NCLEX : Causes and Treatments of OB/GYN Conditions

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #21 : Causes And Treatments Of Ob/Gyn Conditions

What would be the primary concern in the case of rubella infection during pregnancy?

Possible Answers:

Gestational diabetes

Birth defects

Maternal ocular damage

Maternal death

Correct answer:

Birth defects

Explanation:

The primary risk in rubella infection during pregnancy is to the fetus. The rubella virus is able to cross the placenta, and acts as a teratogen by inducing apoptosis in fetal cells. This is termed congenital rubella syndrome. Birth defects can include deafness, ocular damage, cataracts, congenital heart defects, hepatomegaly, and developmental disability or delays. 

Example Question #22 : Causes And Treatments Of Ob/Gyn Conditions

At what time during gestation is a fetus most susceptible to congenital rubella syndrome?

Possible Answers:

Week 20-30

Week 30-40

The first 12 weeks after conception

Week 12-20

Correct answer:

The first 12 weeks after conception

Explanation:

Infants who are exposed to rubella during weeks 0-12 of gestation have a 51% chance of developing congenital rubella syndrome. If the fetus is exposed to the virus between 12 and 26 weeks, the incidence of defects drops to 23%. Congenital rubella syndrome is rare in infants whose mothers were initially exposed to the virus after 26 weeks of gestation. Interestingly, the fetus is more likely to have birth defects if the mother contracted rubella before conception - infants whose mothers contracted the virus 0-4 weeks before conception have as much as 43% incidence of congenital rubella syndrome, due to it's long incubation period. 

Example Question #23 : Causes And Treatments Of Ob/Gyn Conditions

Which of the following is the definition of gestational hypertension?

Possible Answers:

Blood pressure over 140/90 mmHg or rise of more than 40 mmHg systolic or 25 mmHg diastolic over baseline

Blood pressure over 140/90 mmHg or rise of more than 30 mmHg systolic or 15 mmHg diastolic over baseline

Blood pressure over 160/95 mmHg or rise of more than 30 mmHg systolic or 15 mmHg diastolic over baseline

Blood pressure over 130/85 mmHg or rise of more than 35 mmHg systolic or 20 mmHg diastolic over baseline

Correct answer:

Blood pressure over 140/90 mmHg or rise of more than 30 mmHg systolic or 15 mmHg diastolic over baseline

Explanation:

Gestational hypertension is defined as a blood pressure over 140/90 mmHg or rise of more than 30 mmHg systolic or 15 mmHg diastolic over baseline. It generally develops after week 20 of pregnancy and returns to normal after delivery.

Example Question #1035 : Nclex

Which of the following is NOT a part of the triad of gestational hypertension?

Possible Answers:

High blood pressure

Proteinuria

Headache

Edema

Correct answer:

Headache

Explanation:

The classic triad of gestational hypertension is high blood pressure, proteinuria, and edema. New-onset headaches during a pregnancy that includes gestational hypertension may be a sign of a more severe condition, such as preeclampsia. 

Example Question #233 : Conditions And Treatments

At what point in a pregnancy is preeclampsia most likely to develop?

Possible Answers:

12-24 weeks

20-32 weeks

0-12 weeks

After 32 weeks

Correct answer:

After 32 weeks

Explanation:

Preeclampsia occurs more frequently in the last 8 weeks of pregnancy. Occurrence at an earlier gestational age is associated with increased severity and poorer outcomes for both mother and fetus.  

Example Question #24 : Causes And Treatments Of Ob/Gyn Conditions

Which of the following increases risk of ectopic pregnancy?

Possible Answers:

History of pelvic inflammatory disease

Endometriosis

All of these are correct

Post-tubal ligation

Correct answer:

All of these are correct

Explanation:

Ectopic pregnancy is a serious condition in which an embryo implants in tissue outside the uterus. Risk factors include pelvic inflammatory disease, tubal ligation, endometriosis, tobacco smoking, history of infertility, and the use of assisted reproductive technology.

Example Question #25 : Causes And Treatments Of Ob/Gyn Conditions

Which of the following is a risk factor for development of toxoplasmosis in pregnancy?

Possible Answers:

Undercooked meat

Contaminated water

Exposure to cat feces (often via a litter box)

All of these

Correct answer:

All of these

Explanation:

Toxoplasmosis is a parasitic infection that is capable of crossing the placenta. It can cause birth defects such as hearing loss, learning disorders, and visual impairment. Toxoplasmosis infection is primarily a concern only in individuals who have never been exposed to the parasite before pregnancy, as most people develop immunity to infection 6-9 months after their first exposure (often through contact with cat feces in litter boxes or soil). The main routes of toxoplasmosis infection in pregnant women are exposure to cat feces, water contamination, consumption of undercooked meats, and blood transfusion. 

Example Question #1041 : Nclex

Which of the following conditions can be triggered by Rh incompatibility between mother and fetus? 

Possible Answers:

Hemolytic disease of the newborn

Postpartum hemorrhage

Gestational diabetes

Hyperemesis gravidarum 

Preeclampsia

Correct answer:

Hemolytic disease of the newborn

Explanation:

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 #1042 : Nclex

Which of the following maternal/fetal blood types can lead to hemolytic disease of the newborn?

Possible Answers:

Rh positive mother, Rh negative fetus

Rh negative mother, Rh negative fetus

Rh positive mother, Rh positive fetus

Rh negative mother, Rh positive fetus

Correct answer:

Rh negative mother, Rh positive fetus

Explanation:

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 #1043 : Nclex

What treatment can prevent the development of sensitization to Rh-D antigen in an Rh negative mother carrying an Rh positive fetus?

Possible Answers:

Rh-D fetal serum injections

Short-course immunosuppressant treatment

Therapeutic abortion

Rho(D) immune globulin

Correct answer:

Rho(D) immune globulin

Explanation:

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.

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