July 2011 Nursing Board Exam Results July 2011 Nurse Licensure Examination Results

Obstetrics Nursing Questions Answer Key

Here’s the answer key for the OB Nursing questions. All answers are correct to the best of my knowledge. If you see something wrong, you can PM me or just post a comment. Thank You, hope this little endeavor helps. Rationale will follow shortly. Good luck to everyone. God Bless. (sorry for the delay 3 days kaming alang kuryente!!)

Select the best answer

1. Mr. and Mrs. Cremasteric arrive at the clinic for their first pre natal visit. Mr. Crema tells the nurse that the women in his family usually have girl babies first and wonders why some women always have girls. The nurse correct response is:

a. “The sex of the baby is determined by the sperm.”
b. “Some women are just more fertile with females.”
c. “Nature determines whether the baby will be a girl or a boy.”
d. “The sex of the baby is determined by the egg.”

2. The hormone responsible for the development of the ovum during the menstrual cycle is?

a. Estrogen
b. Progesterone
c. Follicle Stimulating hormone (FSH)
d. Luteneizing hormone (LH)

3. Which hormone is not responsible for differentiation of male reproductive organs during fetal life?

a. Mullerian duct inhibitor (MDI)
b. Dyhydrotestosterone
c. Dehydroepiandosterone sulfate
d. Testosterone

4. Which principal factor causes vaginal pH to be acidic?

a. Cervical mucus changes
b. Secretion of the Skene’s gland
c. The action of the doderlein bacillus
d. Secretion of the bartholins gland

5. Family centered nursing care for women and newborn focuses on which of the following?
a. Assisting individuals and families achieve their optimal health
b. Diagnosing and treating problems promptly
c. Preventing further complications from developing
d. Conducting nursing research to evaluate clinical skills

6. When reviewing the ethical dilemmas facing maternal and newborn nurses today, which of the following has contributed to their complexity?
a. Limitation of available options
b. Support for one viable action
c. Advancement in technology
d. Consistent desirable standards

7. The frenulum and prepuce of the clitoris are formed by the?

a. Fossa Navicularis
b. Mons veneris
c. Labia majora
d. Labia minora

8. The vas deferens is a:

a. storage for spermatozoa
b. Site of spermatozoa production
c. Conduit of spermatozoa
d. Passageway of sperm

9. Cremasteric visits the clinic and is told that his sperm count is normal. A normal sperm count ranges from:

a. 20 to 100/ml
b. 100, 000 to 200, 000/ml
c. 100 to 200/ml
d. 20 to 100 million/ml

10. During which of the following phase of the menstrual cycle is it ideal for implantation of a fertilized egg to occur?

a. Ischemic phase
b. Menstrual phase
c. Proliferative phase
d. Secretory phase

11. Variation on the length of menstrual cycle is due to variations in the number of days in which of the following phase?

a. Proliferative phase
b. Luteal phase
c. Ischemic phase
d. Secretory phase

Situation: Mrs. Calamares G2P1 1001, comes out of the labor and delivery room and reports ruptured amniotic membranes and contractions that occur every 3 minutes lasting 50-60 seconds. The fetus is in LOA position

12. The nurse’s first action should be to:

a.Check the FHR
b.Call the physician
c. Check the vaginal discharge with nitrazine paper
d.Admit Mrs. Calamares to the delivery area

13. When asked to describe the amniotic fluid, Mrs. Calamares states that it is “brown-tinged”. This indicates that:

a. The fetus had infection
b. At some point, the fetus experienced oxygen deprivation
c. The fetus is in distress and should be delivered immediately
d. The fetus is not experiencing any undue stress

14. The nurse established an IV line, and then connects Calamares to an electronic fetal monitor. The fetal monitoring strip shows FHR deceleration occurring about 30 sec after each contraction begins; the FHR returns to baseline after the contraction is over. This type of deceleration is caused by:

a. Fetal head compression
b. Umbilical cord compression
c. Utero-placental insufficiency
d. Cardiac anomalies

15. With this type of deceleration, the nurse’s first action should be to:

a. Do nothing, this is a normal occurrence
b. Call the physician
c. Position the patient on her left side
d. Continue monitoring the FHR

16. Which of the following methods would be avoided for a woman who is 38 years old, has 3 children and smokes a pack of cigarette per day?

a. Oral contraceptives
b. Cervical cap
c. Diaphragm
d. IUD (Intra-uterine device)

17. A woman using diaphragm for contraception should be instructed to leave it in place for at least how long after intercourse?

a. 1 hour
b. 6 hours
c. 12 hours
d. 28 hours

18. When assessing the adequacy of sperm for conception to occur, which of the following is the most helpful criterion?

a. sperm count
b. sperm motility
c. Sperm maturity
d. Semen volume

19. A couple with one child had been trying, without success for several years to have another child. Which of the following terms would describe the situation?

a. Primary Infertility
b. Secondary Infertility
c. Irreversible infertility
d. Sterility

Situation: Melanie a 33y/o G1P0 at 32 weeks AOG is admitted to the Hospital with the diagnosis of PIH.

20. Magnesium Sulfate is ordered per IV. Which of the following should prompt the nurse to refer to the obstetricians prior to administration of the drug?

a. BP= 180/100
b. Urine output is 40 ml/hr
c. RR=12 bpm
d. (+) 2 deep tendon reflex

21. The nurse knows that Melanie is knowledgeable about the occurrence of PIH when she remarks:

a. “It usually appears anytime during the pregnancy”
b. “Its similar to cardio-vascular disease”
c. “PIH occurs during the 1st trimester”
d. “PIH occurs after the 20th wks AOG”

22. After several hours of MgSO4 administration to Melanie, she should be observed for clinical manifestations of:

a. Hyperkalemia
b. Hypoglycemia
c. Hypermagnesemia
d. Hypercalcemia

23. The nurse instructs Melanie to report prodromal symptoms of seizures associated with PIH. Which of the following will she likely identify?

a. Urine output of 15ml/hr
b. (-) deep tendon reflex
c. sudden increase in BP
d. Epigastric pain

Situation: The following questions pertain to intrapartum complications:

24. Which of the following may happen if the uterus becomes over stimulated by oxytocin during induction of labor?

a. Weak contractions prolonged to more than 70 sec
b. Titanic contractions prolonged for more than 90 sec
c. Increased pain with bright red vaginal bleeding
d. Increased restlessness

25. Which of the following factors is the underlying cause of dystocia?

a. Nutritional
b. Environmental
c. Mechanical
d. Medical

26. When Umbilical cord is inserted at the edge of the placenta is termed:

a. Central insertion
b. Battledore insertion
c. Velamentous insertion
d. Lateral insertion

27. When fetal surface of the placenta presents a central depression surrounded by a thickened grayish white ring, the condition is known as:

a. Placenta succenturiata
b. Placenta marginata
c. Fenestrated placenta
d. Placenta Circumvallata

28. Which of the following is derived form mesoderm?

a. lining of the GI tract
b. liver
c. brain
d. skeletal system

29. The average length of the umbilical cord in human is:

a. 35 cm
b. 55 cm
c. 65 cm
d. 45 cm

30. Urinary excretion of HCG is maximal between which days of gestation?

50-60
40-50
60-70
30-40

31. Which of the following is not a part of conceptus?

a. deciduas
b. amniotic fluid
c. fetus
d. membranes

32. Protection of the fetus against syphilis during the 1st trimester is attributed to:

a. amniotic fluid
b. langhan’s layer
c. syncitiothrophoblast
d. placenta

Situation: Diane is pregnant with her first baby. She went to the clinic for check up.

33. To determine the clients EDC, which day of the menstrual period will you ask?

a. first
b. last
c. third
d. second

34. According to Diane, her LMP is November 15, 2002, using the Naegle’s rule what is her EDC?

a. August 22, 2003
b. August 18, 2003
c. July 22, 2003
d. February 22, 2003

35. She complained of leg cramps, which usually occurs at night. To provide relief, the nurse tells Diane to:

a. Dorsiflex the foot while extending the knee when the cramps occur
b. Dorsiflex the foot while flexing the knee when the cramps occurs
c. Plantar flex the foot while flexing the knee when the cramps occur
d. Plantar flex the foot while extending the knee when the cramp occur

Situation: Marita is a nurse working in a STD clinic (question 36-45)

36. The main symptom of gonorrhea in male is:

a. Maculopapular rash
b. Jaundice
c. Urinary retention
d. Urethral discharge

37. In providing education to your clients, you should take into account the fact that the most effective method known to control the spread of HIV infection is:

a. Premarital serological screening
b. Prophylactic treatment of exposed person
c. On going sex education about preventive behaviors
d. Laboratory screening of pregnant woman

38. You counseled one of your clients who developed herpes genitalis concerning follow up care. Women who have developed the disease are at risk of developing:

a. Heart and CNS damage
b. Cervical cancer
c. Infant Pneumonia and eye infection
d. Sterility

39. Cremasteric, 19 y/o states that he has Gonorrhea. In performing assessment, the nurse should expect to identify which of the following symptoms?

a. Lesion on the palms and soles
b. A pinpoint rash on the penis
c. Urinary dribbling
d. Dysuria

40. The nurse should explain to Rhone, 15 y/o that untreated Gonorrhea in the female frequently leads to:

a. Obstruction of the Fallopian tubes
b. Ovarian cysts
c. Ulceration of the cervix
d. Endometrial polyps

41. Diane, a 16 y/o female high school student has syphilis. Treatment is initiated. Before the client leaves the clinic, which of the following actions is essential for the nurse to take?
a. Advice the client to avoid sexual contact for 2 months
b. Ask the client to identify her sexual contacts
c. Arrange for the client to have hearing and vision screening
d. Have the client to return to the clinic weekly for blood test

42. Kris complains of fishy smelling, white cheeslike vaginal discharge with pruritus. You suspect that Kris may have:

a. Moniliasis
b. Trichomoniasis
c. Syphilis
d. Gonorrhea

43. Demi who has history of repeated Trichomonas infections was advised to have Pap-smear by her physician. She asked you what the test is for. Your appropriate response is:

a. It’s a screening for cervical cancer
b. It’s a screening test for presence of cancer in the female reproductive tract
c. It is a diagnostic test for the presence of Trichomonas infection
d. It is a test that will show if she has cervical cancer or not.

44. The result of the pap-test is class II. This means that:

a. Presence of malignant cells
b. Presence of benign or possible malignancy
c. Normal finding
d. Possible inflammation or infections

45. You should be aware that a major difficulty in preventing spread of gonorrhea is that many women who have the disease:

a. Is un aware that they have it
b. Have milder form of the disease than most men
c. Are more reluctant to seek health care than men
d. Acquire the disease without having sexual contact

Situation: Mrs. Rhona Mahilum was admitted to the hospital with signs and symptoms of pre-eclampsia

46. Because of the possibility of convulsive seizures, which of the following should the nurse have available at the client’s bed side?
a. Oxygen and nasopharyngeal suction
b. leather restraints
c. cardiac monitor
d. venous cutdown set

47. One morning, Rhona tells the nurse that she think she is having contractions. Which of the following approaches should the nurse use to fully assess the presence of uterine co tractions?

a. Place the hand on opposite side of the upper part of the abdomen, and curve them somewhat around the uterine fundus.
b. Place the heel of the hand on the abdomen just above the umbilicus firmly
c. Place the hand flat on the abdomen over the uterine fundus, with the fingers apart and press lightly
d. Place the hand in the middle of the upper abdomen and then move hand several times to different parts of the abdomen

48. Exposure of a woman pregnant of a female offspring to which of the following substance increases the risk of the offspring during reproductive years to cervical and uterine cancer

steroids
thalidomides
diethylstilbestrol
tetracyclines

49. In which of the following conditions is vaginal rugae most prominent?
a. multiparous women
b. before menopause
c. after menopause
d. nulliparous waman

50. The deepest part o the perineal body surrounding the urethra, vagina and rectum that when damaged can result to cystocele, rectocele and urinary stress incontinence is the?

a. Pubococcygeus muscle
b. Spinchter of urethra and anus
c. Bulbocavernous muscle
d. Ischiocavernous muscle

Situation: Review of concepts of parturition was made by the clinical instructor to a group of nursing students preliminary to their assignment to Labor and delivery room
51. Which plays an important role in the initiation of labor?

a. maternal adrenal cortex
b. fetal adrenal cortex
c. fetal adrenal medulla
d. maternal adrenal medulla

52. Which is not considered an uteroronin?

a. Prostaglandin
b. Endothelin-1
c. Oxytocin
d. Relaxin

53. Which is a primary power of labor?

a. uterine contractions
b. pushing of the mother
c. intrathoracic pressure
d. abdominal contraction

54. The lower uterine segment is formed from the:

a. cervix
b. isthmus and cervix
c. body of the uterus
d. isthmus

55. Ripening of the cervix occurs during the:

a. first stage
b. second stage
c. third stage
d. fourth stage

56. In the second stage of labor, uterine contraction last:

a. 20 seconds
b. 30 seconds
c. 60 seconds
d. 120 seconds

57. The time between uterine contractions is:

a. intensity
b. interval
c. duration
d. frequency

58. Midpelvic capacity may be precisely determined by:

a. imaging studies
b. clinical measurement of the sidewall convergence
c. clinical measurement of the ischial spine prominence
d. sub pubic angel measurement

59. The inanimate bone of the pelvis is not composed of the:

a. sacrum
b. ilium
c. Pubis
d. Ischium

60. Which does not refer to the transverse diameter of the pelvic outlet?

a. Bi-ischial diameter
b. Bi-spinous diameter
c. Bi-tuberous diameter
d. Intertuberous diameter

61. The Antero-posterior diameter of the pelvic inlet where the fetus will likely most difficulty during labor is the:

a. Diagonal conjugate
b. True conjugate
c. conjugate Vera
d. obstetric conjugate

62. The true conjugate can be measured by subtracting ______ to the diagonal conjugate?

a. 2.5 – 3 cm
b. 3.5 – 4 cm
c. 3 – 4 cm
d. 1.5 – 2 cm

63. The most important muscle of the pelvic floor is the:

a. levator ani muscle
b. ischiocavernous
c. bulbocavernous
d. pubococcygeous

64. Which pelvic shape has the poorest prognosis fro vaginal delivery?

a. platypelloid
b. anthropoid
c. android
d. gynecoid

65. The two pubic bones meet anteriorly at the:

a. symphysis pubis
b. coccyx
c. sacrococcygeal
d. sacro-illiac joint

66. In the second stage of labor, expulsion of the fetus from birth canal depends on which important factor?
a. Maternal bearing down
b. Cervical dilatation
c. Uterine contractions
d. Adequate pelvic size

67. In what presentation is the head in extreme flexion?

a. sinciput
b. brow
c. vertex
d. face

Situation: a 26 y/o primigravida admitted to the hospital. Vaginal exam reveals that her cervix is 5cm dilated, 80% effaced and the presenting part in zero station, membranes still intact, occiput is in posterior position

68. Due to fetal position, the nurse caring for her would be correct in telling her that:

a. she will not have the urge to bear down when she becomes fully dilated
b. she can expect to have more back discomfort than most woman in labor
c. the position of baby’s head is optimum for passing through the pelvis
d. a caesarian section may be necessary to deliver the baby in thin position

69. Upon IE, you noted that the cervix ix ¼ its original length. This mean that effacement is:

a. 25%
b. 75%
c. 100%
d. 50%

70. Because of the position of the fetus, an episiotomy has to be performed to enlarge the birth canal. Which of the following is an advantage of episiotomy over lacerations?

a. it is more difficult to repair than laceration
b. it is more painful than laceration
c. it involve a more blood loss than laceration
d. heals more faster than laceration

71. Supporting the perenium at the time of crowning will facilitate:

a. flexion of the fetal head
b. external rotation
c. extension of the fetal head
d. expulsion

72. When the bi-parietal diameter of the fetal head passes through the pelvic inlet, this is referred as:

a. descent
b. flexion
c. engagement
d. extension

73. Sudden gush of blood or lengthening of the cord after the delivery of infant should warn the nurse of:

a. placenta acrreta
b. placental separation
c. placental retention
d. abruption placenta

Situation: Nurse Tsunade is a staff nurse in the OB ward of Konoha Medical Hospital

74. When separation begins at the center of the placenta and slides down the birth canal like a folded umbrella this is referred as:

a. Duncan mechanism
b. Shultz mechanism
c. Brandt Andrews mechanism
d. Ritgen’s maneuver

75. Which of the following is not true regarding the third stage of labor?

a. Care should be taken in the administration of bolus of oxytocin because it can cause hypertension
b. Signs of placental separation are lengthening of the cord, sudden gush of blood and sudden change in shape of the uterus
c. It ranges from the time of expulsion of the fetus to the delivery of the placenta
d. The placenta is delivered approximately 5-15 minutes after delivery of the baby

76. In the immediate postpartum period the action of methylegonovine is to:

a. cause sustained uterine contractions
b. causes intermittent uterine contractions
c. relaxes the uterus
d. induces sleep so that the mother can rest after an exhausting labor

77. Rhina is a primipara hospitalized due to preeclampsia. The doctor decided to perform NST. The nurse should apply the fetal transducer over the fetus:

a. chest
b. back
c. head
d. buttocks

78. Marisse, a newly delivered multipara complains of heavy and painful breast accompanied by fever. The nurse tells Gina that it is normal breast engorgement as the fever is characterized by

a. More than 38 degrees
b. Does not last more than 24 hours
c. Caused by infection
d. Needs to be treated with antibiotic

79. Postpartum depression occurs during which time frame?

a. within weeks after delivery
b. within 12 weeks
c. within 16 weeks
d. within 24 hours

80. Demi, a 38 y/o multipara is admitted with a tentative diagnosis of femoral thrombophlebitis. The nurse assesses the patient with:

a. burning on urination
b. leg pain
c. abdominal pain
d. increased lochial flow

81. Fever, foul lochial discharge and subinvolution of the uterus are signs of:

a. puerperal psychosis
b. puerperal sepsis
c. postpartum hemorrhage
d. hypertensive disorder

82. Which is most important when caring for a high risk postpartum clients?

a. discussing hygiene and nutrition
b. referring the mother to others for emotional support
c. discussing complications and treatment
d. promoting mother-newborn contact

83. A direct cause of mis-management of the third stage of labor is:

a. inversion of the uterus
b. cord prolapse
c. prolonged labor
d. all of these

84. Rachel, a diabetic woman at 36 weeks gestation is scheduled for biophysical profile in order to:

a. ascertain correct gestational age
b. determine fetal lung maturity
c. determine fetal well being
d. determine fetal size and obvious congenital anomaly

85. In a primigravida, the following demotes contracted pelvis except:

a. absence of quickening
b. absence of lightening
c. absence of engagement
d. none of these

86. Which of the following changes in Diane’s BP would nurse Tsunade not expect?

a. it tends to be highest in sitting
b. BP may increase a little in the 2nd tri
c. It should be taken at every visit at the clinic
d. It is normal for blood pressure to increase as much as 33 in systolic in the 3rd tri when a woman is near delivery

87. Nurse Tsunade referred to Diane to an Obstetrician. At 8 months she was orderd for a contraction stress test and the result is negative. Diane asked when she should be back for her next check up?

a. Monthly
b. Within 24-hours
c. Within a week
d. Weekly for 2 weeks then monthly

89. Diane wants to know how many fetal movements per hour is normal. The correct response of Nurse tsunade is:

a. twice
b. thrice
c. four times
d. 10-12 times

90. Which of the following statement about L/S ratio in amniotic fluid is correct?

a. a slight variation in technique does not significantly affect the accuracy of result
b. a L/S ratio of 2:1 is incompatible with life
c. a L/S ratio of less than 1:0 is compatible with fetal survival
d. when L/S ratio is 2:1 below, majority of infants develop respiratory distress

91. Every visit, you obtain the pregnant woman’s fundic height.. At what age of gestion does the fundic height in cm strongly correlates with gestational age in wks?

a. 20-24 wks
b. 18-24 wks
c. 18-32 wks
d. 12-38 wks

92. Which is not an indication of amniocentesis?

a. previous pregnancy with chromosomal abnormal fetus
b. down syndrome in siblings
c. pregnancies in women over 35 y/o
d. at 8 wks gestation for chromosomal study

Situation: Erica is 24 y/o Filipina married to an American. She is pregnant for the second time and now at 8 weeks AOG. She is RH (-) with blood type B

93. Erica gave birth to a term baby with yellowish skin and sclera. The baby is placed on phototherapy. The treatment is effective when blood test shows:

a. Low serum bilirubin
b. O2 level of 99%
c. Normal RBC and WBC count
d. Low platelet count

94. Because of rapidly rising bilirubin level, exchange transfusion was performed on Erica’s NB. The nurse understands that the blood to be transfused to the baby should be:

a. Type B, RH +
b. Type O, RH –
c. ABO compatible, RH –
d. Type B, RH –

95. Immediately after delivery of Erica’s Baby, the nurse should remember to:

a. delay clamping of the cord to previde the newborn with more blood
b. cut immediately after birth of the baby
c. administer RHoGam to the NB immediately on the 3rd stage of labor
d. place the NB in an isolette for phototherapy

96. The doctor ordered Kleihauer-Betke. The nurse know which of the following to be wrong about the test:

a. it is used to identify the amount of antibodies in the maternal serum
b. it is used to determine presence of fetal blood
c. it is used to asses whether the mother is RH – or RH +
d. It is used to determine fetal blood type and RH factor

97. Which of the following findings in Erica’s history would identify a need for her to receive RHo (d) immune globulin?

a. Rh -, coombs +
b. Rh -, Coombs –
c. Rh +, Coombs –
d. Rh +, Coombs +

98. The portion of the placenta overlying the blastocyst

a. decidua capsularis
b. decidua vera
c. decidua basalis
d. decidua parietalis

99. The cardinal function of deciduas is

a. Immune resonse
b. Production of hormones
c. Maintenance of pregnancy
d. None of the above

100. O2 and Co2 are exchanged in the placenta through the process of:

a. pinocytosis
b. diffusion
c. facilitated diffusion
d. active transport

End of Test! Good luck!

Master Tsunade aka Jeddah :P

Posted by Jeddah on Sunday, October 01, 2006 at 10:44 PM | Permalink

..were is the rationale of this correction? thankz! n GODBLESS

Posted by Anonymous | 2:00 PM

hi just wanna clarify about the answer in no. 16 one contraindication of pills is chain smoking so the answer should be contraceptive pills not IUD.

Posted by Anonymous | 11:53 PM

in no. 17 questions diaphragm should be place 6-8 hours after the intercourse so the answer should be 6 hours.

Posted by Anonymous | 11:56 PM

Can you please post the rationales for the answers. We learn a lot from the rationales. Thanks.

Posted by caje | 10:34 AM

how can i copy it. because it want to have it as a referrence or a review material.. thanks

Posted by Anonymous | 7:58 PM

dun po sa number 8 question bakit po conduit of spermatozoa ang sag0t? nabasa ko po kasi kanina na ang xas deference ay storage of sperm...can we have the rationale?

Posted by Anonymous | 10:27 PM

nasan n po ang rationale????

Posted by Anonymous | 9:28 AM