Causes and Treatments of OB/GYN Conditions

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NCLEX-PN › Causes and Treatments of OB/GYN Conditions

Questions 1 - 10
1

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

Birth defects

Gestational diabetes

Maternal ocular damage

Maternal death

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.

2

Which of the following reasons does not indicate the need to induce labor?

Fetal macrosomia

Diabetes

Postmaturity

Gestational hypertension

Fetal jeopardy

Explanation

Induction of labor may occur for various indications: diabetes, postmaturity, hypertensive disorders or pregnancy, fetal jeopardy, or logistical factors including distance from qualified hospital or a rate of rapid birth. Induction of labor may only occur if the mother does not have cephalopelvic disproportion (CPD), the fetus has a vertex presentation with an engaged head, and the mother has a "ripened" cervic or is prepared to be "ripened". Fetal macrosomia is a concerning condition and may require intervention, but is typically not resolved by inducing labor. With fetal macrosomia, a cesarean section may be considered instead of vaginal delivery, due to the potential risks of delivering a large infant vaginally.

3

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

Hemolytic disease of the newborn

Preeclampsia

Gestational diabetes

Hyperemesis gravidarum

Postpartum hemorrhage

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.

4

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

Rh negative mother, Rh positive fetus

Rh positive mother, Rh negative fetus

Rh positive mother, Rh positive fetus

Rh negative mother, Rh negative 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.

5

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

Rho(D) immune globulin

Therapeutic abortion

Rh-D fetal serum injections

Short-course immunosuppressant treatment

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.

6

Which of the following is false regarding the respiratory system of pregnant women?

The rib cage becomes slightly more compact

Total lung capacity decreases

The diaphragm elevates

Oxygen consumption is increased

There is increased metabolic demand for oxygen from the body

Explanation

In pregnancy, the ribs start to flare (expand slightly) as the pressure from the growing fetus moves the diaphragm upwards. Many women experience this during the third trimester as the baby is at it's largest. The flaring of the ribs is assisted by maternal hormones that enable more flexibility throughout the body.

7

A woman is hospitalized for preeclampsia. Which medication may the nurse administer to prevent the occurrence of seizures?

Magnesium sulfate

Calcium gluconate

Pitocin

Nubain

Zolpidem

Explanation

Magnesium sulfate is used to prevent seizures in women with severe preeclampsia. Calcium gluconate is the antidote if magnesium toxicity is assessed. It should be readily available when a woman is receiving magnesium sulfate. Pitocin is used to stimulate the uterus, often to induce labor. Nubain is an opioid that can be given to women during labor to treat pain. Zolpidem (Ambien) is a sleep aid.

8

Which of the following is not a risk-factor for uterine leiomyoma?

Smoking

Obesity

Red meat consumption

Family history

Explanation

The main risk factors for uterine leiomyoma are family history, obesity, and red meat consumption. Smoking is not a risk factor.

9

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

All of these

Exposure to cat feces (often via a litter box)

Contaminated water

Undercooked meat

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.

10

Which of the following increases risk of ectopic pregnancy?

All of these are correct

History of pelvic inflammatory disease

Post-tubal ligation

Endometriosis

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.

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