Symptoms and Tests for OB/GYN Conditions

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NCLEX-PN › Symptoms and Tests for OB/GYN Conditions

Questions 1 - 10
1

Which of the following symptoms is not a danger sign of pregnancy?

Increased urination

Vaginal bleeding

Fever or chills

Swelling in face or fingers

Persistent vomiting

Explanation

It is important for the obstetric registered nurse to recognize the following danger signs of pregnancy: profuse vaginal bleeding, severe headaches/visual disturbances/abdominal pain, persistent vomiting, fever, chills, or swelling in the face or fingers. These may be signs of placental abnormalities, hypertensive disorders or pregnancy, maternal infection, or hyperemesis. Increased urination may be concerning to some women, but during pregnancy, the increased mass of the uterus induces pressure upon the bladder.

2

Which of the following tests may be used to assess the risk for neural tube defects in the fetus during pregnancy?

Alpha-fetal protein (AFP) test

Chorionic villus sampling (CVS)

Amniocentesis

Ultrasound

Non-stress test (NST)

Explanation

The alpha-fetal protein (AFP) test is the only test that can predict neural tube defects in a fetus during pregnancy. CVS can detect fetal karyotype, sickle-cell anemia, phenylketonuria (PKU), Down syndrome, and Duchenne muscular dystrophy. Amniocentesis can detect genetic disorders and lung maturity. Ultrasounds provide images of the fetal position, measurements of the fetus and placenta, and can confirm pregnancy and gestational age. Non-stress tests (NST) are used to record fetal heart rate to assess fetal well being after 28 weeks gestation.

3

While caring for a laboring patient, the nurse is called into the room because her patient felt a "gush" of fluid. Which of the following should be the nurse's next action?

Assess fetal heart rate

Turn the mother to her right side

Alert the physician

Inform the mother of what she should expect next

Change the sheets

Explanation

The nurse must suspect rupture of the membranes (amniotic sac). Assess fetal heart rate if rupture of the membranes may have occurred. With rupture comes the potential for cord prolapse. Assess fetal heart rate for baseline variability. Marked variability may be cause for concern and the nurse should monitor the patient for signs of infection.

4

The term placenta previa describes which of the following conditions?

All or part of the placenta is positioned between the fetus and the cervix

The placenta develops before the uterine lining is mature

The placenta separates from the uterine wall

The fetus is inferior to the placental position

Explanation

In placenta previa, the placenta develops in such a way that all or part of it is positioned in the lower one-third of the uterus, placing it between the fetus and the cervix. This can cause the placenta to tear and bleed. The most common sign is painless vaginal bleeding in the third trimester (generally after week 32).

5

Basal body temperature is determined by __________.

taking the temperature before rising

taking the temperature mid-morning

taking the temperature in the afternoon

taking the temperature in the evening

taking the temperature before bed

Explanation

The basal body temperature is a method many women use to determine when ovulation occurs. To take a basal body temperature, one must use a basal thermometer (which is more sensitive) and take their body temperature before getting out of bed (or even sitting up) each morning. This method is utilized the best if a woman wakes up and takes her temperature at the same time daily.

6

A nursing student is participating in clinical practice on a labor and delivery unit. He is learning how to measure contractions. He knows that contractions are measured by frequency, duration, and intensity. Which timeframe correctly describes how the student should measure the frequency of contractions?

The increment of the first contraction to the increment of the second

The increment of the first contraction to the acme of the second

The increment of the first contraction to the decrement of the second

The increment of the first contraction to the decrement of the first

The acme of the first contraction to the acme of the second

Explanation

Increment is the beginning or rise of the contraction. Acme is the peak of the contraction. Decrement is the fall of the contraction. Frequency is measured from the beginning of one contraction to the beginning of another, so it should be measured from the increment of the first contraction to the increment of the second contraction.

7

How is glomerular filtration rate (GFR) affected during a normal pregnancy?

Increases by 50%

Decreases by 15%

Increases by 15%

No change

Explanation

In the average normal pregnancy, the GFR increases by upwards of 50%. This correlates with an overall 50% increase in blood plasma volume.

8

What follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels would be present in a patient with premature ovarian failure?

and

and

and

and

Explanation

Premature ovarian failure is the loss of ovarian function in an individual under the age of 40. A and would be indicative of this condition.

9

What is the proper management of atypical squamous cells of undetermined significance (ASC-US) or low grade intraepithelial lesion (LSIL) in women age 21-24?

Repeat cytology in 1 year

Repeat cytology in 6 months

Cervical conization

LEEP (loop electrosurgical excision procedure)

Explanation

ASC-US or LSIL in women age 21-24 should be managed by repeat cytology in one year. Neither cervical conization nor LEEP (loop electrosurgical excision procedure) would be appropriate in a patient of this age or presentation.

10

A 25 year old female primigravida presents to the clinic for a prenatal visit and is concerned with new onset skin changes she has noticed lately. The nurse caring for this client is aware that there are several skin changes associated with pregnancy.

All of the following are skin changes associated with pregnancy except __________.

Hegar's sign

Linea nigra

Chloasma gravidarium

Palmar erythema

Subclinical jaundice

Explanation

Hegar's sign is indicated by a softening of the portion of the uterus between the uterus and a portion of the cervix. The remaining choices are all examples of various skin discolorations commonly associated with pregnancy.

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