NCLEX Q and A with Rationales – OB MATERNITY NURSING
ANATOMY & PHYSIOLOGY OF REPRODUCTION:
1. State the objective signs that signify ovulation
– abundant, thin, clear cervical mucus; open cervical os; slight drop in BBT and then 0.5-1.0 F rise; ferning under the microscope
2. Ovulation occurs how many days before the next menstrual period?
– 14 days.
3. State three ways to identify the chronological age of a pregnancy (gestation)?
– 10 lunar months, 9 calendar months consisting of 3 trimesters of 3 months each, 40 weeks, 280 days.
4. What maternal position provides optimum fetal maternal/placental perfusion during pregnancy?
– The knee-chest position, but the ideal position of COMFORT for the mother which supports fetal/maternal/placental perfusion is the side-lying position off the abdominal vessels (vena cava, aorta)
5. Name the major discomforts of the first trimester and one suggestion for amelioration of each.
– Nausea and vomiting: crackers before rising. Fatigue: teach the need for rest periods/naps and 7-8 hours sleep at night.
6. If the first day of a woman’s last normal menstrual period was May 28, what is the estimated delivery date (EDD) using Nagele’s rule?
– Count back 3 months and add 7 days: March 7 (always give February 28 days).
7. At twenty weeks gestation, the fundal height would be ______ , the fetus would weigh approximately _______ and look like _____ .
– At the umbilicus; 300-400 grams; a baby with hair, lanugo and verniz, but without subcutaneous fat.
8. State the normal psychosocial responses to pregnancy in the 2nd trimester
– Ambivalence wanes and acceptance of pregnancy occurs; pregnancy becomes “real;” signs of maternal-fetal bonding occur.
9. Hemodilution of pregnancy peaks at ______ weeks and results in a/an ______ in a women’s Hct.
– 28-32 weeks; increase in Hct
10. State three principles relative to the PATTERN of weight gain in pregnancy.
– Total gain should average 24-30 lbs. Gain should be consistent throughout pregnancy. An average of 0.9 lb/week should be gained in the 2nd & 3rd trimester.
11. During pregnancy a woman should add ____ calories to her diet, and drink ____ of milk/day.
– 300 calories; 1 quart of milk
12. Fetal heart rate can be auscultated by Doppler at ____ weeks gestation.
– 10-12 weeks
13. Describe the schedule for prenatal visits for a low-risk pregnant woman.
– Once a month until 28 weeks, then once every week until delivery.