Question 1

What symptom,no matter what stage of pregnancy,should be reported immediately?

Accepted Answer

Vaginal bleeding is not a normal symptom of pregnancy and can indicate a potential miscarriage, ectopic pregnancy, or other serious complication. It should be reported to a healthcare provider immediately.

Question 2

A patient is admitted to the hospital with hyperemesis gravidarum.The patient is malnourished and severely dehydrated.The care plan should be altered to include which interventions?

Accepted Answer

IV fluids and electrolyte replacement are essential in the treatment of hyperemesis gravidarum as they help to restore fluid and electrolyte balance in the body. Hyperalimentation, hormone replacement therapy, and vitamin supplements may also be included in the care plan, but they are not typically the first line of treatment for hyperemesis gravidarum.

Question 3

A pregnant woman comes to the hospital 3 weeks before her estimated date of birth (EDB)complaining of severe pain and a rigid abdomen.What should the nurse immediately suspect as the cause of the pain?

Accepted Answer

The symptoms of severe pain and rigid abdomen are consistent with abruptio placentae, which is an obstetrical emergency that can lead to fetal distress or death if not addressed immediately. Placenta previa and ectopic pregnancy may also cause abdominal pain, but they typically present with different symptoms such as vaginal bleeding and shoulder pain respectively. Appendicitis is not related to pregnancy and would not be a likely cause of abdominal pain in a pregnant woman.

Question 4

Why is the fetus dependent on the mother for glucose control?

Accepted Answer

Insulin does not cross the placenta, so the fetus cannot produce its own insulin to regulate glucose levels. Instead, it relies on the mother's insulin to help control its glucose levels.

Question 5

What percent of first-trimester pregnancies spontaneously abort?

Accepted Answer

Approximately 10% to 15% of first-trimester pregnancies spontaneously abort.

Question 6

A patient is admitted to the hospital with signs of an ectopic pregnancy.What should the plan of care include for the patient?

Accepted Answer

The plan of care for a patient with an ectopic pregnancy includes surgery to remove the embryo/fetus, as ectopic pregnancies are not viable and can be life-threatening if left untreated. Options A, B, and D are not necessarily part of the plan of care for an ectopic pregnancy.

Question 7

The nurse is assessing a "kick count" for a patient with gestational hypertension.What result should be a cause for concern?

Accepted Answer

Less than three kicks per hour should be a cause for concern as this may indicate fetal distress and could require immediate medical attention. It is important for patients with gestational hypertension to monitor their baby's movements regularly and report any abnormalities to their healthcare provider.

Question 8

A 14-year-old pregnant adolescent arrives at the hospital in early labor.The nurse should recognize that the adolescent is at a greater risk for which problem?

Accepted Answer

Cephalopelvic disproportion is a greater risk for adolescent mothers as their pelvic bones may not have completed growth, leading to difficulty in vaginal delivery. Calcium deficit, bleeding tendency and low hemoglobin levels may also be concerns, but they are not specifically related to the adolescent population.

Question 9

A patient in her second trimester of pregnancy arrives at the hospital complaining of bright red,painless vaginal bleeding.What condition should the nurse immediately suspect?

Accepted Answer

Placenta previa is a condition where the placenta partially or completely covers the cervix, leading to painless vaginal bleeding. Abruptio placentae is a condition where the placenta detaches from the uterine lining, causing painful bleeding. Hemorrhage is a general term for excessive bleeding, which may be caused by a variety of factors. Placentitis is not a commonly recognized pregnancy complication.

Question 10

How should twins who share a placenta and come from one fertilized ovum be identified?

Accepted Answer

Twins who share a placenta and come from one fertilized ovum are monozygotic, meaning they come from a single zygote that split into two embryos during early development.

Question 11

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

Accepted Answer

Toxoplasmosis is commonly contracted through exposure to cat feces, so pregnant women should avoid emptying litter boxes bare-handed. Contact with infected individuals, having unprotected sex, and shellfish consumption are not primary modes of transmission for toxoplasmosis.

Question 12

A patient with hyperemesis gravidarum asks the nurse what would have happened if she had not come to the hospital.What result is the best response by the nurse?

Accepted Answer

Untreated hyperemesis gravidarum can lead to dehydration, electrolyte imbalances, and malnutrition, which can ultimately result in maternal or fetal death.

Question 13

A patient presents with symptoms of abruptio placentae.To facilitate uterine-placental perfusion,in what position would the nurse place the patient?

Accepted Answer

The modified side-lying position (also known as the lateral tilt position) is the best option to facilitate uterine-placental perfusion in a patient with abruptio placentae. This position helps to decrease pressure on the vena cava and aorta, allowing for better blood flow to the uterus and placenta. The other positions listed (prone, Trendelenburg's, supine) can all impair blood flow and should be avoided in this situation.

Question 14

A pregnant woman visits a clinic visit during her 21st week of pregnancy.The nurse identifies edema,hypertension,and proteinuria.What condition does the nurse suspect?

Accepted Answer

The presence of edema, hypertension, and proteinuria are all signs of gestational hypertension, also known as pregnancy-induced hypertension. This condition, if left untreated, can lead to serious complications for both the mother and baby. It is important for medical professionals to closely monitor and manage gestational hypertension throughout the remainder of the pregnancy.

Question 15

What should the nurse hope to identify by keeping a record of a patient's blood pressure during prenatal visits?

Accepted Answer

Keeping a record of a patient's blood pressure during prenatal visits can help identify the development of gestational hypertension, which is high blood pressure during pregnancy. This condition can be a sign of pre-eclampsia, a serious complication that can harm both the mother and the baby. It is important for the nurse to monitor blood pressure regularly to catch any potential problems early on.

Question 16

What condition is a possible cause of gestational hypertension?

Accepted Answer

Renal disease can affect blood pressure regulation and can be a possible cause of gestational hypertension. Too much salt and diabetes can contribute to high blood pressure, but they are not direct causes of gestational hypertension. A toxin is a vague term and cannot be identified as a specific cause.

Question 17

A patient with a history of rheumatic heart disease is being admitted to the labor and delivery unit.To prevent further stress on the heart,what should the nurse anticipate to be ordered?

Accepted Answer

Oxygen administration can help decrease the workload on the heart and prevent further stress, especially during labor and delivery when the body is under additional physical stress. Administering large amounts of IV fluids could worsen the patient's heart condition, positioning the patient on her back could also worsen the condition, and encouraging activity between contractions could increase the workload on the heart.

Question 18

A pregnant patient who has type 2 diabetes (NIDDM)may require insulin.Why is the insulin necessary?

Accepted Answer

Oral hypoglycemics are discontinued because of teratogenic effects.

Question 19

What complication of delivery should the nurse expect with the birth of multiple fetuses?

Accepted Answer

Multiple fetuses can cause excessive stretching of the uterus, resulting in a higher risk for loss of uterine tone following delivery. This can lead to postpartum hemorrhage and other complications. A vaginal delivery may be possible depending on the position of the fetuses, but there is a higher risk for difficulties with delivery, such as shoulder dystocia. Breast-feeding difficulties and an ectopic tendency are not directly related to multiple fetuses.

Question 20

What is a major complication of gestational diabetes that affects the infant?

Accepted Answer

Infants born to mothers with gestational diabetes may experience hypoglycemia after birth, as they have been exposed to high levels of glucose during pregnancy, which can stimulate their pancreas to produce more insulin. However, after birth, the baby's glucose supply decreases, but their insulin production remains high, leading to low blood glucose levels. This can cause seizures, developmental delays, and other complications if left untreated. Therefore, careful monitoring of the infant's blood glucose levels and, if necessary, prompt treatment is essential.

Quiz 29: Care of the High-Risk Mother, newborn, and Family With Special Needs