NCLEX-PN › Identifying OB/GYN Conditions
The nurse completes a cervical exam on her laboring patient. She determines that her patient's cervix is 1cm in length. How would the nurse describe this length?
effaced
effaced
effaced
effaced
effaced
The normal cervical canal is 2cm in length. Effacement is the thinning of the cervix as the body prepares for delivery. Thus, a 2cm cervix is 0% effaced and a 0cm cervix is 100% effaced.
Which of the following is a possible cause of vaginal bleeding in early pregnancy?
All of these are correct
Spontaneous abortion/miscarriage
Cervical ectropion
Trophoblastic disease
All of these could be possible reasons for bleeding in early pregnancy, including physiologic or implantation bleeding. Bleeding may indicate threatened miscarriage or other serious condition, or it may simply be due to the implantation of the embryo into the endometrium.
Which of the following terms denotes a menstrual cycle that is irregular, of shorter duration than normal, and of excessive volume or duration?
Menometrorrhagia
Metrorrhagia
Amenorrhea
Oligomenorrhea
Menometrorrhagia is a term used to describe a menstrual cycle that is irregular, of shorter duration than normal, and of excessive volume or duration. Amenorrhea is the absence of a menstrual cycle. Metrorrhagia is a term for a menstrual cycle that is of normal flow duration and volume, but which is irregular and has a shorter-than normal cycle length. Oligomenorrhea describes a menstrual cycle that is longer than 35 days, often characterized by a prolonged follicular phase.
The nurse helps the healthcare team to deliver a healthy baby girl. Upon delivery of the placenta, the nurse notices that it is not 100% intact. What is the nurse's first concern?
Hemorrhage
Infection
Tissue perfusion
Deep vein thrombosis
Pulmonary embolism
If the placenta is not whole upon delivery, a piece may still be present in the uterus. This inhibits the ability of the uterus to shrink in size and may cause hemorrhage. The missing piece needs to be located immediately.
Which of the following increase the risk of endometriosis?
All of these are correct
Lack of exercise
Family history of endometriosis
Presence of an intrauterine device (IUD)
The incidence of endometriosis increases significantly in individuals with a family history of the condition. Other contributing factors are sedentary lifestyle (lack of exercise), presence of an intrauterine device, a diet high in fat, the presence of estrogen dominance, and liver dysfunction (due to decreased estrogen metabolism).
What is the triad of presenting symptoms with endometriosis?
Dysmenorrhea, infertility, and dyspareunia
Dysmenorrhea, metrorrhagia, and dysuria
Menorrhagia, infertility, and dyspraeunia
Hirsutism, infertility, and oligomenorrhea
The triad of presenting symptoms for endometriosis is dysmenorrhea (painful menses), infertility, and dyspareunia (pain on sexual intercourse). The most common presenting symptom is extreme, intense uterine cramps which may radiate to the back or down the thighs. Endometriosis is also a common cause of infertility due to a local paracrine effect. Pain on intercourse may be due to the implantation of endometrial cells in the vagina or the area around the cervix. Endometriosis will not necessarily result in menorrhagia, or excessively heavy bleeding. Hirsutism, infertility, and oligomenorrhea are symptoms commonly seen in polycystic ovarian syndrome (PCOS), rather than endometriosis.
A nurse is assessing an 18-year-old woman who has come into the emergency department for bilateral abdominal pain. Which of the following should the nurse not consider a risk factor for ectopic pregnancy?
Yeast infection
Endometriosis
Neisseria gonorrhoeae
Chlamydia trachomatis
Uterine fibroids
Uterine conditions such as endometriosis and uterine fibroids increase the risk of ectopic pregnancy. Endometriosis is the inappropriate growth of uterine tissue outside the uterus. Uterine fibroids are benign tumors within the uterus. Sexually transmitted infections can cause a condition called pelvic inflammatory disease which can result in scarring. Scarring of the reproductive system greatly increases the risk of ectopic pregnancy and infertility. Yeast infections are common after antibiotic therapy and are treated with an over-the-counter medication. They generally do not cause permanent damage to the body.
Which of the following is not a risk factor for gestational diabetes?
Poor diet
Obesity
Family history of diabetes
Previous stillbirth
Previous macrosomic infant
Risk factors for gestational diabetes include: obesity, family history of diabetes, history of gestational diabetes, hypertension, pre-eclampsia/eclampsia, recurrent urinary tract infections, vaginitis, polyhydramnios, previous large infants (9lbs or greater than 4000g), glycosuria or proteinuria on two or more occasions. While poor diet may contribute to diabetic concerns, it is not directly associated with a higher risk of gestation diabetes as the other risk factors are. During the prenatal period, nurses are responsible for educating their patients on all of these risk factors as well as a proper prenatal diet.
In a fetus positioned at left occiput anterior (LOA), where should the nurse assess the fetal heart rate (FHR)?
Below umbilicus on mother's left side
Above umbilicus on mother's right side
Above umbilicus on mother's left side
Below umbilicus on mother's right side
At level of umbilicus
When considering where to hear fetal heart rate best, the nurse must consider the location of the fetal back. Weeks gestation or size may also effect the location of the best place to assess fetal heart rate. LOA, or left occiput anterior, is the most common fetal lie. A fetus in LOA is in vertex presentation with the fetal occiput on the mother's left side toward the front of her pelvis. In LOA, the FHR is best heard below the umbilicus on the mother's left side.
In LOP (left occiput posterior), the FHR is best heard on the mother's left side at the level of the umbilicus. In ROA (right occiput anterior): the mother's right side below the umbilicus. In ROP (right occiput posterior): the mother's right side at the level of the umbilicus. In LSA (left sacrum anterior): the mother's left side above the umbilicus. In RSA (right sacrum anterior): the mother's right side above the umbilicus.
Which of the following is not a risk factor for gestational diabetes?
Asian ethnicity
High blood pressure
Advanced maternal age
Newborn weighing 9lbs 2oz
Prior birth of a child with a congenital disorder
Asian ethnicity is not considered a risk factor. Hispanic, Native American and African American ethnicities are considered risk factors for gestational diabetes. Others include maternal obesity, previous pregnancies with gestational diabetes, delivery of a very large baby, and a family history of diabetes.