Deck 28: Care of the High-Risk Mother, Newborn, and Family with Special Needs

Question 1

A major concern for the diabetic patient who is pregnant is the effect her blood glucose control has on the fetus.The fetus is totally dependent on the mother for this control because insulin:

A) requirements are higher.
B) is destroyed by the placenta.
C) does not cross the placenta.
D) is absorbed by the fetus.

Answer 1

does not cross the placenta.

Question 2

During prenatal visits,the nurse keeps a record of a patient's blood pressure to identify:

A) ketoacidosis.
B) placenta previa.
C) gestational diabetes.
D) gestational hypertension.

Answer 2

gestational hypertension.

Question 3

When a patient is diagnosed with gestational diabetes,the nurse cautions that a major complication is that during the early pregnancy the fetus suffers from:

A) lack of nutrition.
B) dehydration.
C) hypoglycemia.
D) hyperglycemia.

Answer 3

hyperglycemia.

Question 4

A patient is admitted to the hospital with signs of an ectopic pregnancy.The nurse modifies the care plan to include:

A) long-term bed rest.
B) episodes of extreme hypertension.
C) surgery to remove the embryo/fetus.
D) risk for dehydration.

Question 5

A patient was admitted following a spontaneous abortion.When attempting to console the patient,the nurse tells her the percentage of first trimester pregnancies that abort is:

A) 5%.
B) 10%.
C) 15%.
D) 20%.

Question 6

A pregnant woman visits a clinic visit during her 21st week of pregnancy.The nurse identifies edema,hypertension,and proteinuria.The nurse recognizes these signs as indicative of a(n):

A) allergy.
B) protein deficiency.
C) circulatory problem.
D) gestational hypertension.

Question 7

A patient is admitted to the hospital with hyperemesis gravidarum.The patient is malnourished and severely dehydrated.The nurse alters the care plan to include interventions for:

A) hyperalimentation.
B) IV feedings and electrolyte replacement.
C) hormone replacement therapy.
D) vitamin supplements.

Question 8

When assessing the woman who is pregnant with multiple fetuses,the nurse recognizes that the delivery will probably be:

A) complicated by an ectopic tendency.
B) difficult due to the fetal lie.
C) a vaginal delivery.
D) complicated by loss of uterine tone.

Question 9

When discussing toxoplasmosis infection during pregnancy,the nurse should caution the patient to avoid:

A) contact with an infected person.
B) emptying cat litterboxes bare-handed.
C) having unprotected sex.
D) eating excessive amounts of shellfish.

Question 10

When assessing a newly admitted pregnant patient,the nurse identifies a history of rheumatic heart disease.To prevent further stress on the heart,the nurse anticipates a protocol of:

A) potassium.
B) calcium.
C) zinc.
D) iron.

Question 11

A pregnant woman comes to the hospital 3 weeks before her estimated date of birth (EDB)complaining of severe pain and a rigid abdomen.The nurse recognizes these as signs and symptoms of:

A) placenta previa.
B) appendicitis.
C) ectopic pregnancy.
D) abruptio placentae.

Question 12

During an antepartum visit,the nurse tells the mother that one sign that must be reported immediately,no matter what the stage of pregnancy,is:

A) backache.
B) urinary frequency.
C) vaginal bleeding.
D) uterine tightening.

Question 13

A patient with hyperemesis gravidarum asks the nurse what would have happened if she had not come to the hospital.The nurse explains that if untreated,this condition could result in:

A) a large for gestational age infant.
B) anorexia nervosa.
C) preterm delivery.
D) maternal or fetal death.

Question 14

The nurse is assessing a "kick count" for a patient with gestational hypertension.A serious cause for concern is a count of fewer than:

A) three.
B) five.
C) seven.
D) nine.

Question 15

A 14-year-old pregnant adolescent arrives at the hospital in early labor.The nurse recognizes that because the adolescent is still growing,she is at greater risk for:

A) calcium deficit.
B) cephalopelvic disproportion.
C) bleeding tendency.
D) low hemoglobin levels.

Question 16

A pregnant patient who has type 2 diabetes (NIDDM)may require insulin.When the patient asks the nurse why this is necessary,the nurse responds that:

A) the growing baby will require more glucose.
B) oral hypoglycemic agents may be teratogenic.
C) increased hormone levels raise blood glucose.
D) oral hypoglycemics do not reach the fetus.

Question 17

A patient presents with symptoms of abruptio placentae.To facilitate uterine-placental perfusion,the nurse positions the patient in:

A) prone position.
B) Trendelenburg position.
C) supine position.
D) side-lying position.

Question 18

A patient in her second trimester of pregnancy arrives at the hospital complaining of bright red,painless vaginal bleeding.Based on this information,the nurse suspects a(n):

A) abruptio placentae.
B) hemorrhage.
C) placenta previa.
D) placentitis.

Question 19

A patient who has been diagnosed with gestational hypertension asks the nurse what caused it.The nurse explains that there are many theories,but the cause is:

A) too much salt.
B) a toxin.
C) unknown.
D) diabetes.

Question 20

The nurse uses a picture to explain that twins who share a placenta,come from one fertilized ovum,and are identical are identified as:

A) dizygotic.
B) trizygotic
C) genetically different.
D) monozygotic.

Question 21

Following an abruptio placentae,the patient suddenly becomes dyspneic,complains of chest pain,and begins to ooze blood from her IV insertion site.The nurse assesses these as indicators of _____________ ______________ _________________.

Question 22

The nurse uses a chart to demonstrate the cognitive impairment,facial abnormalities,and growth retardation in the fetus that are characteristic of:

A) fetal dependency.
B) fetal immaturity.
C) malnutrition dependency.
D) fetal alcohol syndrome.

Question 23

A primigravida is Rh negative and her husband is Rh positive.She is concerned about the health of the fetus.The nurse explains that the only danger to the fetus is if it is Rh positive and the mother became sensitized during delivery.If this were the case,the mother would produce what in subsequent pregnancies?

A) Rh-negative blood cells
B) Rh-positive blood cells
C) Rh-negative antibodies
D) Rh-positive antibodies

Question 24

The nurse is assessing the newborn and discovers a yellowing of the skin.This jaundice appeared at birth and is considered:

A) within normal limits.
B) pathological.
C) a result of iron deficiency.
D) indicating possible hepatitis.

Question 25

When the gestational hypertensive patient is hospitalized,the nurse monitors the:

A) blood sugar.
B) temperature.
C) level of consciousness.
D) deep tendon reflexes.

Question 26

A patient who delivered her baby 4 weeks ago calls the home-health nurse because she is feeling very depressed.The nurse recognizes this call for help as a symptom of postpartum depression (PPD),and that one of the prominent features of this is:

A) failure to thrive.
B) rejection of the infant.
C) inability to care for the baby.
D) problems with the baby's father.

Question 27

The nurse closely monitors a baby born to a diabetic mother for the presence of:

A) hyperglycemia.
B) abnormal reflexes.
C) hypoglycemia.
D) brain damage.

Question 28

The nurse assures a patient who has become sensitized to the Rh antigen that she can be protected for future pregnancies by receiving injections of:

A) iron.
B) vitamin B₁₂.
C) RhoGAM.
D) type O blood.

Question 29

When teaching a class of primigravidas,the nurse explains that while the mother is pregnant,the physician may order a blood test to identify the maternal level of Rh antibodies.This test is called a(n):

A) indirect Coombs' test.
B) hemolytic test.
C) Rh antibody test.
D) direct Coombs' test.

Question 30

The nurse explains that severe preeclampsia needs to be controlled because it can develop into another syndrome called _________________.

Question 31

The neonate is born with weak muscle tone,the extremities are froglike,and the ears fold easily.From these observations,the nurse places the gestational age at:

A) full term.
B) small for gestational age.
C) preterm.
D) post-term.

Question 32

For the mother suffering from postpartum depression (PPD),gradual improvement occurs over a 6-month period.When this does not occur,the usual treatment is:

A) improved nutrition.
B) vitamin therapy.
C) pharmacological interventions.
D) support group therapy.

Question 33

The nurse who administers magnesium sulfate to a patient with eclampsia recognizes the risk of toxic levels.The nurse ensures the availability of the antidote for magnesium sulfate toxicity,which is:

A) vitamin K.
B) calcium gluconate.
C) potassium sulfate.
D) calcium carbonate.

Question 34

The nurse reports to the charge nurse that the 3-hour postpartum patient is bleeding excessively as she has saturated one peri-pad in less than ______ minutes.

Question 35

When an infant is delivered,it is important for the nurse to determine the gestational age of the baby within:

A) 5 to 10 minutes.
B) 1 to 2 hours.
C) 2 to 8 hours.
D) 12 to 24 hours.

Question 36

Respiratory distress syndrome is the greatest potential problem for the preterm infant,resulting from the immature respiratory system.The nurse explains this lack of oxygenation results because the lungs have not produced adequate:

A) mucus.
B) oxygen exchange.
C) surfactant.
D) carbon dioxide removal.

Question 37

The home health nurse cautions a pregnant patient who ingests alcohol or illicit drugs that she places herself at risk and endangers her fetus,because alcohol and drugs:

A) are all absorbed into the bloodstream.
B) affect the mother.
C) cross the placental barrier.
D) increase the heart rate.

Question 38

The nurse explains that the mortality and morbidity rate for preterm infants is higher than that of an older infant of comparable weight by:

A) 1 to 2 times.
B) 2 to 3 times.
C) 3 to 4 times.
D) 4 to 5 times.

Question 39

The nursery nurse is implementing phototherapy for the jaundiced infant.The nurse explains that the phototherapy:

A) is initiated when the bilirubin level reaches 5 mg/dL.
B) converts bilirubin to a water-soluble form to be excreted in the urine.
C) changes bilirubin to a bile salt to be excreted through the bowel.
D) requires eye patches to remain in place 24 hours a day.

Question 40

The newborn infant is determined to be preterm and has oxygenation problems and lack of subcutaneous fat.The nurse assesses the gestational age of the preterm infant as:

A) 0 to 37 complete weeks of pregnancy.
B) 38 to 41 complete weeks of pregnancy.
C) 14 to 36 complete weeks of pregnancy.
D) 42 or more complete weeks of pregnancy.

Question 41

The patient who has taken the ovulation stimulant clomiphene (Clomid),and who has been determined to be pregnant,calls the clinic nurse to report that she is bleeding and has passed a small grape-like object.From this information the nurse suspects a _________ ____________.

Question 42

A woman who is 14 weeks pregnant calls the clinic nurse to report that after a brief bleeding episode a week ago,her uterus seems to have gotten smaller,but her periods have not begun.The nurse assesses the indicators for a _____________ abortion.