Obstetrics and Gynaecology Nursing Questions and Answers
1. What is the most common complication associated with too rapid delivery in precipitate labor?
a. Pitting edema of the baby’s scalp
b. Dural or subdural tears in fetal brain tissue
c. Premature separation of the placenta
d. Prolonged retention of the placenta
2. The nurse has just completed emergency delivery of a term infant. What is the priority nursing concern at this time?
a. Controlling hemorrhage in the mother
b. Removing the afterbirth
c. Keeping the infant warm
d. Cutting the umbilical cord
3. A woman spontaneously delivers a baby girl who is immediately handed to the nurse. Which action is of highest priority for the nurse?
a, Do an Apgar assessment.
b. Check neonatal heart rate.
c. Apply identification bracelets.
d. Clear the nasopharynx.
4. Which of the following is the most important nursing assessment during the fourth stage of labor?
a. Bonding behaviors
b. Distention of the bladder
c. Ability to relax
d. Knowledge of newborn behavior
5. The nursing care plan for a woman who has placenta abruptio should include careful assessment for signs and symptoms of which of the following?
b. Hypovolemic shock
c. Impending convulsions
6. A woman is admitted with suspected placenta previa. What test does the nurse expect will be done to confirm the diagnosis?
a. Internal exam
b. Nonstress test
c. Oxytocin challenge test
7. Magnesium sulfate is ordered for a client who is hospitalized for pregnancy-induced hypertension (PIH). What effects would the nurse expect to see as a result of this medication?
a. CNS depression
b. Decreased gastric acidity
c. Onset of contractions
d. Decrease in number of bowel movements
8. The nurse is caring for a laboring woman who has a history of rheumatic heart disease. How should the nurse position her during labor?
9. Which area of health teaching will a new mother be most responsive to during the taking in phase of the postpartum period?
a. Family planning
b. Newborn care
c. Community support groups
d. Perineal care
Obstetrics and Gynaecology Nursing Questions and Answers – Rationale
1. The sudden change of pressure tends to tear away dural linings. The mother can also get perineal tears.
Answer 1 is not correct. Oedema of the scalp is not a complication with precipitate labour. Sometimes prolonged labour can cause caput succedaneum, where the baby has to bleed under the scalp.
Answers 3 and 4 are not correct. Rapid delivery is not particularly associated with placental problems.
2. Newborns have immature temperature-regulating mechanisms. The nurse should dry the infant and place the infant in a blanket or towel on the mother’s abdomen. Answer 1 is not correct. The first concern
is clearing the infant’s airway and keeping the infant warm. The mother is not likely to haemorrhage at this time. Maternal haemorrhage would be more likely after delivery of the placenta. Answer 2 is not correct. The afterbirth or placenta should separate and deliver itself within 5 to 15 minutes after the baby is born. The nurse should care for the baby until this happens. Answer 4 is not correct. There is no hurry to cut the cord. The cord should never be cut with anything that is not sterile because the baby could develop a fatal infection.
3. Always make sure the airway is clear first. Apgar scoring is not the licensed practical nurse’s responsibility, and it is not the highest priority. Checking heart rate and applying identification bracelets are secondary to clearing the airway.
4. A distended bladder may interfere with the involution of the uterus and cause excessive bleeding. The nurse will observe for appropriate bonding behaviours and maternal relaxation and maternal knowledge
of newborn behaviour, but the most important is assessment for bladder distention (because that could cause uterine relaxation and haemorrhage).
5. Abruptio placenta causes haemorrhage, either apparent or concealed. The nurse must observe for hypovolemic shock. Jaundice is not seen with placenta abruption. Convulsions occur with eclampsia or pregnancy-induced hypertension. The client who is haemorrhaging will develop shock, not
hypertension. Note the opposites; the shock is low blood pressure, and hypertension is high blood pressure.
The answer is likely to be one of the opposites.
6. A sonogram will show the position of the placenta in the uterus. An internal exam will probably not be done because it can cause severe bleeding when there is a placenta previa. The nonstress test and the oxytocin challenge test are done to see how the fetus responds to contractions.
7. Magnesium sulfate is a central nervous system depressant. It is given to prevent seizures.
Magnesium hydroxide gel is an antacid. Oxytocin is given to initiate contractions. Magnesium sulfate may decrease contractions. Magnesium sulfate does not cause constipation. Some laxatives contain magnesium.
8. The semi-recumbent or semi-sitting position would be the most appropriate position to reduce the cardiac workload and ease breathing. The labouring woman who has a history of rheumatic heart disease is at risk for congestive heart failure.
The supine and side-lying positions would increase the cardiac workload. Sitting upright is not the best choice.
9. During the taking phase, the mother is more self-centred. She will be most responsive to perineal care. She will be most responsive to family planning and newborn care during the taking hold phase. Awareness of community support groups would be in the taking hold or letting go phases.
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