NURSING OB 204 EXAM 1 REVIEW- Saunders Comprehensive Review for the NCLEX-RN® Examination
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Course
NURSING OB 204
Institution
NURSING OB 204
The nurse is preparing to teach a prenatal class about fetal circulation. Which statements should be included in the teaching plan? Select all that apply.
1. "The ductus arteriosus allows blood to bypass the fetal lungs."
2. "One vein carries oxygenated blood from the placenta to the fetus."
...
saunders comprehensive review for the nclex rn® examination
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OB EXAM1 review
The nurse is preparing to teach a prenatal class about fetal circulation. Which
statements should be included in the teaching plan? Select all that apply.
1. "The ductus arteriosus allows blood to bypass the fetal lungs."
2. "One vein carries oxygenated blood from the placenta to the fetus."
3. "The normal fetal heart tone range is 140 to 160 beats per minute in early
pregnancy."
4. "Two arteries carry deoxygenated blood and waste products away from
the fetus to the placenta."
5. "Two veins carry blood that is high in carbon dioxide and other waste
products away from the fetus to the placenta."
Rationale:
The ductus arteriosus is a unique fetal circulation structure that allows the
nonfunctioning lungs to receive only a minimal amount of oxygenated blood for tissue
maintenance. Oxygenated blood is transported to the fetus by one umbilical vein. The
normal fetal heart tone range is considered to be 110 to 160 beats per minute. Arteries
carry deoxygenated blood and waste products from the fetus, and the umbilical vein
carries oxygenated blood and provides oxygen and nutrients to the fetus. Blood
pumped by the embryo's heart leaves the embryo through two umbilical arteries.
The nursing instructor asks the student to describe fetal circulation, specifically the
ductus venosus. Which statement by the student indicates an understanding of the
ductus venosus?
1. "It connects the pulmonary artery to the aorta."
2. "It is an opening between the right and left atria."
3. "It connects the umbilical vein to the inferior vena cava."
4. "It connects the umbilical artery to the inferior vena cava."
Rationale:
The ductus venosus connects the umbilical vein to the inferior vena cava. The foramen
ovale is a temporary opening between the right and left atria. The ductus arteriosus
joins the aorta and the pulmonary artery.
A pregnant client tells the clinic nurse that she wants to know the sex of her baby as
soon as it can be determined. The nurse informs the client that she should be able to
find out the sex at 12 weeks' gestation because of which factor?
1. The appearance of the fetal external genitalia
2. The beginning of differentiation in the fetal groin
3. The fetal testes are descended into the scrotal sac
4. The internal differences in males and females become apparent
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,OB EXAM1 review
Rationale:
By the end of the twelfth week, the external genitalia of the fetus have developed to
such a degree that the sex of the fetus can be determined visually. Differentiation of
the external genitalia occurs at the end of the ninth week. Testes descend into the
scrotal sac at the end of the thirty-eighth week. Internal differences in the male and
female occur at the end of the seventh week.
The nurse is performing an assessment on a client who is at 38 weeks' gestation and
notes that the fetal heart rate (FHR) is 174 beats/minute. On the basis of this finding,
what is the priority nursing action?
1. Document the finding.
2. Check the mother's heart rate.
3. Notify the health care provider (HCP).
4. Tell the client that the fetal heart rate is normal.
Rationale:
The FHR depends on gestational age and ranges from 160 to 170 beats/minute in the
first trimester, but slows with fetal growth to 110 to 160 beats/minute near or at term.
At or near term, if the FHR is less than 110 beats/minute or more than 160
beats/minute with the uterus at rest, the fetus may be in distress. Because the FHR is
increased from the reference range, the nurse should notify the HCP. Options 2 and 4
are inappropriate actions based on the information in the question. Although the nurse
documents the findings, based on the information in the question, the HCP needs to be
notified.
The nurse is conducting a prenatal class on the female reproductive system. When a
client in the class asks why the fertilized ovum stays in the fallopian tube for 3 days,
what is the nurse's best response?
1. "It promotes the fertilized ovum's chances of survival."
2. "It promotes the fertilized ovum's exposure to estrogen and
progesterone."
3. "It promotes the fertilized ovum's normal implantation in the top portion
of the uterus."
4. "It promotes the fertilized ovum's exposure to luteinizing hormone and
follicle-stimulating hormone."
Rationale:
The tubal isthmus remains contracted until 3 days after conception to allow the
fertilized ovum to develop within the tube. This initial growth of the fertilized ovum
promotes its normal implantation in the fundal portion of the uterine corpus. Estrogen is
a hormone produced by the ovarian follicles, corpus luteum, adrenal cortex, and
placenta during pregnancy. Progesterone is a hormone secreted by the corpus luteum
of the ovary, adrenal glands, and placenta during pregnancy. Luteinizing hormone and
follicle-stimulating hormone are excreted by the anterior pituitary gland. The survival of
the fertilized ovum does not depend on it staying in the fallopian tube for 3 days.
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,OB EXAM1 review
The nursing instructor asks a nursing student to explain the characteristics of the
amniotic fluid. The student responds correctly by explaining which as characteristics of
amniotic fluid? Select all that apply.
1. Allows for fetal movement
2. Surrounds, cushions, and protects the fetus
3. Maintains the body temperature of the fetus
4. Can be used to measure fetal kidney function
5. Prevents large particles such as bacteria from passing to the fetus
6. Provides an exchange of nutrients and waste products between the
mother and the fetus
Rationale:
The amniotic fluid surrounds, cushions, and protects the fetus. It allows the fetus to
move freely and maintains the body temperature of the fetus. In addition, the amniotic
fluid contains urine from the fetus and can be used to assess fetal kidney function. The
placenta prevents large particles such as bacteria from passing to the fetus and
provides an exchange of nutrients and waste products between the mother and the
fetus.
A couple comes to the family planning clinic and asks about sterilization procedures.
Which question by the nurse should determine whether this method of family planning
would be most appropriate?
1. "Did you ever had surgery?"
2. "Do you plan to have any other children?"
3. "Do either of you have diabetes mellitus?"
4. "Do either of you have problems with high blood pressure?"
Rationale:
Sterilization is a method of contraception for couples who have completed their
families. It should be considered a permanent end to fertility because reversal surgery
is not always successful. The nurse would ask the couple about their plans for having
children in the future. Options 1, 3, and 4 are unrelated to this procedure.
The nurse should make which statement to a pregnant client found to have a gynecoid
pelvis?
1. "Your type of pelvis has a narrow pubic arch."
2. "Your type of pelvis is the most favorable for labor and birth."
3. "Your type of pelvis is a wide pelvis, but it has a short diameter."
4. "You will need a cesarean section because this type of pelvis is not
favorable for a vaginal delivery."
Rationale:
A gynecoid pelvis is a normal female pelvis and is the most favorable for successful
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, OB EXAM1 review
labor and birth. An android pelvis (resembling a male pelvis) would be unfavorable for
labor because of the narrow pelvic planes. An anthropoid pelvis has an outlet that is
adequate, with a normal or moderately narrow pubic arch. A platypelloid pelvis (flat
pelvis) has a wide transverse diameter, but the anteroposterior diameter is short,
making the outlet inadequate.
Which purposes of placental functioning should the nurse include in a prenatal
class? Select all that apply.
1. It cushions and protects the baby.
2. It maintains the temperature of the baby.
3. It is the way the baby gets food and oxygen.
4. It prevents all antibodies and viruses from passing to the baby.
5. It provides an exchange of nutrients and waste products between the
mother and developing fetus.
Rationale:
The placenta provides an exchange of oxygen, nutrients, and waste products between
the mother and the fetus. The amniotic fluid surrounds, cushions, and protects the
fetus and maintains the body temperature of the fetus. Nutrients, medications,
antibodies, and viruses can pass through the placenta
The nurse is providing instructions to a pregnant client who is scheduled for an
amniocentesis. What instruction should the nurse provide?
1. Strict bed rest is required after the procedure.
2. Hospitalization is necessary for 24 hours after the procedure.
3. An informed consent needs to be signed before the procedure.
4. A fever is expected after the procedure because of the trauma to the
abdomen.
Rationale:
Because amniocentesis is an invasive procedure, informed consent needs to be
obtained before the procedure. After the procedure, the client is instructed to rest, but
may resume light activity after the cramping subsides. The client is instructed to keep
the puncture site clean and to report any complications, such as chills, fever, bleeding,
leakage of fluid at the needle insertion site, decreased fetal movement, uterine
contractions, or cramping. Amniocentesis is an outpatient procedure and may be done
in the health care provider's office or in a special prenatal testing unit. Hospitalization is
not necessary after the procedure.
A pregnant client in the first trimester calls the nurse at a health care clinic and reports
that she has noticed a thin, colorless vaginal drainage. The nurse should make which
statement to the client?
1. "Come to the clinic immediately."
2. "The vaginal discharge may be bothersome, but is a normal occurrence."
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