Prenatal Maternity Nursing OB Questions And Answers NCLEX Exam

1.) Your patient has underwent testing of her blood type and Rh factor. She has A- blood type. Which of the following statement is correct?

• At 36 weeks she will receive Rh immune globulin.
• At 28 weeks she should receive the Rh immune globulin. 
• No further testing will be done because the patient is Rh negative, instead of Rh positive.
• The patient will be checked for clotting problems.

The patient’s Rh factor is negative so she will need to receive the Rh immune globulin at 28 weeks. If the patient was A+ (meaning her Rh factor is positive) she would not have to receive the Rh immune globulin.

2.) A patient is wanting to become pregnant and has underwent prenatal counsel and testing. Her rubella titer is lower than 1:8. She consents to receiving the rubella vaccine. What education will you provide to the patient?

• She must use an effective birth control method at the time of immunization and not become pregnant for 1-3 months. 
• Once she has a positive pregnancy test she is to call the office to schedule another appointment.
• The patient’s rubella titer is normal and therefore the vaccine is not needed. This question is incorrect.
• It is okay to come into contact with people who are immunocompromised.

The only correct option is: She must use an effective birth control method at the time of immunization and not become pregnant for 1-3 months. Other options are incorrect statements about education regarding the rubella vaccine.

3.) A patient is the third trimester of her pregnancy states she has been getting “terrible” leg cramps at night. Which statement is true about leg cramps during pregnancy?

• Avoiding regular exercise with help prevent tireness in the legs, therefore resting the legs will decrease leg cramps
• Tell the patient to increase her intake of iron fortified foods because low irons levels can cause leg cramps
• Dorsiflexing the foot will help the affected leg
• A prenatal work up needs to be performed for this is not normal in the third trimester of pregnancy 

Legs cramps are normal in the 2nd and 3rd trimester of pregnancy and is usually caused by an altered calcium-phosphorus balance and pressure of the uterus on the nerves. Getting regular exercise, increasing calcium intake (NOT IRON), and dorsiflexing the foot of the affected leg with help this patient.

4.) Your patient is suffering from constipation and is 8 months pregnant. Which statement is incorrect when educating the patient about relief measures?

• Taking a cap-ful of Ex-lax a day will help relieve constipation 
• Try to eat food rich is fiber such as beans, fruits, and vegetables along with sufficient fluid intake.
• Exercise regularly
• Constipation is experienced in the 2nd and 3rd trimester because of decreased intestinal motility

A pregnant patient should be discouraged from taking any type of medications (even over-the-counter) unless prescribed by the OB doctor. This option is out of the scope of practice for the nurse.

5.) A patient in the early stages of pregnancy is suffering from “morning sickness”. Which statement by the patient requires you to further educate the patient about this condition?

• “I have been addicted to Mexican food and fried pickles lately.” 
• “I eat frequently through out the day and they are small amounts”.
• “I have my saltines at my bedside to munch on before I get up”.
• “I know this morning sickness will pass and I should feel better in the 2nd trimester”.

Morning sickness (nausea accompanied sometimes by vomiting) is very common in the first trimester. The patient who suffers from this condition should avoid spicy and fried food because this can makes the morning sickness worst. All other options are correct statements.

6.) A patient is having an abdominal ultrasound to assess fetal gestational age and estimated date of delivery. Which statement is incorrect about this type of testing?

• Before the abdominal ultrasound is performed the patient should empty bladder.
• An abdominal ultrasound can outline and identify fetal and maternal structures. 
• Generally, at 20 weeks an abdominal ultrasound can be performed to assess fetal gender.
• There are two types of ultrasounds that can be safely performed on a pregnant patient: abdominal and transvaginal

A patient should have a full bladder before the procedure so better images of the fetus can be obtained. So instructing the patient to drink water to fill the bladder for the procedure would be ideal.

7.) A patient who is 8 1/2 months pregnant tells you she has been counting her baby’s kicks and is concerned because within a 4 hour period the baby has only kicked 32 times. What nursing intervention is correct?

• Reassure the patient this kick count is normal. 
• Notify the MD of this finding.
• Prep the patient for an abdominal ultrasound.
• Assess the patient’s urine for protein and glucose.

Reassuring the patient this is normal is the correct answer. The mother should feel the baby kick at least 10 times in two consecutive 2 hour periods.

8.) A patient is undergoing an amniocentesis. Which statement is correct about this procedure?

• The patient is to be in the supine position.
• The patient will be ordered a blood type and cross before the procedure.
• It is performed at 30-32 weeks pregnancy.
• It is normal for the patient to leak fluid at the needle insertion site for 2-4 days. 

All options are incorrect expect for that the patient should be in the supine position.

9.) A pregnant patient has a nonstress test performed. The results showed the baby had 4 fetal heart rate accelerations of at least 15 beats/min that lasted 15 seconds from start to finish in association with fetal movement during 20 minutes. The results of this would be documented as:

• “Reactive” Nonstress Test
• “Nonreactive” Nonstress Test
• Negative Contraction Stress Test 
• Positive Contraction Stress Test

The results of the question describe a “reactive” nonstress test and the fetus is healthy.

10.) A patient who is 35 weeks pregnant states she thinks her “water broke” but she isn’t sure because it is a very little amount. What do you anticipate the MD will order first?

• Nitrazine strip test
• Ultrasound
• Nonstress test 
• Amniocentesis

Because 35 weeks is still early for the delivery of a baby, an ultrasound and nonstress test will probably be ordered after the confirmation via the Nitrazine strip test that the membranes have ruptured. The nitrazine strip test is quick and easy to do and will assess for the presence of amniotic fluid in the vaginal secretions.

11.) Which statement by the patient (who is 5’5 127 lbs) would cause you to re-educated the patient about nutrition during her pregnancy?

• “I can expect to gain 50-60 lbs during my pregnancy”
• “I will need to increase by calorie intake by 300 cal/day”
• “I need to be sure to eat a lot foods with folic acid in them”
• “I don’t have to watch my sodium intake unless the MD specifies” 

If a woman has a normal pre-pregnancy weight she should expect to gain 25 to 35 lbs during her pregnancy. All other options are correct statements.