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Inpatient OB Certification exam study guide with actual questions and answers
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Inpatient OB Certification exam studyguide with actual questions and answers
Pain during the first stage of labor is caused by
a. cervical and lower uterine segment stretching and traction on ovaries, fallopian tubes, and
uterine ligaments.
b. pressure on the urethra, bladder, and rectum by the descending fetal presenting part
c. uterine muscle hypoxia, lactic acid accumulation, and distention of the pelvic floor muscles. -
ANS a. cervical and lower uterine segment stretching and traction on ovaries, fallopian tubes,
and uterine ligaments.
A class of antihypertensive drugs that should be avoided in pregnancy is:
a. ACE inhibitors
b. adrenergic blocking agents
c. calcium channel blockers - ANS a. ACE inhibitors
Gestational diabetes places a woman at increased risk of:
a. a birth with a congenital defect
b. oligohydramnios with resultant fetal growth restriction
c. overt diabetes in later life - ANS Overt diabetes in later life
A sign of symptom that indicates a progression of preeclampsia to eclampsia and warrants a
consideration for delivery is:
a. epigastric pain
b. nausea or vomiting
c. persistent proteinuria - ANS epigastric pain
A predisposing factor for preeclampsia is:
a. nulliparity
b. obesity prior to pregnancy
c. previous history of preeclampsia - ANS A, B, and C
A women is receiving magnesium sulfate. A sign that the magnesium sulfate is reaching a toxic
level is:
a. decreased appetite
b. difficulty in swallowing
,c. slurring of speech - ANS Slurring of the speech
A positive ankle clonus that occurs with preeclampsia is usually a result of
a. cerebral edema
b. decreased colloid osmotic pressure
c. dependent edema - ANS cerebral edema
A potentially life saving measure for a fetus that is exposed to chicken pox just prior to delivery
is for the mother to receive:
a. acyclovir (Zovirax)
b. the chicken pox vaccine
c. varicella immune globulin (VZIG) - ANS Varicella immune globulin (VZIG)
Following cesarean delivery for abrupt placenta, a clot observation test is initiated. Placing a
small amount of blood in a test tube for 20 minutes yields a soft clot that dissolves easily. This is
consistent with:
a. hypofibriongenemia
b. normal coagulation process
c. presence of antithrombin III - ANS Hypofibriongenemia
A finding that would indicate a pregnant diabetic patient is at increased risk for giving birth to an
infant with a congenital defect is:
a. a history of macrosomia in her previous pregnancy
b. an elevated hemoglobin A1C levels during the first trimester
c. glucose levels above 140 mg/dL in the third trimester - ANS b. an elevated hemoglobin
A1C levels during the first trimeter
(A1C) — Hemoglobin A1C levels are monitored during pregnancy because they correlate with a
woman's blood glucose concentration over the prior 8 to 12 weeks and are predictive of the risk
for congenital malformations and neonatal birth weight [9]. Lower values have been associated
with better outcomes. (<6)
When a pregnant woman experiences a cardiac arrest, the nurse should:
a. first focus on assessing fetal status
b. if the mother dies, discontinue resuscitative efforts
c. treat the patient as the same as a non-pregnant patient - ANS c. Treat the patient as the
same as a non-pregnant patient
At term, a woman is labor is found to have severe condylomata which has obstructed the
vaginal canal. The appropriate disposition is.
,a. cesarean delivery
b. cryotherapy removal
c. immediate removal with podophyllin - ANS a. cesarean delivery
A hematologic change in pregnancy that predisposes to venous thrombosis is
a. depressed fibrinolytic activity
b. increased white blood cell count
c. reduced erythrocyte production - ANS a. depressed fibrinolytic activity
A women is admitted to labor and delivery at 32 weeks gestation with vaginal bleeding. Her
hematocrit is falling and she is tachycardic. A Kleihauer-Betketest is ordered. This is done to:
a. detect fetal red blood cells in the maternal circulation
b. detect hemolysis of fetal red blood ells
c. rule out Rh isoimmunization - ANS a. detect fetal red blood cells in the maternal
circulation
A pregnant woman at 33 weeks gestation experiences an eclamptic seizure. The medication of
choice for this patient is immediate, intravenous administration of:
a. diazepam (Valium)
b. magnesium sulfate
c. phenytoin (Dilantin) - ANS b. magnesium sulfate
A pregnant woman has a hemoglobin level of 9 g/dL and is stable, afebrile, and can ambulate
without adverse symptoms. The indicated treatment is
a. oral iron preparation
b. parenteral iron therapy
c. whole blood transfusions - ANS a. oral iron preparation
The Centers for Disease Control and Prevention (CDC) has defined anemia as hemoglobin
levels of less than 11 g/dL (hematocrit less than 33 percent) in the first and third trimesters and
less than 10.5 g/dL (hematocrit less than 32 percent) in the second trimester [21]. Since
hemoglobin and hematocrit levels are lower in African-American adults, the Institute of Medicine
recommends lowering the hemoglobin cut-off level by 0.8 g/dL in this population
A women at 34 weeks gestation is admitted to the antepartum unit for influenza type symptoms
and lymphadenopathy. A culture shows an infection caused by T. gondii. The most likely
transmission route for this infection is.
a. ingestion of raw meat
b. rectal transfer
, c. sexual intercourse - ANS ingestion of raw meat
Toxoplasma gondii is a ubiquitous protozoan parasite that infects humans in various settings.
Acute infection in the mother is usually asymptomatic. When symptoms of infection occur, they
are nonspecific, such as fatigue, fever, headache, malaise, and myalgia. Lymphadenopathy is a
more specific sign of the disease.
A pregnant woman who is HIV positive is on combination antiviral therapy comes to the hospital
for delivery. Drug therapy should be:
a. continued on the prenatal dosing regimen throughout labor and delivery
b. discontinued until after delivery where combination therapy should be resumed postpartum
c. switched to zidovudine IV for one hour and followed by continuous infusion until delivery -
ANS a. continued on the prenatal dosing regimen throughout labor and delivery.
Women should continue taking their ART regimen during labor and delivery or scheduled
cesarean delivery. For women who have HIV RNA ≥1000 copies/mL or unknown viral levels in
late pregnancy and around the time of delivery, we recommend intrapartum intravenous
zidovudine to further reduce the risk of perinatal transmission (table 2) (Grade 1B). For women
who have had HIV RNA <1000 copies/mL consistently in late pregnancy and around the time of
delivery and have no concerns related to adherence or resistance to the regimen, intrapartum
intravenous zidovudine is not associated with further reduction of HIV transmission.
A diagnostic test used in the diagnosis of HELLP syndrome is.
a. decreased liver function studies
b. increased creatinine clearance
c. presence of burr cells - ANS c. decreased liver function studies
During labor, women on full dose prophylactic unfractionated heparin anticoagulation should
have the heparin dose.
a. increased
b, maintained
c. withheld - ANS c. withheld
An alternative regimen to hydrazine when treating severe maternal hypertension is
a. diazoxide
b. labetalol
c. sodium nitroprusside - ANS b. labetalol
The vascular manifestation of pregnant women with Class F diabetes is
a. atherosclerotic heart disease
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