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1. Unlike false labor, true labor

8. When used to describe the

produces regular rhythmic

degree of fetal descent during

contractions, abdominal

labor, floating means the

discomfort, progressive descent

presenting part isnt engaged in

of the fetus, bloody show, and

the pelvic inlet, but is freely

progressive effacement and

movable (ballotable) above the

dilation of the cervix.

pelvic inlet.

2. To help a mother break the

9. When used to describe the

suction of her breast-feeding

degree of fetal descent,

infant, the nurse should teach

engagement means when the

her to insert a finger at the

largest diameter of the

corner of the infants mouth.

presenting part has passed

3. Administering high levels of

oxygen to a premature neonate

through the pelvic inlet.

10.

Fetal station indicates the

can cause blindness as a result

location of the presenting part in

of retrolental fibroplasia.

relation to the ischial spine. Its

4. Amniotomy is artificial rupture of

the amniotic membranes.
5. During pregnancy, weight gain

described as 1, 2, 3, 4, or 5
to indicate the number of
centimeters above the level of

averages 25 to 30 lb (11 to 13.5

the ischial spine; station 5 is at

kg).

the pelvic inlet.

6. Rubella has a teratogenic effect

11.

Fetal station also is described

on the fetus during the first

as +1, +2, +3, +4, or +5 to

trimester. It produces

indicate the number of

abnormalities in up to 40% of

centimeters it is below the level

cases without interrupting the

of the ischial spine; station 0 is

pregnancy.

at the level of the ischial spine.

7. Immunity to rubella can be

12.

During the first stage of

measured by a

labor, the side-lying position

hemagglutination inhibition test

usually provides the greatest

(rubella titer). This test identifies

degree of comfort, although the

exposure to rubella infection and

patient may assume any

determines susceptibility in

comfortable position.

pregnant women. In a woman, a

13.

During delivery, if the

titer greater than 1:8 indicates

umbilical cord cant be loosened

immunity.

and slipped from around the

neonates neck, it should be

OB BULLETS
clamped with two clamps and

between 16 and 19 weeks

cut between the clamps.

gestation.

14.

An Apgar score of 7 to 10

indicates no immediate distress,

4 to 6 indicates moderate

20.

Ovulation ceases during

pregnancy.
21.

Any vaginal bleeding during

distress, and 0 to 3 indicates

pregnancy should be considered

severe distress.

a complication until proven

15.

To elicit Moros reflex, the

otherwise.

nurse holds the neonate in both

To estimate the date of delivery

hands and suddenly, but gently,

using Ngeles rule, the nurse

drops the neonates head

counts backward 3 months from

backward. Normally, the

the first day of the last

neonate abducts and extends all

menstrual period and then adds

extremities bilaterally and

7 days to this date.

symmetrically, forms a C shape

22.

At 12 weeks gestation, the

with the thumb and forefinger,

fundus should be at the top of

and first adducts and then flexes

the symphysis pubis.

the extremities.
16.

Pregnancy-induced

23.

Cows milk shouldnt be

given to infants younger than

hypertension (preeclampsia) is

age 1 because it has a low

an increase in blood pressure of

linoleic acid content and its

30/15 mm Hg over baseline or

protein is difficult for infants to

blood pressure of 140/95 mm Hg

digest.

on two occasions at least 6

24.

If jaundice is suspected in a

hours apart accompanied by

neonate, the nurse should

edema and albuminuria after 20

examine the infant under natural

weeks gestation.

window light. If natural light is

17.

Positive signs of pregnancy

unavailable, the nurse should

include ultrasound evidence,

examine the infant under a

fetal heart tones, and fetal

white light.

movement felt by the examiner

25.

The three phases of a uterine

(not usually present until 4

contraction are increment,

months gestation

acme, and decrement.

18.

Goodells sign is softening of

the cervix.
19.

Quickening, a presumptive

sign of pregnancy, occurs

26.

The intensity of a labor

contraction can be assessed by

the indentability of the uterine
wall at the contractions peak.

OB BULLETS
Intensity is graded as mild

station 1 or lower, so that a

(uterine muscle is somewhat

small electrode can be attached.

tense), moderate (uterine

32.

Fetal alcohol syndrome

muscle is moderately tense), or

presents in the first 24 hours

strong (uterine muscle is

after birth and produces

boardlike).

lethargy, seizures, poor sucking

27.

Chloasma, the mask of

pregnancy, is pigmentation of a
circumscribed area of skin

reflex, abdominal distention, and

respiratory difficulty.
33.

Variability is any change in

(usually over the bridge of the

the fetal heart rate (FHR) from

nose and cheeks) that occurs in

its normal rate of 120 to 160

some pregnant women.

beats/minute. Acceleration is

28.

The gynecoid pelvis is most

ideal for delivery. Other types

include platypelloid (flat),

increased FHR; deceleration is

decreased FHR.
34.

In a neonate, the symptoms

anthropoid (apelike), and

of heroin withdrawal may begin

android (malelike).

several hours to 4 days after

29.

Pregnant women should be

advised that there is no safe

level of alcohol intake.
30.

The frequency of uterine

contractions, which is measured

in minutes, is the time from the

birth.
35.

In a neonate, the symptoms

of methadone withdrawal may

begin 7 days to several weeks
after birth.
36.

In a neonate, the cardinal

beginning of one contraction to

signs of narcotic withdrawal

the beginning of the next.

include coarse, flapping tremors;

31.

Vitamin K is administered to

sleepiness; restlessness;

neonates to prevent

prolonged, persistent, high-

hemorrhagic disorders because

pitched cry; and irritability.

a neonates intestine cant

37.

The nurse should count a

synthesize vitamin K.

neonates respirations for 1 full

Before internal fetal monitoring

minute.

can be performed, a pregnant

38.

Chlorpromazine (Thorazine)

patients cervix must be dilated

is used to treat neonates who

at least 2 cm, the amniotic

are addicted to narcotics.

membranes must be ruptured,

and the fetuss presenting part
(scalp or buttocks) must be at

39.

The nurse should provide a

dark, quiet environment for a

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neonate who is experiencing

specifically, days 14 to 56 of

narcotic withdrawal.

gestation.

40.

In a premature neonate,

47.

After birth, the neonates

signs of respiratory distress

umbilical cord is tied 1 (2.5 cm)

include nostril flaring, substernal

from the abdominal wall with a

retractions, and inspiratory

cotton cord, plastic clamp, or

grunting.

rubber band.

41.

Respiratory distress

48.

Gravida is the number of

syndrome (hyaline membrane

pregnancies a woman has had,

disease) develops in premature

regardless of outcome.

infants because their pulmonary

49.

Para is the number of

alveoli lack surfactant.

pregnancies that reached

Whenever an infant is being put

viability, regardless of whether

down to sleep, the parent or

the fetus was delivered alive or

caregiver should position the

stillborn. A fetus is considered

infant on the back. (Remember

viable at 20 weeks gestation.

back to sleep.)

An ectopic pregnancy is one that

42.

The male sperm contributes

an X or a Y chromosome; the
female ovum contributes an X
chromosome.
43.

Fertilization produces a total

of 46 chromosomes, including
an XY combination (male) or an
XX combination (female).
44.

The percentage of water in a

neonates body is about 78% to

80%.
45.

To perform nasotracheal

implants abnormally, outside the

uterus.
50.

The first stage of labor

begins with the onset of labor

and ends with full cervical
dilation at 10 cm.
51.

The second stage of labor

begins with full cervical dilation

and ends with the neonates
birth.
52.

The third stage of labor

begins after the neonates birth

suctioning in an infant, the nurse

and ends with expulsion of the

positions the infant with his neck

placenta.

slightly hyperextended in a

In a full-term neonate, skin

sniffing position, with his chin

creases appear over two-thirds

up and his head tilted back

of the neonates feet. Preterm

slightly.

neonates have heel creases that

46.

Organogenesis occurs during

the first trimester of pregnancy,

cover less than two-thirds of the

feet.

OB BULLETS
53.

The fourth stage of labor

63.

During the transition phase

(postpartum stabilization) lasts

of the first stage of labor, the

up to 4 hours after the placenta

cervix is dilated 8 to 10 cm and

is delivered. This time is needed

contractions usually occur 2 to 3

to stabilize the mothers physical

minutes apart and last for 60

and emotional state after the

seconds.

stress of childbirth.
54.

At 20 weeks gestation, the

64.

A nonstress test is considered

nonreactive (positive) if fewer

fundus is at the level of the

than two fetal heart rate

umbilicus.

accelerations of at least 15

55.

At 36 weeks gestation, the

fundus is at the lower border of

the rib cage.
56.

A premature neonate is one

beats/minute occur in 20
minutes.
65.

A nonstress test is considered

reactive (negative) if two or

born before the end of the 37th

more fetal heart rate

week of gestation.

accelerations of 15 beats/minute

57.

Pregnancy-induced

hypertension is a leading cause

of maternal death in the United
States.
58.

A habitual aborter is a

above baseline occur in 20

minutes.
66.

A nonstress test is usually

performed to assess fetal wellbeing in a pregnant patient with

woman who has had three or

a prolonged pregnancy (42

more consecutive spontaneous

weeks or more), diabetes, a

abortions.

history of poor pregnancy

59.

Threatened abortion occurs

when bleeding is present

without cervical dilation.
60.

A complete abortion occurs

when all products of conception

are expelled.
61.

Hydramnios

outcomes, or pregnancy-induced
hypertension.
67.

A pregnant woman should

drink at least eight 8-oz glasses

(about 2,000 ml) of water daily.
68.

When both breasts are used

for breast-feeding, the infant

(polyhydramnios) is excessive

usually doesnt empty the

amniotic fluid (more than 2,000

second breast. Therefore, the

ml in the third trimester).

second breast should be used

62.

Stress, dehydration, and

fatigue may reduce a breastfeeding mothers milk supply.

first at the next feeding.

OB BULLETS
69.

A low-birth-weight neonate

77.

In partial (incomplete or

weighs 2,500 g (5 lb 8 oz) or less

marginal) placenta previa, the

at birth.

placenta covers only a portion of

70.

A very-low-birth-weight

neonate weighs 1,500 g (3 lb 5

oz) or less at birth.
71.

the cervical os.

78.

Abruptio placentae is

premature separation of a

When teaching parents to

normally implanted placenta. It

provide umbilical cord care, the

may be partial or complete, and

nurse should teach them to

usually causes abdominal pain,

clean the umbilical area with a

vaginal bleeding, and a

cotton ball saturated with

boardlike abdomen.

alcohol after every diaper

79.

Cutis marmorata is mottling

change to prevent infection and

or purple discoloration of the

promote drying.

skin. Its a transient vasomotor

72.

Teenage mothers are more

response that occurs primarily in

likely to have low-birth-weight

the arms and legs of infants who

neonates because they seek

are exposed to cold.

prenatal care late in pregnancy

80.

The classic triad of symptoms

(as a result of denial) and are

of preeclampsia are

more likely than older mothers

hypertension, edema, and

to have nutritional deficiencies.

proteinuria. Additional

73.

Linea nigra, a dark line that

symptoms of severe

extends from the umbilicus to

preeclampsia include

the mons pubis, commonly

hyperreflexia, cerebral and

appears during pregnancy and

vision disturbances, and

disappears after pregnancy.

epigastric pain.

74.

Implantation in the uterus

81.

Ortolanis sign (an audible

occurs 6 to 10 days after ovum

click or palpable jerk that occurs

fertilization.

with thigh abduction) confirms

75.

Placenta previa is abnormally

low implantation of the placenta

so that it encroaches on or
covers the cervical os.
76.

In complete (total) placenta

previa, the placenta completely

covers the cervical os.

congenital hip dislocation in a

neonate.
82.

The first immunization for a

neonate is the hepatitis B

vaccine, which is administered in
the nursery shortly after birth.
83.

If a patient misses a

menstrual period while taking an

OB BULLETS
oral contraceptive exactly as

90.

Drugs used to treat

prescribed, she should continue

withdrawal symptoms in

taking the contraceptive.

neonates include phenobarbital

84.

If a patient misses two

(Luminal), camphorated opium

consecutive menstrual periods

tincture (paregoric), and

while taking an oral

diazepam (Valium).

contraceptive, she should

91.

Infants with Down syndrome

discontinue the contraceptive

typically have marked

and take a pregnancy test.

hypotonia, floppiness, slanted

85.

If a patient who is taking an

eyes, excess skin on the back of

oral contraceptive misses a

the neck, flattened bridge of the

dose, she should take the pill as

nose, flat facial features,

soon as she remembers or take

spadelike hands, short and

two at the next scheduled

broad feet, small male genitalia,

interval and continue with the

absence of Moros reflex, and a

normal schedule.

simian crease on the hands.

86.

If a patient who is taking an

92.

The failure rate of a

oral contraceptive misses two

contraceptive is determined by

consecutive doses, she should

the experience of 100 women

double the dose for 2 days and

for 1 year. Its expressed as

then resume her normal

pregnancies per 100 woman-

schedule. She also should use an

years.

additional birth control method

for 1 week.
87.

Eclampsia is the occurrence

of seizures that arent caused by

a cerebral disorder in a patient

93.

The narrowest diameter of

the pelvic inlet is the

anteroposterior (diagonal
conjugate).
94.

The chorion is the outermost

who has pregnancy-induced

extraembryonic membrane that

hypertension.

gives rise to the placenta.

88.

In placenta previa, bleeding

is painless and seldom fatal on

the first occasion, but it

95.

The corpus luteum secretes

large quantities of progesterone.

96.

From the 8th week of

becomes heavier with each

gestation through delivery, the

subsequent episode.

developing cells are known as a

89.

Treatment for abruptio

placentae is usually immediate

cesarean delivery.

fetus.
97.

In an incomplete abortion,

the fetus is expelled, but parts of

OB BULLETS
the placenta and membrane
remain in the uterus.
98.

The circumference of a

neonates head is normally 2 to

3 cm greater than the
circumference of the chest.
99.

After administering

105. The neonatal period extends

from birth to day 28. Its also
called the first 4 weeks or first
month of life.
106. A woman who is breastfeeding should rub a mild
emollient cream or a few drops

magnesium sulfate to a

of breast milk (or colostrum) on

pregnant patient for

the nipples after each feeding.

hypertension or preterm labor,

She should let the breasts air-

the nurse should monitor the

dry to prevent them from

respiratory rate and deep

cracking.

tendon reflexes.
100. During the first hour after

107. Breast-feeding mothers

should increase their fluid intake

birth (the period of reactivity),

to 2 to 3 qt (2,500 to 3,000 ml)

the neonate is alert and awake.

daily.

101. When a pregnant patient has

108. After feeding an infant with a

undiagnosed vaginal bleeding,

cleft lip or palate, the nurse

vaginal examination should be

should rinse the infants mouth

avoided until ultrasonography

with sterile water.

rules out placenta previa.

102. After delivery, the first

109. The nurse instills

erythromycin in a neonates

nursing action is to establish the

eyes primarily to prevent

neonates airway.

blindness caused by gonorrhea

103. Nursing interventions for a

patient with placenta previa

or chlamydia.
110. Human immunodeficiency

include positioning the patient

virus (HIV) has been cultured in

on her left side for maximum

breast milk and can be

fetal perfusion, monitoring fetal

transmitted by an HIV-positive

heart tones, and administering

mother who breast-feeds her

I.V. fluids and oxygen, as

infant.

ordered.
104. The specific gravity of a

111. A fever in the first 24 hours

postpartum is most likely caused

neonates urine is 1.003 to

by dehydration rather than

1.030. A lower specific gravity

infection.

suggests overhydration; a higher

one suggests dehydration.

112. Preterm neonates or

neonates who cant maintain a

OB BULLETS
skin temperature of at least

true conjugate of 10.5 cm

97.6 F (36.4 C) should receive

enables the fetal head (usually

care in an incubator (Isolette) or

10 cm) to pass.

a radiant warmer. In a radiant

120. The smallest outlet

warmer, a heat-sensitive probe

measurement of the pelvis is the

taped to the neonates skin

intertuberous diameter, which is

activates the heater unit

the transverse diameter

automatically to maintain the

between the ischial tuberosities.

desired temperature.
113. During labor, the resting

121. Electronic fetal monitoring is

used to assess fetal well-being

phase between contractions is at

during labor. If compromised

least 30 seconds.

fetal status is suspected, fetal

114. Lochia rubra is the vaginal

blood pH may be evaluated by

discharge of almost pure blood

obtaining a scalp sample.

that occurs during the first few

122. In an emergency delivery,

days after childbirth.

115. Lochia serosa is the serous

enough pressure should be

applied to the emerging fetuss

vaginal discharge that occurs 4

head to guide the descent and

to 7 days after childbirth.

prevent a rapid change in

116. Lochia alba is the vaginal

discharge of decreased blood
and increased leukocytes thats

pressure within the molded fetal

skull.
123. After delivery, a multiparous

the final stage of lochia. It

woman is more susceptible to

occurs 7 to 10 days after

bleeding than a primiparous

childbirth.

woman because her uterine

117. Colostrum, the precursor of

milk, is the first secretion from
the breasts after delivery.
118. The length of the uterus

muscles may be overstretched

and may not contract efficiently.
124. Neonates who are delivered
by cesarean birth have a higher

increases from 2 (6.3 cm)

incidence of respiratory distress

before pregnancy to 12 (32

syndrome.

cm) at term.
119. To estimate the true

125. The nurse should suggest

ambulation to a postpartum

conjugate (the smallest inlet

patient who has gas pain and

measurement of the pelvis),

flatulence.

deduct 1.5 cm from the diagonal

conjugate (usually 12 cm). A

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126. Massaging the uterus helps

135. A mother should allow her

to stimulate contractions after

infant to breast-feed until the

the placenta is delivered.

infant is satisfied. The time may

127. When providing phototherapy

vary from 5 to 20 minutes.

to a neonate, the nurse should

136. Nitrazine paper is used to

cover the neonates eyes and

test the pH of vaginal discharge

genital area.

to determine the presence of

128. The narcotic antagonist

naloxone (Narcan) may be given

amniotic fluid.
137. A pregnant patient normally

to a neonate to correct

gains 2 to 5 lb (1 to 2.5 kg)

respiratory depression caused

during the first trimester and

by narcotic administration to the

slightly less than 1 lb (0.5 kg)

mother during labor.

per week during the last two

129. In a neonate, symptoms of

trimesters.

respiratory distress syndrome

138. Neonatal jaundice in the first

include expiratory grunting or

24 hours after birth is known as

whining, sandpaper breath

pathological jaundice and is a

sounds, and seesaw retractions.

sign of erythroblastosis fetalis.

130. Cerebral palsy presents as

139. A classic difference between

asymmetrical movement,

abruptio placentae and placenta

irritability, and excessive, feeble

previa is the degree of pain.

crying in a long, thin infant.

Abruptio placentae causes pain,

131. The nurse should assess a

whereas placenta previa causes

breech-birth neonate for

hydrocephalus, hematomas,

painless bleeding.
140. Because a major role of the

fractures, and other anomalies

placenta is to function as a fetal

caused by birth trauma.

lung, any condition that

132. When a patient is admitted to

interrupts normal blood flow to

the unit in active labor, the

or from the placenta increases

nurses first action is to listen for

fetal partial pressure of arterial

fetal heart tones.

carbon dioxide and decreases

133. In a neonate, long, brittle

fingernails are a sign of
postmaturity.
134. Desquamation (skin peeling)
is common in postmature
neonates.

fetal pH.
141. Precipitate labor lasts for
approximately 3 hours and ends
with delivery of the neonate.
142. Methylergonovine
(Methergine) is an oxytocic

OB BULLETS
agent used to prevent and treat

149. High-sodium foods can cause

postpartum hemorrhage caused

fluid retention, especially in

by uterine atony or

pregnant patients.

subinvolution.
143. As emergency treatment for
excessive uterine bleeding, 0.2
mg of methylergonovine

150. A pregnant patient can avoid

constipation and hemorrhoids by
adding fiber to her diet.
151. If a fetus has late

(Methergine) is injected I.V. over

decelerations (a sign of fetal

1 minute while the patients

hypoxia), the nurse should

blood pressure and uterine

instruct the mother to lie on her

contractions are monitored.

left side and then administer 8

144. Braxton Hicks contractions

to 10 L of oxygen per minute by

are usually felt in the abdomen

mask or cannula. The nurse

and dont cause cervical change.

should notify the physician. The

True labor contractions are felt in

side-lying position removes

the front of the abdomen and

pressure on the inferior vena

back and lead to progressive

cava.

cervical dilation and effacement.

145. The average birth weight of
neonates born to mothers who
smoke is 6 oz (170 g) less than

152. Oxytocin (Pitocin) promotes

lactation and uterine
contractions.
153. Lanugo covers the fetuss

that of neonates born to

body until about 20 weeks

nonsmoking mothers.

gestation. Then it begins to

146. Culdoscopy is visualization of

the pelvic organs through the
posterior vaginal fornix.
147. The nurse should teach a

disappear from the face, trunk,

arms, and legs, in that order.
154. In a neonate, hypoglycemia
causes temperature instability,

pregnant vegetarian to obtain

hypotonia, jitteriness, and

protein from alternative sources,

seizures. Premature,

such as nuts, soybeans, and

postmature, small-for-

legumes.

gestational-age, and large-for-

148. The nurse should instruct a

gestational-age neonates are

pregnant patient to take only

susceptible to this disorder.

prescribed prenatal vitamins

155. Neonates typically need to

because over-the-counter high-

consume 50 to 55 cal per pound

potency vitamins may harm the

of body weight daily.

fetus.

OB BULLETS
156. Because oxytocin (Pitocin)
stimulates powerful uterine
contractions during labor, it

neonate to help her come to

terms with the death.
164. Molding is the process by

must be administered under

which the fetal head changes

close observation to help

shape to facilitate movement

prevent maternal and fetal

through the birth canal.

distress.
157. During fetal heart rate

165. If a woman receives a spinal

block before delivery, the nurse

monitoring, variable

should monitor the patients

decelerations indicate

blood pressure closely.

compression or prolapse of the

umbilical cord.
158. Cytomegalovirus is the

166. If a woman suddenly

becomes hypotensive during
labor, the nurse should increase

leading cause of congenital viral

the infusion rate of I.V. fluids as

infection.

prescribed.

159. Tocolytic therapy is indicated

167. The best technique for

in premature labor, but

assessing jaundice in a neonate

contraindicated in fetal death,

is to blanch the tip of the nose

fetal distress, or severe

or the area just above the

hemorrhage.

umbilicus.

160. Through ultrasonography, the

168. During fetal heart

biophysical profile assesses fetal

monitoring, early deceleration is

well-being by measuring fetal

caused by compression of the

breathing movements, gross

head during labor.

body movements, fetal tone,

169. After the placenta is

reactive fetal heart rate

delivered, the nurse may add

(nonstress test), and qualitative

oxytocin (Pitocin) to the

amniotic fluid volume.

patients I.V. solution, as

161. A neonate whose mother has

prescribed, to promote

diabetes should be assessed for

postpartum involution of the

hyperinsulinism.

uterus and stimulate lactation.

162. In a patient with

170. Pica is a craving to eat

preeclampsia, epigastric pain is

nonfood items, such as dirt,

a late symptom and requires

crayons, chalk, glue, starch, or

immediate medical intervention.

hair. It may occur during

163. After a stillbirth, the mother

should be allowed to hold the

pregnancy and can endanger

the fetus.

OB BULLETS
171. A pregnant patient should

anomalies noted, and the risks

take folic acid because this

clearly outweigh the potential

nutrient is required for rapid cell

benefits.

division.
172. A woman who is taking

176. A patient with a ruptured

ectopic pregnancy commonly

clomiphene (Clomid) to induce

has sharp pain in the lower

ovulation should be informed of

abdomen, with spotting and

the possibility of multiple births

cramping. She may have

with this drug.

abdominal rigidity; rapid,

173. If needed, cervical suturing is

usually done between 14 and 18
weeks gestation to reinforce an

shallow respirations;
tachycardia; and shock.
177. A patient with a ruptured

incompetent cervix and maintain

ectopic pregnancy commonly

pregnancy. The suturing is

has sharp pain in the lower

typically removed by 35 weeks

abdomen, with spotting and

gestation.

cramping. She may have

During the first trimester, a

abdominal rigidity; rapid,

pregnant woman should avoid

shallow respirations;

all drugs unless doing so would

tachycardia; and shock.

adversely affect her health.

174. Most drugs that a breast-

178. The mechanics of delivery

are engagement, descent and

feeding mother takes appear in

flexion, internal rotation,

breast milk.

extension, external rotation,

175. The Food and Drug

Administration has established

restitution, and expulsion.

179. A probable sign of

the following five categories of

pregnancy, McDonalds sign is

drugs based on their potential

characterized by an ease in

for causing birth defects: A, no

flexing the body of the uterus

evidence of risk; B, no risk found

against the cervix.

in animals, but no studies have

been done in women; C, animal
studies have shown an adverse

180. Amenorrhea is a probable

sign of pregnancy.
181. A pregnant womans partner

effect, but the drug may be

should avoid introducing air into

beneficial to women despite the

the vagina during oral sex

potential risk; D, evidence of

because of the possibility of air

risk, but its benefits may

embolism.

outweigh its risks; and X, fetal

OB BULLETS
182. The presence of human
chorionic gonadotropin in the
blood or urine is a probable sign

190. Strabismus is a normal

finding in a neonate.
191. A postpartum patient may

of pregnancy.

resume sexual intercourse after

Radiography isnt usually used in

the perineal or uterine wounds

a pregnant woman because it

heal (usually within 4 weeks

may harm the developing fetus.

after delivery).

If radiography is essential, it

192. A pregnant staff member

should be performed only after

shouldnt be assigned to work

36 weeks gestation.

with a patient who has

183. A pregnant patient who has

cytomegalovirus infection

had rupture of the membranes

because the virus can be

or who is experiencing vaginal

transmitted to the fetus.

bleeding shouldnt engage in

sexual intercourse.
184. Milia may occur as pinpoint
spots over a neonates nose.
185. The duration of a contraction
is timed from the moment that
the uterine muscle begins to

193. Fetal demise is death of the

fetus after viability.
194. Respiratory distress
syndrome develops in premature
neonates because their alveoli
lack surfactant.
195. The most common method of

tense to the moment that it

inducing labor after artificial

reaches full relaxation. Its

rupture of the membranes is

measured in seconds.

oxytocin (Pitocin) infusion.

186. The union of a male and a

196. After the amniotic

female gamete produces a

membranes rupture, the initial

zygote, which divides into the

nursing action is to assess the

fertilized ovum.

fetal heart rate.

187. The first menstrual flow is

197. The most common reasons

called menarche and may be

for cesarean birth are

anovulatory (infertile).

malpresentation, fetal distress,

188. Spermatozoa (or their

cephalopelvic disproportion,

fragments) remain in the vagina

pregnancy-induced

for 72 hours after sexual

hypertension, previous cesarean

intercourse.

birth, and inadequate progress

189. Prolactin stimulates and

sustains milk production.

in labor.
198. Amniocentesis increases the
risk of spontaneous abortion,

OB BULLETS
trauma to the fetus or placenta,

maternal antibodies attached to

premature labor, infection, and

red blood cells in the neonate.

Rh sensitization of the fetus.

199. After amniocentesis,

206. Nausea and vomiting during

the first trimester of pregnancy

abdominal cramping or

are caused by rising levels of the

spontaneous vaginal bleeding

hormone human chorionic

may indicate complications.

gonadotropin.

200. To prevent her from

207. Before discharging a patient

developing Rh antibodies, an Rh-

who has had an abortion, the

negative primigravida should

nurse should instruct her to

receive Rho(D) immune globulin

report bright red clots, bleeding

(RhoGAM) after delivering an Rh-

that lasts longer than 7 days, or

positive neonate.

signs of infection, such as a

201. If a pregnant patients test

temperature of greater than

results are negative for glucose

100 F (37.8 C), foul-smelling

but positive for acetone, the

vaginal discharge, severe

nurse should assess the

uterine cramping, nausea, or

patients diet for inadequate

vomiting.

caloric intake.
202. If a pregnant patients test

208. When informed that a

patients amniotic membrane

results are negative for glucose

has broken, the nurse should

but positive for acetone, the

check fetal heart tones and then

nurse should assess the

maternal vital signs.

patients diet for inadequate

caloric intake.
203. Rubella infection in a
pregnant patient, especially
during the first trimester, can

209. The duration of pregnancy

averages 280 days, 40 weeks, 9
calendar months, or 10 lunar
months.
210. The initial weight loss for a

lead to spontaneous abortion or

healthy neonate is 5% to 10% of

stillbirth as well as fetal cardiac

birth weight.

and other birth defects.

204. A pregnant patient should
take an iron supplement to help
prevent anemia.
205. Direct antiglobulin (direct
Coombs) test is used to detect

211. The normal hemoglobin value

in neonates is 17 to 20 g/dl.
212. Crowning is the appearance
of the fetuss head when its
largest diameter is encircled by
the vulvovaginal ring.

OB BULLETS
213. A multipara is a woman who

higher in these infants than in

has had two or more

those born to nondiabetic

pregnancies that progressed to

women.

viability, regardless of whether

the offspring were alive at birth.
214. In a pregnant patient,

219. Skeletal system

abnormalities and ventricular
septal defects are the most

preeclampsia may progress to

common disorders of infants

eclampsia, which is

who are born to diabetic women.

characterized by seizures and

The incidence of congenital

may lead to coma.

malformation is three times

215. The Apgar score is used to

higher in these infants than in

assess the neonates vital

those born to nondiabetic

functions. Its obtained at 1

women.

minute and 5 minutes after

220. The patient with

delivery. The score is based on

preeclampsia usually has

respiratory effort, heart rate,

puffiness around the eyes or

muscle tone, reflex irritability,

edema in the hands (for

and color.

example, I cant put my

216. Because of the anti-insulin

effects of placental hormones,

wedding ring on.).

221. Kegel exercises require

insulin requirements increase

contraction and relaxation of the

during the third trimester.

perineal muscles. These

217. Gestational age can be

exercises help strengthen pelvic

estimated by ultrasound

muscles and improve urine

measurement of maternal

control in postpartum patients.

abdominal circumference, fetal

222. Symptoms of postpartum

femur length, and fetal head

depression range from mild

size. These measurements are

postpartum blues to intense,

most accurate between 12 and

suicidal, depressive psychosis.

18 weeks gestation.
218. Skeletal system

223. The preterm neonate may

require gavage feedings

abnormalities and ventricular

because of a weak sucking

septal defects are the most

reflex, uncoordinated sucking, or

common disorders of infants

respiratory distress.

who are born to diabetic women.

224. Acrocyanosis (blueness and

The incidence of congenital

coolness of the arms and legs) is

malformation is three times

normal in neonates because of

OB BULLETS
their immature peripheral
circulatory system.
225. To prevent ophthalmia
neonatorum (a severe eye
infection caused by maternal

232. If the neonate is stable, the

mother should be allowed to
breast-feed within the neonates
first hour of life.
233. The nurse should check the

gonorrhea), the nurse may

neonates temperature every 1

administer one of three drugs,

to 2 hours until its maintained

as prescribed, in the neonates

within normal limits.

eyes: tetracycline, silver nitrate,

At birth, a neonate normally

or erythromycin.

weighs 5 to 9 lb (2 to 4 kg),

Neonatal testing for

measures 18 to 22 (45.5 to 56

phenylketonuria is mandatory in

cm) in length, has a head

most states.

circumference of 13 to 14

226. The nurse should place the

(34 to 35.5 cm), and has a chest

neonate in a 30-degree

circumference thats 1 (2.5 cm)

Trendelenburg position to

less than the head

facilitate mucus drainage.

circumference.

227. The nurse may suction the

234. In the neonate, temperature

neonates nose and mouth as

normally ranges from 98 to 99

needed with a bulb syringe or

F (36.7 to 37.2 C), apical pulse

suction trap.

rate averages 120 to 160

228. To prevent heat loss, the

beats/minute, and respirations

nurse should place the neonate

are 40 to 60 breaths/minute.

under a radiant warmer during

235. The diamond-shaped anterior

suctioning and initial delivery-

fontanel usually closes between

room care, and then wrap the

ages 12 and 18 months. The

neonate in a warmed blanket for

triangular posterior fontanel

transport to the nursery.

usually closes by age 2 months.

229. The umbilical cord normally

has two arteries and one vein.
230. When providing care, the
nurse should expose only one
part of an infants body at a
time.
231. Lightening is settling of the

236. In the neonate, a straight

spine is normal. A tuft of hair
over the spine is an abnormal
finding.
237. Prostaglandin gel may be
applied to the vagina or cervix
to ripen an unfavorable cervix

fetal head into the brim of the

before labor induction with

pelvis.

oxytocin (Pitocin).

OB BULLETS
238. Supernumerary nipples are

244. Mongolian spots are common

occasionally seen on neonates.

in non-white infants and usually

They usually appear along a line

disappear by age 2 to 3 years.

that runs from each axilla,

245. Vernix caseosa is a

through the normal nipple area,

cheeselike substance that

and to the groin.

covers and protects the fetuss

239. Meconium is a material that

skin in utero. It may be rubbed

collects in the fetuss intestines

into the neonates skin or

and forms the neonates first

washed away in one or two

feces, which are black and tarry.

baths.

240. The presence of meconium in

246. Caput succedaneum is

the amniotic fluid during labor

edema that develops in and

indicates possible fetal distress

under the fetal scalp during

and the need to evaluate the

labor and delivery. It resolves

neonate for meconium

spontaneously and presents no

aspiration.

danger to the neonate. The

241. To assess a neonates rooting

reflex, the nurse touches a
finger to the cheek or the corner

edema doesnt cross the suture

line.
247. Nevus flammeus, or port-

of the mouth. Normally, the

wine stain, is a diffuse pink to

neonate turns his head toward

dark bluish red lesion on a

the stimulus, opens his mouth,

neonates face or neck.

and searches for the stimulus.

242. Harlequin sign is present

248. The Guthrie test (a screening

test for phenylketonuria) is most

when a neonate who is lying on

reliable if its done between the

his side appears red on the

second and sixth days after birth

dependent side and pale on the

and is performed after the

upper side.

neonate has ingested protein.

243. Mongolian spots can range

249. To assess coordination of

from brown to blue. Their color

sucking and swallowing, the

depends on how close

nurse should observe the

melanocytes are to the surface

neonates first breast-feeding or

of the skin. They most

sterile water bottle-feeding.

commonly appear as patches

250. To establish a milk supply

across the sacrum, buttocks,

pattern, the mother should

and legs.

breast-feed her infant at least

every 4 hours. During the first

OB BULLETS
month, she should breast-feed 8

257. Common complications of

to 12 times daily (demand

early pregnancy (up to 20

feeding).

weeks gestation) include fetal

251. To avoid contact with blood

and other body fluids, the nurse
should wear gloves when

loss and serious threats to

maternal health.
258. Fetal embodiment is a

handling the neonate until after

maternal developmental task

the first bath is given.

that occurs in the second

252. If a breast-fed infant is

trimester. During this stage, the

content, has good skin turgor,

mother may complain that she

an adequate number of wet

never gets to sleep because the

diapers, and normal weight gain,

fetus always gives her a thump

the mothers milk supply is

when she tries.

assumed to be adequate.
253. In the supine position, a

259. Visualization in pregnancy is

a process in which the mother

pregnant patients enlarged

imagines what the child shes

uterus impairs venous return

carrying is like and becomes

from the lower half of the body

acquainted with it.

to the heart, resulting in supine

260. Hemodilution of pregnancy is

hypotensive syndrome, or

the increase in blood volume

inferior vena cava syndrome.

that occurs during pregnancy.

254. Tocolytic agents used to treat

The increased volume consists

preterm labor include

of plasma and causes an

terbutaline (Brethine), ritodrine

imbalance between the ratio of

(Yutopar), and magnesium

red blood cells to plasma and a

sulfate.

resultant decrease in

255. A pregnant woman who has

hyperemesis gravidarum may

hematocrit.
261. Mean arterial pressure of

require hospitalization to treat

greater than 100 mm Hg after

dehydration and starvation.

20 weeks of pregnancy is

256. Diaphragmatic hernia is one

considered hypertension.

of the most urgent neonatal

262. The treatment for supine

surgical emergencies. By

hypotension syndrome (a

compressing and displacing the

condition that sometimes occurs

lungs and heart, this disorder

in pregnancy) is to have the

can cause respiratory distress

patient lie on her left side.

shortly after birth.

OB BULLETS
263. A contributing factor in
dependent edema in the
pregnant patient is the increase

regulatory, and respiratory

systems.
270. Obstetric data can be

of femoral venous pressure from

described by using the F/TPAL

10 mm Hg (normal) to 18 mm

system:

Hg (high).

F/T: Full-term delivery at 38

264. Hyperpigmentation of the

weeks or longer

pregnant patients face, formerly

P: Preterm delivery between 20

called chloasma and now

and 37 weeks

referred to as melasma, fades

A: Abortion or loss of fetus

after delivery.

before 20 weeks

265. The hormone relaxin, which

L: Number of children living (if a

is secreted first by the corpus

child has died, further

luteum and later by the

explanation is needed to clarify

placenta, relaxes the connective

the discrepancy in numbers).

tissue and cartilage of the

271. Parity doesnt refer to the

symphysis pubis and the

number of infants delivered,

sacroiliac joint to facilitate

only the number of deliveries.

passage of the fetus during

delivery.
266. Progesterone maintains the

272. Women who are carrying

more than one fetus should be
encouraged to gain 35 to 45 lb

integrity of the pregnancy by

(15.5 to 20.5 kg) during

inhibiting uterine motility.

pregnancy.

267. Ladins sign, an early

273. The recommended amount of

indication of pregnancy, causes

iron supplement for the

softening of a spot on the

pregnant patient is 30 to 60 mg

anterior portion of the uterus,

daily.

just above the uterocervical

juncture.
268. During pregnancy, the

274. Drinking six alcoholic

beverages a day or a single
episode of binge drinking in the

abdominal line from the

first trimester can cause fetal

symphysis pubis to the

alcohol syndrome.

umbilicus changes from linea

Chorionic villus sampling is

alba to linea nigra.

performed at 8 to 12 weeks of

269. In neonates, cold stress

affects the circulatory,

pregnancy for early

identification of genetic defects.

OB BULLETS
275. In percutaneous umbilical
blood sampling, a blood sample
is obtained from the umbilical

281. The major cause of uterine

atony is a full bladder.
282. If the mother wishes to

cord to detect anemia, genetic

breast-feed, the neonate should

defects, and blood

be nursed as soon as possible

incompatibility as well as to

after delivery.

assess the need for blood

transfusions.
276. The period between

283. A smacking sound, milk

dripping from the side of the
mouth, and sucking noises all

contractions is referred to as the

indicate improper placement of

interval, or resting phase. During

the infants mouth over the

this phase, the uterus and

nipple.

placenta fill with blood and allow

284. Before feeding is initiated, an

for the exchange of oxygen,

infant should be burped to expel

carbon dioxide, and nutrients.

air from the stomach.

277. In a patient who has

285. Most authorities strongly

hypertonic contractions, the

encourage the continuation of

uterus doesnt have an

breast-feeding on both the

opportunity to relax and there is

affected and the unaffected

no interval between

breast of patients with mastitis.

contractions. As a result, the

286. Neonates are nearsighted

fetus may experience hypoxia or

and focus on items that are held

rapid delivery may occur.

10 to 12 (25 to 30.5 cm) away.

278. Two qualities of the

287. In a neonate, low-set ears are

myometrium are elasticity,

associated with chromosomal

which allows it to stretch yet

abnormalities such as Down

maintain its tone, and

syndrome.

contractility, which allows it to

288. Meconium is usually passed

shorten and lengthen in a

in the first 24 hours; however,

synchronized pattern.

passage may take up to 72

279. During crowning, the

presenting part of the fetus

hours.
289. Boys who are born with

remains visible during the

hypospadias shouldnt be

interval between contractions.

circumcised at birth because the

280. Uterine atony is failure of the

uterus to remain firmly
contracted.

foreskin may be needed for

constructive surgery.

OB BULLETS
290. In the neonate, the normal
blood glucose level is 45 to 90
mg/dl.
291. Hepatitis B vaccine is usually
given within 48 hours of birth.

298. To obtain an estriol level,

urine is collected for 24 hours.
299. An estriol level is used to
assess fetal well-being and
maternal renal functioning as

292. Hepatitis B immune globulin

well as to monitor a pregnancy

is usually given within 12 hours

thats complicated by diabetes.

of birth.
293. HELLP (hemolysis, elevated
liver enzymes, and low platelets)
syndrome is an unusual

300. A pregnant patient with

vaginal bleeding shouldnt have
a pelvic examination.
301. In the early stages of

variation of pregnancy-induced

pregnancy, the finding of

hypertension.

glucose in the urine may be

294. Maternal serum alpha-

related to the increased

fetoprotein is detectable at 7

shunting of glucose to the

weeks of gestation and peaks in

developing placenta, without a

the third trimester. High levels

corresponding increase in the

detected between the 16th and

reabsorption capability of the

18th weeks are associated with

kidneys.

neural tube defects. Low levels

302. A patient who has premature

are associated with Down

rupture of the membranes is at

syndrome.

significant risk for infection if

295. An arrest of descent occurs

when the fetus doesnt descend

labor doesnt begin within 24

hours.

through the pelvic cavity during

303. Infants of diabetic mothers

labor. Its commonly associated

are susceptible to macrosomia

with cephalopelvic disproportion,

as a result of increased insulin

and cesarean delivery may be

production in the fetus.

required.
296. A late sign of preeclampsia is

304. To prevent heat loss in the

neonate, the nurse should bathe

epigastric pain as a result of

one part of his body at a time

severe liver edema.

and keep the rest of the body

297. In the patient with

preeclampsia, blood pressure

covered.
305. A patient who has a cesarean

returns to normal during the

delivery is at greater risk for

puerperal period.

infection than the patient who

gives birth vaginally.

OB BULLETS
306. The occurrence of thrush in
the neonate is probably caused
by contact with the organism

paleness, turn the patient on her

left side.
315. If the ovum is fertilized by a

during delivery through the birth

spermatozoon carrying a Y

canal.

chromosome, a male zygote is

307. The nurse should keep the

sac of meningomyelocele moist
with normal saline solution.
308. If fundal height is at least 2

formed.
316. Implantation occurs when the
cellular walls of the blastocyte
implants itself in the

cm less than expected, the

endometrium, usually 7 to 9

cause may be growth

days after fertilization.

retardation, missed abortion,

317. Implantation occurs when the

transverse lie, or false

cellular walls of the blastocyte

pregnancy.

implants itself in the

309. Fundal height that exceeds

expectations by more than 2 cm
may be caused by multiple

endometrium, usually 7 to 9
days after fertilization.
318. Heart development in the

gestation, polyhydramnios,

embryo begins at 2 to 4 weeks

uterine myomata, or a large

and is complete by the end of

baby.

the embryonic stage.

310. A major developmental task

for a woman during the first
trimester of pregnancy is
accepting the pregnancy.
311. Unlike formula, breast milk
offers the benefit of maternal
antibodies.
312. Spontaneous rupture of the
membranes increases the risk of
a prolapsed umbilical cord.
313. A clinical manifestation of a
prolapsed umbilical cord is
variable decelerations.
314. During labor, to relieve
supine hypotension manifested
by nausea and vomiting and

319. Methergine stimulates

uterine contractions.
320. The administration of folic
acid during the early stages of
gestation may prevent neural
tube defects.
321. With advanced maternal age,
a common genetic problem is
Down syndrome.
322. With early maternal age,
cephalopelvic disproportion
commonly occurs.
323. In the early postpartum
period, the fundus should be
midline at the umbilicus.
324. A rubella vaccine shouldnt
be given to a pregnant woman.

OB BULLETS
The vaccine can be administered

be ordered at 15 to 17 weeks

after delivery, but the patient

gestation.

should be instructed to avoid

334. To avoid puncturing the

becoming pregnant for 3

placenta, a vaginal examination

months.

shouldnt be performed on a

325. A 16-year-old girl who is

pregnant is at risk for having a
low-birth-weight neonate.
326. The mothers Rh factor

pregnant patient who is

bleeding.
335. A patient who has
postpartum hemorrhage caused

should be determined before an

by uterine atony should be given

amniocentesis is performed.

oxytocin as prescribed.

327. Maternal hypotension is a

complication of spinal block.
328. After delivery, if the fundus is

336. Laceration of the vagina,

cervix, or perineum produces
bright red bleeding that often

boggy and deviated to the right

comes in spurts. The bleeding is

side, the patient should empty

continuous, even when the

her bladder.

fundus is firm.

329. Before providing a specimen

337. Hot compresses can help to

for a sperm count, the patient

relieve breast tenderness after

should avoid ejaculation for 48

breast-feeding.

to 72 hours.
330. The hormone human

338. The fundus of a postpartum

patient is massaged to stimulate

chorionic gonadotropin is a

contraction of the uterus and

marker for pregnancy.

prevent hemorrhage.

331. Painless vaginal bleeding

339. A mother who has a positive

during the last trimester of

human immunodeficiency virus

pregnancy may indicate

test result shouldnt breast-feed

placenta previa.

her infant.

332. During the transition phase

of labor, the woman usually is
irritable and restless.
333. Because women with

340. Dinoprostone (Cervidil) is

used to ripen the cervix.
341. Breast-feeding of a
premature neonate born at 32

diabetes have a higher

weeks gestation can be

incidence of birth anomalies

accomplished if the mother

than women without diabetes,

expresses milk and feeds the

an alpha-fetoprotein level may

neonate by gavage.

OB BULLETS
342. If a pregnant patients rubella

346. The nurse must place

titer is less than 1:8, she should

identification bands on both the

be immunized after delivery.

mother and the neonate before

343. The administration of

oxytocin (Pitocin) is stopped if

they leave the delivery room.

347. Erythromycin is given at birth

the contractions are 90 seconds

to prevent ophthalmia

or longer.

neonatorum.

344. For an extramural delivery

348. Pelvic-tilt exercises can help

(one that takes place outside of

to prevent or relieve backache

a normal delivery center), the

during pregnancy.

priorities for care of the neonate

349. Before performing a Leopold

include maintaining a patent

maneuver, the nurse should ask

airway, supporting efforts to

the patient to empty her

breathe, monitoring vital signs,

bladder.

and maintaining adequate body

temperature.

350. According to the Unang

Yakap program (Essential

345. Subinvolution may occur if

Newborn Care), the cord should

the bladder is distended after

not be clamped until pulsations

delivery.

have stopped (thats about 1-3

minutes).