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obstetrics and gynaecology


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#1. During which of the following stages of labor would the nurse assess “crowning”?

  • Crowing, which occurs when the newborn’s head or presenting part appears at the vaginal opening, occurs during the second stage of labor.
  • During the first stage of labor, cervical dilation and effacement occur.
  • During the third stage of labor, the newborn and placenta are delivered.
  • The fourth stage of labor lasts from 1 to 4 hours after birth, during which time the mother and newborn recover from the physical process of birth and the mother’s organs undergo the initial readjustment to the nonpregnant state.

#2. Which of the following assessment findings would the nurse expect if the client develops DVT?

  • Classic symptoms of DVT include muscle pain, the presence of Homans sign, and swelling of the affected limb.
  • Midcalf pain, tenderness, and redness, along the vein reflect superficial thrombophlebitis.
  • Chills, fever and malaise occurring 2 weeks after delivery reflect pelvic thrombophlebitis.
  • Chills, fever, stiffness and pain occurring 10 to 14 days after delivery suggest femoral thrombophlebitis.

#3. Which of the following would cause a false-positive result on a pregnancy test?

  • A false-positive reaction can occur if the pregnancy test is performed less than 10 days after an abortion.
  • Performing the tests too early or too late in the pregnancy, storing the urine sample too long at room temperature, or having a spontaneous or missed abortion impending can all produce false-negative results.

#4. Which of the following amounts of blood loss following birth marks the criterion for describing postpartum hemorrhage?

  • Postpartum hemorrhage is defined as blood loss of more than 500 ml following birth.
  • Any amount less than this not considered postpartum hemorrhage.

#5. Which of the following would the nurse assess in a client experiencing abruptio placenta?

Abruptio Placentae - Obstetrics - Medbullets Step 2/3

  • A client with abruptio placentae may exhibit concealed or dark red bleeding, possibly reporting sudden intense localized uterine pain.
  • The uterus is typically firm to boardlike, and the fetal presenting part may be engaged.
  • Bright red, painless vaginal bleeding, a palpable fetal outline and a soft nontender abdomen are manifestations of placenta previa.

#6. When assessing the adequacy of sperm for conception to occur, which of the following is the most useful criterion?

  • Although all of the factors listed are important, sperm motility is the most significant criterion when assessing male infertility.
  • Sperm count, sperm maturity, and semen volume are all significant, but they are not as significant sperm motility.

#7. When talking with a pregnant client who is experiencing aching swollen, leg veins, the nurse would explain that this is most probably the result of which of the following?

  • Pressure of the growing uterus on blood vessels results in an increased risk for venous stasis in the lower extremities.
  • Subsequently, edema and varicose vein formation may occur.
  • Thrombophlebitis is an inflammation of the veins due to thrombus formation.
  • Pregnancy-induced hypertension is not associated with these symptoms.
  • Gravity plays only a minor role with these symptoms.

#8. Which of the following statements best describes hyperemesis gravidarum?

  • The description of hyperemesis gravidarum includes severe nausea and vomiting, leading to electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems.
  • Hyperemesis is not a form of anemia.
  • Loss of appetite may occur secondary to the nausea and vomiting of hyperemesis, which, if it continues, can deplete the nutrients transported to the fetus.
  • Diarrhea does not occur with hyperemesis.

#9. When PROM occurs, which of the following provides evidence of the nurse’s understanding of the client’s immediate needs?

  • PROM can precipitate many potential and actual problems; one of the most serious is the fetus loss of an effective defense against infection.
  • This is the client’s most immediate need at this time.
  • Typically, PROM occurs about 1 hour, not 4 hours, before labor begins.
  • Fetal viability and gestational age are less immediate considerations that affect the plan of care.
  • Malpresentation and an incompetent cervix may be causes of PROM.

#10. A client LMP began July 5. Her EDD should be which of the following? A

  1. To determine the EDD when the date of the client’s LMP is known use Nagele rule.
  2. To the first day of the LMP, add 7 days, subtract 3 months, and add 1 year (if applicable) to arrive at the EDD as follows: 5 7 = 12 (July) minus 3 = 4 (April). Therefore, the client’s EDD is April 12.
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