Obstetrics and Gynecological Conditions

1. Which of the following is a possible complication of

amniocentesis?

Possible Answers:

a) Needle injury
b) All of these
c) Miscarriage
d) RH sensitization

Correct answer:

All of these

Explanation:

There are several risks to amniocentesis, including (but not limited to)
miscarriage, infection, needle injury, and RH sensitization. The rate of
miscarriage due to amniocentesis is between 1 in 300 and 1 in 500. The
other complications listed are relatively rare.

2.Fundal height of a pregnant woman is measured

from __________.

Possible Answers:

a) the top of the pubic bone to the top of the uterus

b) the bottom of the pubic bone to the top of the uterus
c) the middle of the pubic bone to the top of the uterus
d) the top of the pubic bone to the middle of the uterus
e) the middle of the pubic bone to the bottom of the uterus

Correct answer:

the top of the pubic bone to the top of the uterus

Explanation:

Fundal height (sometimes referred to as McDonald's rule) is measured in

centimeters from the top of the pubic bone to the top of the uterus. The top
of the uterus may also be called the fundus of the uterus. It is used to
assess the growth and development of the fetus inside the womb. 

3.Alex is 17 weeks pregnant. She comes into the clinic to get a

alpha-fetoprotein test. A low result could indicate all of the
following except __________.

Possible Answers:

a) fetal trisomy 21
b) the gestational age of the baby is incorrect
c) fetal trisomy 18
d) hydatidiform mole
e) preeclampsia

Correct answer:

preeclampsia

Explanation:

Alpha-fetoprotein is made by the fetus. Congenital abnormalities (fetal

trisomy 18, fetal trisomy 21) are associated with low levels of this protein.
Additionally, so is hydatidiform mole. Hydatidiform mole is the presence of
an abnormal mass or growth inside the uterus. Based on a low result, the
physician may want to conduct further testing. Preeclampsia is a
dangerous medical condition characterized by high blood pressure. It is not
associated with alpha-fetoprotein.

4.The nurse is assessing a woman in labor. He knows that fetal

bradycardia occurs when the heart rate drops below __________.

Possible Answers:

a) 110 beats per minute

b) 120 beats per minute
c) 90 beats per minute
d) 100 beats per minute
e) 130 beats per minute
Correct answer:

110 beats per minute

Explanation:

Fetal bradycardia is recognized when fetal heart rate drops below 110
beats per minute for 10 minutes or longer. The normal fetal heart rate is
between 120 beats per minute and 160 beats per minute. Fetal tachycardia
is a heart rate above 160 beats per minute. 

5.Anne, a 32-year-old woman, presents for her first prenatal visit.

The doctor orders a CBC (complete blood count). Which of the
following is not included in a CBC?

Possible Answers:

a) White blood cells

b) Hemoglobin
c) Hematocrit
d) Platelets
e) Blood type

Correct answer:

Blood type

Explanation:

A separate test called a "type and screen" is needed to assess the blood
type. Complete blood counts (CBC's) typically contain hemoglobin and
hematocrit, platelet counts, white blood cell counts, and red blood cell
counts among many other measures. They are among the most frequently
ordered laboratory tests by providers. The physician will use this
information to diagnose conditions such as anemia. 
6.The nurse is assessing fetal heart rate in a pregnant patient. The
nurse records a pulse of 82 beats per minute. The nurse
should __________.

Possible Answers:

a) ask the mother to lay on her right side

b) call the physician immediately
c) try another doppler device
d) add lubricant to the doppler's surface
e) move the doppler device

Correct answer:

move the doppler device

Explanation:

An 82 beat per minute reading could be the mother's heart rate, indicating
that the nurse does not have the doppler in the correct position. A normal
fetal heart rate is between 120 and 160 beats per minute. The nurse must
always remember to take the mother's pulse before assessing the fetal
heart rate. Before calling the physician, it is important to determine that the
data is accurate. To increase oxygen perfusion to the fetus, ask the mother
to lay on her left side.
7.Brittany is 40 weeks pregnant and calls because she is seeing
pink-tinged discharge for the first time. The nurse should tell
Brittany to __________.

Possible Answers:

a) continue to monitor
b) call an ambulance
c) lie on her back and place her feet in the air until help arrives
d) drive to the hospital immediately
e) eat a bland diet and continue regular exercise

Correct answer:

continue to monitor

Explanation:

This is most likely the normal "bloody show" at the beginning of labor.
There is no need to immediately arrive at the hospital, change position, or
eat a bland diet. The patient should continue to monitor and call back or
seek care when she experiences regular contractions that are becoming
more intense and frequent.

8.Sarah is a seventeen-year-old female who has not gotten her first

period and is visiting her doctor for an exam. She has displayed the
normal growth and development of several secondary sex
characteristics. The nurse would describe to the doctor that Sarah
is showing signs of __________.

Possible Answers:

a) oligomenorrhea 
b) primary amenorrhea
c) secondary dysmenorrhea
d) primary dysmenorrhea
e) secondary amenorrhea

Correct answer:

primary amenorrhea

Explanation:
Primary amenorrhea occurs when a female is fourteen years old and has
not gotten her first period and has not developed secondary sex
characteristics. Primary amenorrhea also occurs when a female sixteen or
older has not gotten her first period but has developed secondary sex
characteristics. Primary dysmenorrhea refers to painful menstruation not
linked to a physiological disorder. Secondary dysmenorrhea refers to
painful menstruation due to an underlying cause such as endometriosis.
Oligomenorrhea refers to the absence of a period, typically for at least 35
days. 

9.Amber is a 39-year-old woman who is experiencing secondary

dysmenorrhea. The nurse knows that Amber could be suffering
from which of the following?

Possible Answers:

a) Amenorrhea
b) Low levels of aldosterone
c) Endometriosis
d) Turner syndrome
e) High levels of prostaglandin

Correct answer:

Endometriosis

Explanation:

Secondary dysmenorrhea refers to painful menstruation due to an

underlying condition. Endometriosis, an example of a condition that
frequently causes secondary dysmenorrhea, refers to the growth of uterine
tissue in inappropriate places such as the ovary or rectum. High levels of
prostaglandin are frequently found in women with primary dysmenorrhea
which is painful menstruation without an underlying condition. Low levels of
aldosterone would not likely cause painful menstruation. Turner syndrome
is a chromosomal disorder that can frequently cause amenorrhea, or
absence of a period.
10.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?

Possible Answers:

a) Neisseria gonorrhoeae
b) Yeast infection
c) Uterine fibroids
d) Chlamydia trachomatis
e) Endometriosis

Correct answer:

Yeast infection

Explanation:
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