Obstetric Nurse Test Obstetric Nurse Antepartum Complications 3 — Questions and Answers
Question 1: A 38-week patient with gestational diabetes has an ultrasound showing estimated fetal weight of 4,600 g. Which complication is most anticipated during labor?
- Placental abruption
- Shoulder dystocia (Correct answer)
- Cord prolapse
- Uterine atony
Correct answer: Shoulder dystocia
Macrosomia (EFW >4,500 g) significantly increases the risk of shoulder dystocia during vaginal delivery.
Question 2: A pregnant woman at 10 weeks presents with severe nausea, vomiting, and a uterus larger than expected for dates. Beta-hCG is extremely elevated. Which diagnosis should the nurse suspect?
- Twin gestation
- Hydatidiform mole (Correct answer)
- Ectopic pregnancy
- Normal pregnancy variation
Correct answer: Hydatidiform mole
Hydatidiform mole presents with markedly elevated beta-hCG, uterus large for dates, and hyperemesis gravidarum due to abnormal trophoblastic proliferation.
Question 3: A patient in her second trimester has a hemoglobin of 9.2 g/dL with microcytic, hypochromic red cells. Which intervention is the nurse's priority?
- Administer folic acid supplementation
- Encourage increased dietary iron and initiate iron supplementation (Correct answer)
- Prepare for blood transfusion
- Order a Kleihauer-Betke test
Correct answer: Encourage increased dietary iron and initiate iron supplementation
Iron deficiency anemia in pregnancy is treated with dietary counseling and supplemental iron; transfusion is reserved for severe symptomatic cases.
Question 4: A patient at 34 weeks is admitted with preterm labor. Which medication is used to accelerate fetal lung maturity?
- Magnesium sulfate
- Betamethasone (Correct answer)
- Indomethacin
- Nifedipine
Correct answer: Betamethasone
Betamethasone (a corticosteroid) is administered to the mother between 24-34 weeks to stimulate fetal surfactant production and reduce respiratory distress syndrome.
Question 5: Which assessment finding is the nurse's primary concern when a patient is receiving IV magnesium sulfate for preeclampsia?
- Blood glucose level
- Deep tendon reflexes (Correct answer)
- Urine color
- Temperature
Correct answer: Deep tendon reflexes
Loss of deep tendon reflexes is the earliest sign of magnesium toxicity; absent DTRs indicate therapeutic levels are exceeded.
Question 6: A Rh-negative patient at 28 weeks has an amniocentesis. Which medication must be administered afterward?
- Progesterone
- Rho(D) immune globulin (RhoGAM) (Correct answer)
- Folic acid
- Betamethasone
Correct answer: Rho(D) immune globulin (RhoGAM)
Rho(D) immune globulin is given to Rh-negative mothers after any invasive procedure or potential sensitizing event to prevent isoimmunization.
Question 7: A patient at 20 weeks is diagnosed with oligohydramnios (AFI of 4 cm). Which fetal condition is most commonly associated with this finding?
- Neural tube defect
- Renal agenesis or urinary tract obstruction (Correct answer)
- Cardiac defect
- Chromosomal trisomy
Correct answer: Renal agenesis or urinary tract obstruction
Oligohydramnios is most commonly associated with fetal renal agenesis (Potter sequence) or urinary tract obstruction, as fetal urine is the primary source of amniotic fluid in the second half of pregnancy.
Obstetric Nurse Test Obstetric Nurse Antepartum Complications 3
A 38-week patient with gestational diabetes has an ultrasound showing estimated fetal weight of 4,600 g.
Which complication is most anticipated during labor?