on learning from mistakes and improving systems rather than solely identifying and disciplining individuals at fault. It helps to create a culture of safety and continuous improvement within the institution and reduces liability by preventing adverse outcomes.

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  • 11. 

    Nurse/ Physician difference of opinion about patient management should be:

    • A.

      Considered unprofessional behavior

    • B.

      Discussed with the patient's family

    • C.

      Focused on the issue in question

    Correct Answer
    B. Discussed with the patient's family
    Explanation
    When nurses and physicians have a difference of opinion about patient management, it is important to discuss this with the patient's family. Involving the family in the discussion allows them to understand the different perspectives and make an informed decision about the best course of action for the patient. It promotes transparency and ensures that the patient's best interests are considered. By discussing the difference of opinion with the patient's family, healthcare professionals can work together to provide the highest quality of care.

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  • 12. 

    Despite repeated requests to a physician to come to the bedside to evaluate a deteriorating maternal condition, the physician has failed to respond. The nurse appropriately:

    • A.

      Consults with another physician in the unit.

    • B.

      Institutes the chain of command/ chain of consultation.

    • C.

      Provides the intervention indicated.

    Correct Answer
    A. Consults with another pHysician in the unit.
    Explanation
    In this scenario, the nurse is faced with a deteriorating maternal condition and has made repeated requests for the physician to come and evaluate the situation. However, the physician has failed to respond. The nurse's appropriate action would be to consult with another physician in the unit. This is necessary to ensure that the patient receives the necessary medical attention and intervention in a timely manner. By consulting another physician, the nurse can seek their expertise and guidance to address the deteriorating condition and provide the appropriate care for the patient.

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  • 13. 

    Outcome measures of patient safety include:

    • A.

      How care is delivered

    • B.

      Policies and procedures

    • C.

      Rates of maternal morbidity and mortality

    Correct Answer
    C. Rates of maternal morbidity and mortality
    Explanation
    Rates of maternal morbidity and mortality are considered outcome measures of patient safety because they reflect the effectiveness of healthcare in preventing harm and ensuring the well-being of pregnant women. These rates provide important information about the quality of care provided during pregnancy, delivery, and postpartum periods. Monitoring and reducing maternal morbidity and mortality rates are crucial in identifying areas for improvement in healthcare systems and implementing interventions to enhance patient safety and outcomes.

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  • 14. 

    Structure measures of patient safety include:

    • A.

      The number of elective inductions of labor prior to 39 weeks' gestation

    • B.

      The rates of third and fourth degree lacerations

    • C.

      Unit protocols

    Correct Answer
    C. Unit protocols
    Explanation
    Unit protocols are a measure of patient safety because they provide standardized guidelines and procedures for healthcare providers to follow. These protocols ensure that all members of the healthcare team are on the same page and are following evidence-based practices, which can help prevent errors and improve patient outcomes. By implementing unit protocols, healthcare facilities can enhance patient safety by reducing variations in care, promoting effective communication, and ensuring that best practices are consistently followed.

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  • 15. 

    Process measures of patient safety include:

    • A.

      How tachysystole is identified and treated

    • B.

      Number of nurses who are certified in fetal monitoring

    • C.

      Rates of cesarean birth for indeterminate fetal status

    Correct Answer
    A. How tachysystole is identified and treated
    Explanation
    The correct answer is "how tachysystole is identified and treated." Process measures of patient safety refer to the specific steps or actions taken to ensure patient safety. In this case, tachysystole is a condition characterized by excessively frequent uterine contractions during labor. Identifying and treating tachysystole promptly is crucial to prevent complications for both the mother and the baby. Therefore, monitoring and addressing tachysystole effectively contribute to patient safety in the context of childbirth. The other options, such as the number of nurses certified in fetal monitoring and rates of cesarean birth for indeterminate fetal status, may also be relevant to patient safety but do not directly pertain to the process of identifying and treating tachysystole.

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  • 16. 

    Qualitative measures of patient safety include:

    • A.

      Focus groups

    • B.

      Number of sentinel events per year

    • C.

      Policies and procedures consistent with national standards and guidelines

    Correct Answer
    A. Focus groups
    Explanation
    Focus groups are a qualitative measure of patient safety because they involve gathering opinions, experiences, and perceptions from a small group of patients or healthcare professionals. By conducting focus groups, healthcare organizations can gain valuable insights into patient safety issues, identify potential risks, and develop strategies for improvement. This qualitative approach allows for in-depth discussions and exploration of patient safety concerns, providing a more comprehensive understanding of the factors that contribute to safety incidents. Unlike the other options listed, focus groups provide subjective information that cannot be measured in numbers or policies and procedures.

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  • 17. 

    According to ACOG (2009) the preferred method of fetal assessment during labor for women with high-risk conditions is:

    • A.

      Dopplering FHTs every 30 minutes during early labor

    • B.

      Electronic fetal monitoring

    • C.

      Fetal scalp electrode

    Correct Answer
    B. Electronic fetal monitoring
    Explanation
    ACOG (American College of Obstetricians and Gynecologists) recommends electronic fetal monitoring as the preferred method of fetal assessment during labor for women with high-risk conditions. This method involves continuously monitoring the baby's heart rate and the mother's contractions using electronic devices. It provides a more accurate and continuous assessment of the baby's well-being and allows for early detection of any signs of distress or complications. Doppler FHTs every 30 minutes during early labor and fetal scalp electrode are alternative methods that may be used in certain situations but are not the preferred method according to ACOG.

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  • 18. 

    Elective labor induction should not occur prior to:

    • A.

      38

    • B.

      39

    • C.

      40

    Correct Answer
    B. 39
    Explanation
    Elective labor induction should not occur prior to 39 weeks of gestation. This is because babies born before 39 weeks may have an increased risk of complications, such as respiratory distress syndrome, jaundice, and low blood sugar. Waiting until 39 weeks allows the baby's lungs and other organs to fully mature, reducing the risk of these complications. Inducing labor before 39 weeks should only be done for medical reasons, as determined by a healthcare provider.

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  • 19. 

    According to ACOG (2009) misoprostol is not recommended for women:

    • A.

      Requesting elective induction at 39 weeks

    • B.

      With preeclampsia

    • C.

      Attempting VBAC

    Correct Answer
    C. Attempting VBAC
    Explanation
    Misoprostol is not recommended for women attempting VBAC (vaginal birth after cesarean). This is because misoprostol can increase the risk of uterine rupture in women who have had a previous cesarean section. Uterine rupture is a serious complication that can be life-threatening for both the mother and the baby. Therefore, it is important to avoid using misoprostol in women attempting VBAC and consider alternative methods for induction of labor.

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  • 20. 

    A 25 yr old Vietnamese woman admitted to the birthing unit requests that her husband stay in the waiting area until she gives birth. The appropriate response is based on the nurses knowledge that:

    • A.

      All husbands should be present during labor and birth

    • B.

      The husband may fear his response to his wife giving birth

    • C.

      The woman's request should be honored

    Correct Answer
    C. The woman's request should be honored
    Explanation
    The appropriate response is to honor the woman's request because it is important to respect her autonomy and preferences during the birthing process. Every woman has the right to decide who she wants to have present during labor and birth, and it is the nurse's responsibility to support her choices. It is possible that the woman has personal reasons for wanting her husband to stay in the waiting area, and it is important to ensure that she feels comfortable and in control during this vulnerable time.

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  • 21. 

    Wang Din Wah, A Laotian mother who is 24 hours postpartum, rejects the nurses' instructions to bring the newborn back to the clinic by the 7th day of life for a phenylketonuria test. Wang's reasons for this refusal are most likely based on:

    • A.

      Her lack of knowledge of appropriate health-care for the baby

    • B.

      The baby's early care being provided largely by a maternal grandmother

    • C.

      The first month after birth being considered a time for confinement and rest

    Correct Answer
    C. The first month after birth being considered a time for confinement and rest
    Explanation
    Wang Din Wah's refusal to bring the newborn back to the clinic for a phenylketonuria test is most likely based on the cultural belief that the first month after birth is a time for confinement and rest. In some cultures, it is believed that the mother and baby should stay at home and avoid going out or engaging in activities outside of the house during this time. Wang may be adhering to this cultural practice and therefore refusing to bring the baby to the clinic.

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  • 22. 

    Berta Wolf Creek is 4 hours postpartum and requests permission to take her placenta home with her. Appropriate instruction by the nurse would include:

    • A.

      Keeping the placenta in a leak proof container

    • B.

      Requiring disposal of the placenta by internment (burial)

    • C.

      Keeping the placenta frozen until burial

    Correct Answer
    A. Keeping the placenta in a leak proof container
    Explanation
    The correct answer is keeping the placenta in a leak proof container. This is because it is important to keep the placenta in a leak proof container to prevent any potential contamination or spread of infection. It is not necessary to require disposal of the placenta by internment (burial) or keeping it frozen until burial.

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  • 23. 

    Maria Ochoa, a 23 yr old Filipino American, is 18 weeks pregnant. After receiving a prescription for prenatal vitamins, she tells the nurse that her mother warned her to take only herbal medication during pregnancy. The nurse appropriately:

    • A.

      Advises Maria that the pills are only vitamins and not considered medication

    • B.

      Assess the significance of Maria's mother's advice

    • C.

      Reminds her that the vitamins were ordered by the nurse-midwife

    Correct Answer
    B. Assess the significance of Maria's mother's advice
    Explanation
    The nurse appropriately assesses the significance of Maria's mother's advice because it is important to understand the reasoning behind her mother's suggestion to take only herbal medication during pregnancy. By assessing the significance, the nurse can determine if there are any cultural beliefs or concerns that need to be addressed and can provide appropriate education and guidance to Maria based on her individual needs and preferences.

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  • 24. 

    The percentage of the U.S. population who are African American or black is nearly:

    • A.

      6%

    • B.

      13%

    • C.

      20%

    Correct Answer
    B. 13%
    Explanation
    According to the given information, the correct answer is 13%. This means that approximately 13% of the U.S. population consists of African Americans or black individuals.

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  • 25. 

    An African American/ black woman who believes she should not swallow her saliva and carries a spit cup with her during pregnancy is most likely from:

    • A.

      Barbados

    • B.

      Haiti

    • C.

      West Indies

    Correct Answer
    B. Haiti
    Explanation
    The correct answer is Haiti. In Haitian culture, there is a belief that swallowing saliva during pregnancy can harm the baby. This belief is rooted in the traditional practice of avoiding certain foods and behaviors to ensure a healthy pregnancy. Carrying a spit cup to avoid swallowing saliva is a common practice among some Haitian women during pregnancy. It is important to note that this belief may not be representative of all Haitian women, as cultural practices can vary within a community.

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  • 26. 

    A major cultural group of childbearing women at increased risk for alcoholism, heart disease, cirrhosis of the liver, and diabetes mellitus is the population of women who are:

    • A.

      African American/ black

    • B.

      American Indian/ Alaskan native

    • C.

      Asian American/ Pacific Islander

    Correct Answer
    B. American Indian/ Alaskan native
    Explanation
    American Indian/ Alaskan native women are at increased risk for alcoholism, heart disease, cirrhosis of the liver, and diabetes mellitus. This may be due to a combination of genetic predisposition, lifestyle factors, and limited access to healthcare and resources. Historical trauma, social and economic disparities, and cultural factors also contribute to the higher risk among this population. It is important to provide targeted interventions and support to address these health disparities and improve the overall well-being of American Indian/ Alaskan native women.

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  • 27. 

    According to the hot/cold theory, pregnancy is thought to be which kind of a condition?

    • A.

      Cold

    • B.

      Hot

    • C.

      Lukewarm

    Correct Answer
    B. Hot
    Explanation
    According to the hot/cold theory, pregnancy is believed to be a "hot" condition. This theory suggests that certain conditions or states of the body can be classified as either hot or cold, and pregnancy is considered to fall under the hot category. This classification is based on traditional beliefs and practices in some cultures, where hot conditions are associated with increased energy, activity, and warmth, while cold conditions are associated with decreased energy and activity.

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  • 28. 

    Ethnocentrism is the belief that:

    • A.

      Cultural values are major determiners of one's behavior

    • B.

      Every cultural group has a core or center of common beliefs

    • C.

      Values and practices of one's own culture are superior

    Correct Answer
    C. Values and practices of one's own culture are superior
    Explanation
    Ethnocentrism refers to the belief that the values and practices of one's own culture are superior to those of other cultures. This perspective often leads individuals to judge other cultures based on their own cultural standards, resulting in a biased and narrow-minded view. Ethnocentrism can hinder cultural understanding and appreciation, as it promotes the idea that one's own culture is the ultimate benchmark for evaluating others. This belief can lead to prejudice, discrimination, and a lack of respect for diversity.

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  • 29. 

    A woman whose discharge plan includes her mother-in-law caring for her and her newborn during the postpartum period by tradition is the most likely from which of the following cultures?

    • A.

      Korean

    • B.

      Laotian

    • C.

      Tongan

    Correct Answer
    A. Korean
    Explanation
    The correct answer is Korean. In Korean culture, it is common for the mother-in-law to play a significant role in caring for the mother and newborn during the postpartum period. This tradition is known as "samchilil" and is believed to provide support and assistance to the new mother as she recovers and adjusts to motherhood. The mother-in-law typically takes on responsibilities such as cooking, cleaning, and taking care of the baby, allowing the new mother to rest and recover.

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  • 30. 

    What percentage of nurses come from racial or ethnic minority backgrounds?

    • A.

      9%

    • B.

      13%

    • C.

      17%

    Correct Answer
    A. 9%
    Explanation
    The correct answer is 9%. This means that out of all the nurses, only 9% come from racial or ethnic minority backgrounds. This suggests that there is a lack of diversity in the nursing profession, with the majority of nurses being from non-minority backgrounds. Increasing diversity in the nursing workforce is important to ensure culturally competent care and representation for all patients.

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  • 31. 

    Goals each nurse can set to increase cultural competence while caring for culturally diverse childbearing women and their families are described as:

    • A.

      Culturally driven

    • B.

      Externally based

    • C.

      Self-generated

    Correct Answer
    C. Self-generated
    Explanation
    The explanation for the correct answer, "self-generated," is that each nurse can individually take the initiative to set goals for themselves in order to increase their cultural competence while caring for culturally diverse childbearing women and their families. This means that the nurse is personally motivated and responsible for their own growth and development in this area, rather than relying on external factors or being driven by cultural influences. By setting self-generated goals, nurses can actively engage in learning and acquiring the necessary knowledge and skills to provide culturally competent care.

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  • 32. 

    By 28 to 34 weeks' gestation in a normal pregnancy, blood volume has increased by approximately

    • A.

      10%-20%

    • B.

      30%-50%

    • C.

      60%-80%

    Correct Answer
    B. 30%-50%
    Explanation
    By 28 to 34 weeks' gestation in a normal pregnancy, the blood volume increases by approximately 30%-50%. This is because during pregnancy, the body produces more blood to support the growing fetus and provide oxygen and nutrients. The increase in blood volume helps to ensure an adequate blood supply to the placenta and the developing baby. It also helps to compensate for the increase in blood flow to the uterus and other organs. Therefore, it is expected for blood volume to increase by 30%-50% during this stage of pregnancy.

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  • 33. 

    During pregnancy, the position for optimum maternal cardiac output is:

    • A.

      Lateral

    • B.

      Semi-fowlers

    • C.

      Supine

    Correct Answer
    A. Lateral
    Explanation
    During pregnancy, the optimum position for maternal cardiac output is lateral. This position allows for better blood flow and circulation to the placenta, which is essential for providing oxygen and nutrients to the developing fetus. Lying on the side also helps to minimize pressure on major blood vessels, such as the inferior vena cava, which can become compressed in the supine position and impede blood flow. Therefore, the lateral position is recommended to ensure adequate cardiac output and promote a healthy pregnancy.

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  • 34. 

    During labor, maternal cardiac output:

    • A.

      Decreases slightly

    • B.

      Increases progressively

    • C.

      Remains the same

    Correct Answer
    B. Increases progressively
    Explanation
    During labor, maternal cardiac output increases progressively. This is because the body needs to supply more oxygen and nutrients to the growing fetus. As the uterus contracts and the intensity of contractions increases, it leads to an increase in maternal heart rate and stroke volume, resulting in a higher cardiac output. This helps to ensure an adequate blood supply to the placenta and meet the increased metabolic demands of both the mother and the baby during labor.

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  • 35. 

    An intravenous (IV) fluid bolus is given before epidural anesthesia to prevent:

    • A.

      Hypotension

    • B.

      Renal hypoperfusion

    • C.

      Sympathetic blockade

    Correct Answer
    A. Hypotension
    Explanation
    An intravenous (IV) fluid bolus is given before epidural anesthesia to prevent hypotension. This is because epidural anesthesia can cause a drop in blood pressure, and the IV fluid bolus helps maintain blood volume and prevent hypotension.

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  • 36. 

    Normally during pregnancy, maternal sitting and standing diastolic blood pressure readings:

    • A.

      Decrease, then increase

    • B.

      Increase progressively

    • C.

      Remain unchanged

    Correct Answer
    A. Decrease, then increase
    Explanation
    During pregnancy, maternal sitting and standing diastolic blood pressure readings initially decrease. This is because of the increased progesterone levels, which cause relaxation of the blood vessels, leading to lower blood pressure. However, as the pregnancy progresses and the blood volume increases, the diastolic blood pressure gradually increases. This is a normal physiological response to accommodate the increased demands of the growing fetus and placenta.

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  • 37. 

    The volume of the maternal autotransfusion immediately after birth is approximately:

    • A.

      600ml

    • B.

      800ml

    • C.

      1000ml

    Correct Answer
    C. 1000ml
    Explanation
    The volume of the maternal autotransfusion immediately after birth is approximately 1000ml. Autotransfusion refers to the process of the mother's blood being transferred back into her circulation after delivery. This blood is typically collected from the placenta and umbilical cord. The average volume of blood collected during autotransfusion is around 1000ml, which helps replenish the mother's blood volume and prevent postpartum hemorrhage.

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  • 38. 

    What happens to maternal PaO2 and PaCO2 levels during pregnancy?

    • A.

      Both decrease

    • B.

      Both increase

    • C.

      PaO2 increases and PaCO2 decreases

    Correct Answer
    C. PaO2 increases and PaCO2 decreases
    Explanation
    During pregnancy, the maternal PaO2 (partial pressure of oxygen) levels increase while the PaCO2 (partial pressure of carbon dioxide) levels decrease. This is due to the increased oxygen demand by the growing fetus, which leads to a higher oxygen intake and improved oxygenation of the blood. Additionally, the increased respiratory rate and tidal volume during pregnancy help to eliminate carbon dioxide more efficiently, resulting in a decrease in PaCO2 levels.

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  • 39. 

    The slight increase in pH that occurs during pregnancy is due to:

    • A.

      A decrease in hemoglobin and hematocrit

    • B.

      A decrease in renal excretion of bicarbonate

    • C.

      An increase in ventilator rate

    Correct Answer
    C. An increase in ventilator rate
    Explanation
    During pregnancy, there is an increase in the ventilator rate, which refers to an increase in the respiratory rate. This increased rate of breathing helps to meet the increased oxygen demand of the mother and the developing fetus. As a result of the increased ventilator rate, there is a slight decrease in the amount of carbon dioxide in the blood, leading to a slight increase in pH. This is because carbon dioxide is an acidic compound, and its removal from the blood leads to a more alkaline environment, causing the pH to increase.

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  • 40. 

    During pregnancy serum urea and creatine levels:

    • A.

      Decrease

    • B.

      Increase

    • C.

      Remain constant

    Correct Answer
    A. Decrease
    Explanation
    During pregnancy, the body undergoes various physiological changes to support the growing fetus. One of these changes is an increase in blood volume, which leads to an increase in kidney function. As a result, the kidneys are able to filter waste products more efficiently, leading to a decrease in serum urea and creatine levels. This decrease is considered normal during pregnancy and is not a cause for concern.

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  • 41. 

    Heartburn is common during pregnancy due primarily to:

    • A.

      Decreased gastric motility

    • B.

      Increased secretion of hydrochloric acid

    • C.

      Relaxation of the lower esophageal sphincter

    Correct Answer
    C. Relaxation of the lower esopHageal spHincter
    Explanation
    During pregnancy, the relaxation of the lower esophageal sphincter is the primary reason for heartburn. The lower esophageal sphincter normally acts as a barrier to prevent stomach acid from flowing back into the esophagus. However, hormonal changes during pregnancy can cause this sphincter to relax, allowing stomach acid to reflux into the esophagus. This reflux leads to the burning sensation known as heartburn. Decreased gastric motility and increased secretion of hydrochloric acid may contribute to heartburn, but the relaxation of the lower esophageal sphincter is the main cause.

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  • 42. 

    A physical finding that may occur during pregnancy in response to normal cardiovascular changes is:

    • A.

      Decreased heart rate

    • B.

      Dependent edema

    • C.

      Elevated blood pressure

    Correct Answer
    B. Dependent edema
    Explanation
    During pregnancy, the body undergoes various changes to accommodate the growing fetus. One of these changes is an increase in blood volume, which can lead to fluid retention and swelling in the lower extremities, known as dependent edema. This occurs due to the pressure on the veins and the decreased return of blood flow from the legs to the heart. Therefore, dependent edema is a normal physical finding that can occur during pregnancy.

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  • 43. 

    The average blood loss during vaginal birth is less than:

    • A.

      300ml

    • B.

      500ml

    • C.

      700ml

    Correct Answer
    B. 500ml
    Explanation
    The average blood loss during vaginal birth is generally less than 500ml. This is because the body naturally constricts blood vessels and forms blood clots to minimize bleeding after childbirth. However, it is important to note that every birth is different, and some women may experience more or less blood loss depending on various factors such as the duration of labor, the presence of complications, and individual differences in physiology.

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  • 44. 

    The average blood loss during cesarean birth is less than:

    • A.

      600ml

    • B.

      800ml

    • C.

      1000ml

    Correct Answer
    C. 1000ml
    Explanation
    The average blood loss during cesarean birth is less than 1000ml. This means that on average, women who undergo a cesarean birth do not lose more than 1000ml of blood during the procedure. It is important to note that this is an average and individual cases may vary.

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  • 45. 

    During pregnancy, cardiac output increases approximately:

    • A.

      10%-25%

    • B.

      30%-50%

    • C.

      60%-75%

    Correct Answer
    B. 30%-50%
    Explanation
    During pregnancy, the body undergoes numerous physiological changes to support the growing fetus. One of these changes is an increase in cardiac output, which refers to the volume of blood pumped by the heart per minute. The correct answer is 30%-50% because during pregnancy, the cardiac output typically increases by this range. This increase is necessary to meet the increased demands of the mother and the developing baby, ensuring an adequate supply of oxygen and nutrients.

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  • 46. 

    Cardiac output is greatest during which period of the birth process?

    • A.

      First stage, active phase

    • B.

      Immediately after birth

    • C.

      Second stage

    Correct Answer
    B. Immediately after birth
    Explanation
    Immediately after birth, the cardiac output is at its greatest. This is because during the birthing process, the baby transitions from receiving oxygen and nutrients through the placenta to breathing on its own. As a result, there is a sudden increase in blood flow to the lungs, which leads to an increase in cardiac output. Additionally, the baby's heart undergoes changes in structure and function to adapt to the new postnatal circulation, further contributing to the increased cardiac output during this period.

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  • 47. 

    A cardiovascular parameter which normally decreases during pregnancy is:

    • A.

      Heart rate

    • B.

      Stroke volume

    • C.

      Systemic vascular resistance

    Correct Answer
    C. Systemic vascular resistance
    Explanation
    During pregnancy, the body undergoes several changes to accommodate the growing fetus. One of these changes is the decrease in systemic vascular resistance. This is because the body needs to increase blood flow to the placenta and uterus to provide oxygen and nutrients to the developing baby. By reducing systemic vascular resistance, blood vessels dilate, allowing for easier blood flow and ensuring an adequate blood supply to the fetus. This decrease in resistance also helps to lower blood pressure, which is beneficial for both the mother and the baby.

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  • 48. 

    An expected white blood cell count during labor and early postpartum is:

    • A.

      8,000-10,000 mm3

    • B.

      13,000-15,000 mm3

    • C.

      20,000-22,000 mm3

    Correct Answer
    C. 20,000-22,000 mm3
    Explanation
    During labor and early postpartum, it is expected for the white blood cell count to increase as a normal physiological response to the stress of childbirth. This increase in white blood cell count helps the body fight off any potential infections that may occur during this time. A range of 20,000-22,000 mm3 is considered within the normal expected range for white blood cell count during labor and early postpartum.

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  • 49. 

    Which of the following coagulation factors does not increase during pregnancy?

    • A.

      Fibrin

    • B.

      Platelets

    • C.

      Fibrinogen

    Correct Answer
    B. Platelets
    Explanation
    During pregnancy, the levels of various coagulation factors increase to prevent excessive bleeding during childbirth. Fibrin is a protein that forms blood clots, and its levels increase during pregnancy. Fibrinogen is a precursor to fibrin and also increases during pregnancy. However, platelets, which are responsible for clot formation, do not increase in number during pregnancy. This is because the increase in fibrin and fibrinogen compensates for the lack of increase in platelets, ensuring proper clotting function.

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  • 50. 

    Which of the following increases during pregnancy?

    • A.

      Colloid oncotic pressure

    • B.

      Glomerular filtration rate

    • C.

      Serum osmolarity

    Correct Answer
    B. Glomerular filtration rate
    Explanation
    During pregnancy, the glomerular filtration rate (GFR) increases. This is because the increased blood volume and cardiac output during pregnancy lead to increased renal blood flow. As a result, more blood is filtered through the glomerulus, leading to an increased GFR. This is a normal physiological adaptation to support the increased metabolic demands of the mother and the growing fetus.

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Quiz Review Timeline +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 21, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 10, 2014
    Quiz Created by
    Krussell07
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