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CCPR - OB Exam 1 Questions and Verified Solutions 2023/2024, Exams of Nursing

University of Virginia (UVA)Nursing

A set of multiple-choice questions and verified solutions related to obstetrics (ob) for the ccpr exam. It covers various topics relevant to pregnancy, labor, delivery, and postpartum care, including fetal heart rate monitoring, labor induction, complications, and breastfeeding. The questions are designed to test knowledge and understanding of key concepts in ob, making it a valuable resource for students preparing for the ccpr exam.

Typology: Exams

2024/2025

Available from 02/08/2025

Andy36
Andy36 🇺🇸

121 documents

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CCPR - OB Exam 1 Questions and verified
solutions 2023/2024
1. A
gravida
2,
para 1 in active labor just reported spontaneous rupture of membranes. Ten minutes later, she
suddenly complains of severe shortness of breath and lightheadedness. The nurse should suspect
a.
anaphylactoid syndrome
b. extreme anxiety
c. hyperventilation
anaphylactoid syndrome
2.
Betamethasone given to the mother can transiently affect the fetal heart rate by
a. decreasing the variability
b. increasing the variability
c. lowering the baseline
decreasing the variability
3. When
Cervidil is used for induction of labor, at what point can oxytocin be initiated after removal of the Cervidil?
a. 1 hour
b. 2 hours
c. 4 hours
1 hour
5. When
fundal pressure is used during a shoulder dystocia, the nurse is aware that it will potentially
a. abrupt the placenta
b. assist the provider with delivery of the shoulders
c. impact the fetal shoulder
c. impact the fetal shoulder
6. A postpartum mother who would like to breastfeed her baby is diagnosed with Hepatitis B surface-antigen positive.
What is the recommendation regarding breastfeeding for this mother?
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CCPR - OB Exam 1 Questions and verified

solutions 2023/

  1. A gravida 2, para 1 in active labor just reported spontaneous rupture of membranes. Ten minutes later, she suddenly complains of severe shortness of breath and lightheadedness. The nurse should suspect a. anaphylactoid syndrome b. extreme anxiety c. hyperventilation anaphylactoid syndrome
  2. Betamethasone given to the mother can transiently affect the fetal heart rate by a. decreasing the variability b. increasing the variability c. lowering the baseline decreasing the variability
  3. When Cervidil is used for induction of labor, at what point can oxytocin be initiated after removal of the Cervidil? a. 1 hour b. 2 hours c. 4 hours 1 hour
  4. When fundal pressure is used during a shoulder dystocia, the nurse is aware that it will potentially a. abrupt the placenta b. assist the provider with delivery of the shoulders c. impact the fetal shoulder c. impact the fetal shoulder
  5. A postpartum mother who would like to breastfeed her baby is diagnosed with Hepatitis B surface-antigen positive. What is the recommendation regarding breastfeeding for this mother?

a. Administer HBIG and hepatitis B vaccine to the newborn and then allow breastfeeding b. Breastfeeding is absolutely contraindicated c. Pump and discard milk for 1 week following vaccine administration to the newborn a. Administer HBIG and hepatitis B vaccine to the newborn and then allow breastfeeding

  1. Stimulation of the sympathetic nervous system causes the fetal heart rate to a. decrease b. increase c. remain the same increase
  2. A patient at 37 weeks gestation arrives to labor and delivery from the emergency room after admission for severe gastric discomfort with nausea and vomiting. Her blood pressure is 156/100 mmHg. She complains of blurred vision. These findings are consistent with a diagnosis of a. gestational hypertension b. preeclampsia c. preeclampsia with severe features preeclampsia with severe features
  3. What maternal disease results in damage to the fetal heart conduction system? a. Alpha thalassemia major b. Rh isoimmunization c. Systemic lupus erythematosus Systemic lupus erythematosus
  4. The most appropriate instruction to give parents about what breastfeeding frequency to expect during the first few weeks after birth is a. cluster feedings with 8 to 12 feedings in 24 hours b. regularly spaced feedings every 2 to 3 hours c. six to eight feedings in 24 hours with a longer stretch of sleep during the night a. cluster feedings with 8 to 12 feedings in 24 hours
  5. A woman at 28 weeks gestation reports to the labor and delivery with painless vaginal bleeding that started this morning. The nurse's first step in caring for this woman is to determine a. cervical dilation

a. blocking the capacity of nerve pathways to transmit pain

  1. The phase of labor that distraction techniques are most likely to be effective is a. active b. latent c. transition b. latent
  2. A gravida 1 para 0 is in spontaneous labor at 40 weeks after an uncomplicated pregnancy. She is 5 centimeters dilated, completely effaced with the vertex at -2 station. The above tracing is obtained following the artificial rupture of the membranes (AROM). -- After maternal repositioning, the next step in management is to: a. Administer terbutaline b. Initiate an amnioinfusion c. Perform a vaginal exam c. Perform a vaginal exam
  3. The recommended method to reduce the incidence of nonreactive nonstress tests is a. fetal manipulation b. ingestion of orange juice c. vibroacoustic stimulation c. vibroacoustic stimulation
  4. A woman is 12 hours postpartum and has a white blood cell count of 25,000μL. This indicates a. dehydration and a need to force fluids b. in the expected range at this time c. infection and a need for antibiotics b. in the expected range at this time
  5. The cardinal symptom of cholestasis of pregnancy is a. diaphoresis b. nausea and vomiting c. pruritus c. pruritus
  6. When the chorionic villi attach directly to the myometrium of the uterus, this represents a. early stage placenta previa

b. placenta accreta c. retained placenta b. placenta accreta

  1. After the last dose of misoprostol (Cytotec), oxytocin administration should be delayed for at least a. 30-60 minutes b. 4 hours c. 6-12 hours b. 4 hours
  2. The pushing technique that a woman in second stage should be encouraged to use is a. Alternating between open and closed-glottis pushing b. Closed glottis pushing while holding her breath to the count of 10 c. Open-glottis pushing for 6-8 seconds with 3 to 4 pushes per contraction c. Open-glottis pushing for 6-8 seconds with 3 to 4 pushes per contraction
  3. To avoid a precipitous drop in intra-abdominal pressure, during catheterization of a postpartum patient's bladder, what is the maximum amount of urine that should be removed at one time? a. 500 ml b. 800 ml c. 1000 ml b. 800 ml
  4. A prolonged second stage in a primigravida with regional anesthesia is defined as a lack of continuing progress and a second stage duration of greater than a. 1 hour b. 2 hours c. 3 hours c. 3 hours
  5. Dinoprostone (Cervidil) is being utilized for cervical ripening. The nurse should know the Cervidil should be removed a. in 12 hours or the onset of uterine contractions b. in 24 hours after insertion c. when it is time to administer oxytocin a. in 12 hours or the onset of uterine contractions

a. higher b. lower c. similar a. higher

  1. A newly pregnant woman who is morbidly obese has a strong family history of type 2 diabetes. The recommended time for this woman's initial glucose screen is a. as soon as possible b. at 36 weeks gestation c. between 24 and 28 weeks gestation a. as soon as possible
  2. A Bishop score of 4 indicates a. a favorable cervix b. an intermediate cervix c. an unfavorable cervix c. an unfavorable cervix
  3. During auscultation of the fetal heart rate, the nurse notes a gradual decrease in the fetal heart rate after a contraction that lasts 60 seconds. The appropriate documentation of this finding is that after a contraction, there is a a. decrease in the fetal heart rate after a contraction b. late deceleration c. variable deceleration a. decrease in the fetal heart rate after a contraction
  4. Which one of the following women is the best candidate for a vaginal birth after cesarean? a. A gravida 2 para 1 who had a cesarean for labor dystocia prior to 5 centimeters dilation b. A gravida 3, para 2 who had a cesarean for fetal heart rate issues with her first baby and a cesarean for breech presentation with her second baby c. A gravida 3, para 2 who had a vaginal delivery with her first pregnancy and a cesarean for breech with her second baby c. A gravida 3, para 2 who had a vaginal delivery with her first pregnancy and a cesarean for breech with her second baby
  5. What is the pattern in the above fetal heart rate tracing? a. acceleration

b. late deceleration c. prolonged acceleration c. prolonged acceleration

  1. A predisposing factor to breech presentation is a. android pelvis b. multifetal pregnancy c. primiparity b. multifetal pregnancy
  2. A maternal contraindication to breastfeeding is a. hepatitis A b. group B streptococcus c. HTLV-1(human T-cell leukemia virus, type 1) c. HTLV-1(human T-cell leukemia virus, type 1)
  3. An Rh negative woman at 36 weeks has an external version. She should a. not receive Rh D immunoglobulin (Rhogam) b. receive Rh D immunoglobulin (Rhogam) c. only receive Rh D immunoglobulin (Rhogam) if spotting after procedure b. receive Rh D immunoglobulin (Rhogam)
  4. Fentanyl requires more frequent dosing for management of labor pain because a. it has a shorter duration of action b. multiple smaller doses over time decrease the incidence of side effects c. the peak effect time lengthens with subsequent doses a. it has a shorter duration of action
  5. Which one of the following tachyarrhythmias can result in fetal hydrops? a. Persistent supraventricular tachycardia b. Premature atrial contractions c. Sinus tachycardia a. Persistent supraventricular tachycardia
  6. A pregnant woman at 24 weeks gestation is an elementary school teacher. She states there is an episode of Fifth Disease in the school. This patient is at risk for acquiring a. Cytomegalovirus
  1. A fetal heart rate baseline of 140 with moderate variability, no accelerations and no decelerations is a NICHD category a. I b. II c. III a. I
  2. The fetal heart tones of a baby in the ROP position, would best be heard over which area of the mothers abdomen? a. A (low midline) b. B (low right) c. C (low left) b. B (low right)
  3. Compared to non-pregnant values, the maternal arterial carbon dioxide (pCO₂) during pregnancy is a. decreased b. increased c. the same a. decreased
  4. A 39 week gestation primigravida has had regular contractions for the past 48 hours. She has remained 1 centimeter dilated since the onset of contractions. She is exhausted, uncomfortable and unable to sleep. Which medication is recommended for therapeutic rest? a. Fentanyl b. Morphine c. Stadol b. Morphine
  5. pH 7.0 pCO2 80 mmHg pO2 21 mmHg HCO3 21.3 mm/L B.D. 6 mm/L The umbilical cord blood values above reflect a. metabolic acidemia b. normal values c. respiratory acidemia c. respiratory acidemia
  1. Which statement describes normal uterine activity? a. Frequency of 1-1/2 to 2 minutes b. Intensity of 90 mmHg early in labor c. Resting tone less than 20-25 mmHg c. Resting tone less than 20-25 mmHg
  2. A negative fetal fibronectin test at 30 weeks indicates a. a need for further testing b. increased risk for delivery c. risk of delivery is very low for the next 7-14 days c. risk of delivery is very low for the next 7-14 days
  3. The uterine incision which has the highest risk of heavy blood loss and repair difficulty is a. lower uterine segment transverse (Kerr) b. lower uterine segment vertical (Sellheim) c. upper uterine segment vertical (Classic) c. upper uterine segment vertical (Classic)
  4. A patient diagnosed with a postpartum infection states she does not have any pain but seems confused and agitated. Her vital signs are as follows: Temperature 99.9°F; BP 98/50; Pulse 125, urinary output is decreased. The most likely diagnosis is a. pulmonary embolism b. septic shock c. thromboembolism b. septic shock
  5. The cervical dilation in the above multigravida labor cure is interpreted as a. Arrest of dilation b. Normal labor progress c. Protracted active phase c. Protracted active phase
  6. Following delivery the insulin requirement for most diabetic breastfeeding women is a. decreased b. increased c. the same as for bottlefeeding diabetics

a. Administer ephedrine b. Discontinue the epidural c. Prepare for a cesarean section a. Administer ephedrine

  1. Forty-eight hours after a woman's cesarean birth, the nurse notes that the woman's left calf and foot are cool and pale. The left pedal pulse is diminished and there is decreased capillary refill. The Homan's sign is negative bilaterally. She reports some tenderness in the left calf. The most appropriate initial response to these findings would be to a. administer pain Warfarin b. apply elastic stockings c. place on bedrest with elevation of left leg c. place on bedrest with elevation of left leg
  2. Which maternal age is at greatest risk of a labor dystocia a. 16 b. 28 c. 36 c. 36
  3. A sign of deteriorating status in a pregnancy complicated by hypertension is increased a. albumin b. plasma colloid pressure c. serum creatinine c. serum creatinine
  4. A woman is receiving steroids at 36 weeks gestation for immune thrombocytopenia (ITP). She needs to be followed closely for a. increased risk of infection b. hypoglycemia c. hypertension Priority is c. hypertension! Early detection of HELLP NOT a. increased risk of infection, though perhaps this is a SE of steroids.
  1. The lochia that is pink or brown in color and occurs between 3 and 10 days postpartum is a. alba b. rubra c. serousa c. serousa
  2. A primigravida admitted for induction at 39 weeks gestation for preclampsia. She is not receiving any medication. On admission, her blood pressure is 157/91 and the FHR tracing is above. -- The decelerations in this tracing are (somewhat abrupt, but >30 sec onset to nadir, nadir after peak of ctx): a. early b. late c. variable b. late
  3. Continued increases in oxytocin rates over a prolonged period of time have what effect on oxytocin receptor sites? a. desensitization b. multiplication c. up-regulation a. desensitization
  4. During a shoulder dystocia, the provider has the nurse place the patient on all fours to facilitate delivery. Which of the following maneuvers would the provider request? a. Gaskin b. Woods c. Zavanelli a. Gaskin
  5. The Ferguson reflex is the result of a. cytokine release b. prostaglandin release from the membranes c. stretching of pelvic floor muscles c. stretching of pelvic floor muscles
  6. A young woman at 38 weeks gestation is brought to the hospital via ambulance after having seizures at home. She has been given phenobarbital, labetelol and magnesium sulfate. -- Fetal scalp stimulation is performed in panel
  1. Which finding of this tracing rules out fetal metabolic acidemia at this time? a. Baseline FHR b. Decelerations c. Variability c. Variability
  2. When a fetus is in the occiput posterior position, the position that is most helpful in facilitating rotation is a. hands and knees b. lithotomy c. semi-fowlers a. hands and knees
  3. According to the ACOG guidelines for continuous electronic fetal monitoring, a patient without complications in the active phase of labor should have the fetal heart rate assessed every a. 15 minutes b. 30 minutes c. 60 minutes b. 30 minutes
  4. Group B streptococcus (GBS) and what other organism are currently the most common pathogens seen with neonatal sepsis? a. Chlamydia b. E. coli c. Klebsiella (enterobacteria species) b. E. coli
  5. The disease that is passed through the feces of infected cats is a. cytomegalovirus b. parvovirus c. toxoplasmosis c. toxoplasmosis
  6. Which one of the following women fits the definition of preterm labor? a. A 36 week gestation multigravida who is admitted with regular contractions and who is 3 centimeters dilation b. A 19 week gestation primigravida who has dilated from 2 cm to 4 cm in the last hour c. A 28 week gestation multigravida with regular contractions and no cervical change

a. A 36 week gestation multigravida who is admitted with regular contractions and who is 3 centimeters dilation

  1. A term 3000 gram neonate born to a mother whose HBsAg status is unknown should have a. hepatitis B vaccine and HBIG administered only after the mothers status known b. the first dose of Hepatitis B vaccine within the first 12 hours after birth c. the same schedule as a neonate born to an HBsAg negative mother b. the first dose of Hepatitis B vaccine within the first 12 hours after birth
  2. The decelerations per the NICHD terminology in the tracing shown are defined as a. early b. late c. variable a. early
  3. The second stage position that can increase the pelvic diameter as much as 28 to 30% is a. knee-chest b. semi-fowlers c. squatting c. squatting
  4. A pregnancy is classified as post term beginning at a. 41 weeks and 1 day b. 41 weeks and 6 days c. 42 weeks and 0 days c. 42 weeks and 0 days
  5. A provider asks a nurse to obtain a signature on informed consent for surgery. The nurse's responsibility in this situation is to a. determine if patient was advised of the reasons, risks and benefits of the surgery b. clarify any last minute questions for the patient about the surgery c. insure at least two unbiased witnesses are present when the patient signs the form a. determine if patient was advised of the reasons, risks and benefits of the surgery
  6. When a pattern of coupling and tripling of contractions is occurring the oxytocin dose should be a. decreased b. increased c. maintained

a. improving placental circulation b. thinning of the meconium c. relieving umbilical cord compression c. relieving umbilical cord compression

  1. A placenta in which the umbilical blood vessels are separated when they leave the placenta and not protected with Wharton Jelly is what placenta variation? a. Battedore b. Circumvallate c. Velamentous c. Velamentous
  2. On admission to the labor unit, a woman's deep tendon reflexes are assessed at 4+. Intravenous magnesium sulfate is initiated. At her next assessment her reflexes are assessed as absent with respiratory rate 10. Which of the following actions should be taken? a. Increase the magnesium sulfate per protocol b. No action should be taken at this time c. Stop the magnesium sulfate and notify the provider c. Stop the magnesium sulfate and notify the provider
  3. The baseline of the term fetus in the above tracing (marked variability) is a. 120 b. 120- c. indeterminate c. indeterminate
  4. Immediately following an emergency cesarean delivery for placental abruption, a woman begins to exhibit epistaxis and bleeding from her intravenous site. This clinical presentation is suggestive of a. antithrombin III elevation b. disseminated intravascular dissemination c. Factor V Leiden b. disseminated intravascular dissemination
  5. The medication that is contraindicated in women with a cardiac condition is a. hydralazine

b. oxytocin c. terbutaline c. terbutaline

  1. The recommendation regarding the administration of Narcan (naloxone) to the newborn with respiratory depression secondary to maternal administration of narcotics is to a. administer at 15 minutes after birth b. administer as soon as possible c. avoid administration c. avoid administration
  2. Oligohydramnios is diagnosed when a biophysical profile shows an amniotic fluid index (AFI) of a. 4 cm b. 6 cm c. 8 cm a. 4 cm
  3. The time during labor and birth that is of greatest risk for woman with a cardiac condition is a. active phase of labor b. second stage of labor c. immediately after birth c. immediately after birth
  4. The metabolic state of pregnancy is described as a chronic a. respiratory acidosis b. respiratory alkalosis c. mixed acidosis b. respiratory alkalosis UpToDate: ...respiratory tract changes during pregnancy result in a compensated respiratory alkalosis, with a higher PO2 and a lower PCO2 than in the nonpregnant state. The lower PCO2 is thought to provide a diffusion gradient that may facilitate the fetus' ability to eliminate waste from aerobic metabolism. non-pregnant range: PaCO2: 38 to 42 mm Hg pH: 7.38 to 7.42. SaO2: 94% to 100%; HCO3: 22 to 28 mEq/L