Obstetric Emergencies, Post abortion care | Mock Test | Staff Nurse | Guides Academy
Time: 15:00
A nurse assesses a patient one hour postpartum and finds a soft, boggy uterus and a perineal pad saturated with blood. What is the nurse's priority action?
[a] Check the patient's blood pressure.
[b] Administer a bolus of IV fluids.
[c] Firmly massage the uterine fundus.
[d] Document the findings in the patient's chart.
Which of the following is the most common immediate complication following an abortion procedure?
[a] Infection.
[b] Haemorrhage.
[c] Uterine perforation.
[d] Infertility.
During delivery, the fetal head emerges but then retracts against the perineum (the "turtle sign"). The nurse recognizes this as a sign of which obstetric emergency?
[a] Umbilical cord prolapse.
[b] Uterine rupture.
[c] Amniotic fluid embolism.
[d] Shoulder dystocia.
Upon rupture of membranes, the nurse sees a loop of the umbilical cord protruding from the vagina. What is the immediate, life-saving nursing intervention?
[a] Attempt to push the cord back into the uterus.
[b] Place the patient in a high-Fowler's position.
[c] Manually lift the presenting fetal part off the cord.
[d] Administer oxytocin to speed up the delivery.
Which instruction is essential for a nurse to include in the discharge teaching for a patient after an abortion?
[a] "You can expect your next menstrual period to be lighter than usual."
[b] "Call the clinic immediately if you have a fever or foul-smelling discharge."
[c] "It is safe to use tampons for the bleeding."
[d] "Avoid all physical activity for at least two weeks."
A pregnant patient with severe preeclampsia begins to have a tonic-clonic seizure. The nurse's immediate priority is to:
[a] Administer magnesium sulfate.
[b] Insert a padded tongue blade.
[c] Ensure patient safety and maintain a patent airway.
[d] Check the fetal heart rate.
A patient attempting a vaginal birth after caesarean (VBAC) suddenly complains of a sharp, tearing pain in her abdomen and the fetal heart rate plummets. The nurse should have a high index of suspicion for:
[a] Placenta previa.
[b] Uterine rupture.
[c] Shoulder dystocia.
[d] A retained placenta.
A key component of post-abortion care is providing family planning counseling. The nurse should inform the patient that:
[a] She will not be fertile for at least three months.
[b] An IUD cannot be inserted immediately after the procedure.
[c] She should wait for her first period before starting hormonal contraceptives.
[d] Ovulation can occur very soon after an abortion, so contraception is needed immediately.
A patient is experiencing a postpartum haemorrhage. The physician orders methylergonovine (Methergine). The nurse must first check the patient's:
[a] Respiratory rate.
[b] Temperature.
[c] Blood pressure.
[d] Blood glucose level.
A woman presents to the clinic several days after a spontaneous abortion with continued heavy bleeding and cramping. An ultrasound suggests an incomplete abortion. The nurse anticipates preparing the patient for which procedure?
[a] Administration of antibiotics.
[b] A blood transfusion.
[c] A dilatation and curettage (D&C) or vacuum aspiration.
[d] Administration of oxytocin.
During labour, a patient suddenly becomes acutely short of breath, cyanotic, and hypotensive. This rapid decompensation is characteristic of:
[a] Uterine rupture.
[b] Eclampsia.
[c] Amniotic fluid embolism.
[d] Postpartum haemorrhage.
The McRoberts maneuver is a first-line intervention for shoulder dystocia. It involves:
[a] Applying firm pressure to the uterine fundus.
[b] Placing the mother in a hands-and-knees position.
[c] Sharply flexing the mother's thighs up against her abdomen.
[d] Performing a rotational maneuver on the fetal shoulder.
An Rh-negative woman has a surgical abortion. It is essential for the nurse to administer:
[a] A dose of oxytocin.
[b] Intravenous antibiotics.
[c] Rho(D) immune globulin (RhoGAM).
[d] A tetanus toxoid vaccine.
A patient is experiencing a severe postpartum haemorrhage unresponsive to medication and massage. The nurse might anticipate the use of which device to apply direct pressure to the uterine wall?
[a] A Foley catheter.
[b] An internal fetal monitor.
[c] A Bakri balloon.
[d] A vacuum extractor.
The primary goal of post-abortion care (PAC) is to:
[a] Punish women who have had unsafe abortions.
[b] Ensure all women choose a long-acting contraceptive method.
[c] Treat complications, provide contraceptive counseling, and link to other reproductive health services.
[d] Focus solely on the physical treatment of complications.
A patient with a prolapsed umbilical cord is placed in the knee-chest position to:
[a] Increase her blood pressure.
[b] Make her more comfortable.
[c] Speed up uterine contractions.
[d] Use gravity to shift the fetus off the cord.
Which medication for PPH is a prostaglandin analogue that can be administered rectally and is contraindicated in patients with asthma?
[a] Oxytocin.
[b] Methylergonovine.
[c] Carboprost (Hemabate).
[d] Misoprostol.
A patient develops a fever, chills, uterine tenderness, and foul-smelling vaginal discharge two days after an unsafe abortion. The nurse suspects:
[a] An incomplete abortion.
[b] Normal post-abortion symptoms.
[c] Septic abortion.
[d] A urinary tract infection.
During a shoulder dystocia emergency, which action is strongly contraindicated?
[a] Applying suprapubic pressure.
[b] Performing the McRoberts maneuver.
[c] Applying fundal pressure.
[d] Documenting the time of events.
A key nursing responsibility in managing any obstetric emergency is:
[a] Making sure the family is kept out of the room.
[b] Completing the incident report immediately.
[c] Communicating clearly with the team and documenting events accurately.
[d] Assigning blame for the cause of the emergency.
Uterine inversion is a rare but life-threatening emergency. A key sign that would alert the nurse is:
[a] A firm, midline uterine fundus.
[b] A gradual trickle of bright red blood.
[c] The absence of a palpable fundus in the abdomen and signs of shock.
[d] A sudden increase in the mother's blood pressure.
A crucial component of post-abortion care is providing emotional support. The nurse's best approach is to:
[a] Avoid discussing the patient's feelings about the abortion.
[b] Tell the patient she should not feel sad.
[c] Share personal stories to try and relate to the patient.
[d] Offer non-judgmental listening and provide resources for counseling if needed.
The definition of primary (early) postpartum haemorrhage is a blood loss of more than 500 mL (vaginal birth) or 1000 mL (caesarean) occurring within:
[a] The first hour after delivery.
[b] The first 24 hours after delivery.
[c] The first 48 hours after delivery.
[d] The first week after delivery.
A major secondary complication of an amniotic fluid embolism that the nurse should anticipate is:
[a] Postpartum psychosis.
[b] Uterine atony.
[c] Disseminated Intravascular Coagulation (DIC).
[d] Preeclampsia.
Following a medical abortion, the nurse should instruct the patient that:
[a] She should experience no bleeding or cramping.
[b] Heavy bleeding and cramping are expected, and a follow-up is essential to confirm completion.
[c] She can resume normal activities immediately without any restrictions.
[d] She does not need to consider contraception for several months.
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