Question 1

With regard to the association of maternal diabetes and other risk situations affecting mother and fetus,nurses should be aware that

Accepted Answer

Prompt treatment of DKA is necessary to save the fetus and the mother.Hydramnios occurs 10 times more often in diabetic pregnancies.Infections are more common and more serious in pregnant women with diabetes.Mild to moderate hypoglycemic episodes do not appear to have significant effects on fetal well-being.

Question 2

When the pregnant diabetic experiences hypoglycemia while hospitalized,the nurse should have the patient

Accepted Answer

A

Question 3

Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM).In planning her care,the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM.The nurse identifies that the fetus is at greatest risk for

Accepted Answer

The greatest risk for the fetus in GDM is macrosomia, which is a condition where the fetus is significantly larger than average. This can lead to difficulties during delivery and increases the risk of birth injuries. Congenital anomalies of the central nervous system, preterm birth, and low birth weight are all possible complications of GDM, but not the greatest risk to the fetus.

Question 4

In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy,the nurse recognizes that further teaching is warranted when the patient states

Accepted Answer

Insulin needs are reduced in the first trimester because of increased insulin production by the pancreas and increased peripheral sensitivity to insulin."Insulin dosage will likely need to be increased during the second and third trimesters," "Episodes of hypoglycemia are more likely to occur during the first 3 months," and "Insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding" are accurate statements and signify that the woman has understood the teachings regarding control of her diabetes during pregnancy.

Question 5

When teaching the pregnant woman with class II heart disease,the nurse should

Accepted Answer

Strenuous activity can put excess strain on the heart and may exacerbate symptoms in women with class II heart disease. The woman should be advised to avoid strenuous activity and engage in moderate exercise with her healthcare provider's guidance. Weight gain recommendations are based on pre-pregnancy BMI, and a high calcium diet is beneficial for fetal bone development but not specifically related to heart disease. Fluid intake should be adequate to prevent dehydration.

Question 6

With regard to anemia,nurses should be aware that

Accepted Answer

Anemia is the most common medical disorder during pregnancy, affecting approximately 50% of pregnant women.

Answer: B 
 Anemia can trigger reflex bradycardia due to decreased oxygen delivery to the heart.

Answer: C 
 The most common form of anemia is iron deficiency anemia, not folate deficiency.

Answer: D 
 Thalassemia is not a European version of sickle cell anemia, but rather a genetic blood disorder that is most commonly found in people of Mediterranean, Middle Eastern, and Southeast Asian descent.

Question 7

In caring for a pregnant woman with sickle cell anemia the nurse is aware that signs and symptoms of sickle cell crisis include

Accepted Answer

Signs and symptoms of sickle cell crisis often include fever and pain, particularly in the abdomen, bones, and joints. Anemia and urinary tract infections are possible complications of sickle cell anemia, but they are not necessarily indicative of a crisis. Endometritis specifically refers to inflammation of the lining of the uterus, and is not directly related to sickle cell crisis.

Question 8

Metabolic changes throughout pregnancy that affect glucose and insulin in the mother and the fetus are complicated but important to understand.Nurses should know that

Accepted Answer

During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus. This is due to increased insulin resistance and decreased insulin sensitivity in the mother, which leads to higher blood glucose levels. However, the fetus still requires insulin from the mother to regulate its own glucose levels. This can lead to maternal gestational diabetes if the body cannot produce enough insulin to satisfy both the mother's and the fetus's needs.

Question 9

For which of the infectious diseases can a woman be immunized?

Accepted Answer

A woman can be immunized against rubella (German measles) through the MMR (measles, mumps, rubella) vaccine. There is no vaccine currently available for Toxoplasmosis, Cytomegalovirus, or Herpesvirus type 2.

Question 10

Nursing intervention for the pregnant diabetic is based on the knowledge that the need for insulin

Accepted Answer

The need for insulin varies depending on the stage of gestation. In early pregnancy, insulin needs may decline due to increased insulin sensitivity, but as pregnancy progresses, insulin needs typically increase due to insulin resistance caused by placental hormones. Insulin needs may continue to increase during the postpartum period as well.

Question 11

Prophylaxis of subacute bacterial endocarditis (SBE)is given before and after birth when a pregnant woman has

Accepted Answer

Prophylaxis of subacute bacterial endocarditis (SBE) is recommended for individuals with certain cardiac conditions, such as valvular disease, which puts them at an increased risk for developing SBE. It is not recommended for congestive heart disease, arrhythmias, or postmyocardial infarction.

Question 12

What form of heart disease in women of childbearing years usually has a benign effect on pregnancy?

Accepted Answer

Mitral valve prolapse is the form of heart disease in women of childbearing years that usually has a benign effect on pregnancy. This condition rarely affects the ability to carry a pregnancy to term or to have a normal vaginal delivery. However, it is important for women with mitral valve prolapse to be monitored closely during pregnancy to ensure that their heart function remains stable.

Question 13

Glucose metabolism is profoundly affected during pregnancy because:

Accepted Answer

Placental hormones, such as human placental lactogen, progesterone, and estrogen, are known to be antagonistic to insulin. This results in decreased insulin sensitivity and insulin resistance in pregnant women, leading to increased glucose levels in the blood. This is a normal adaptation to ensure adequate glucose supply to the growing fetus.

Question 14

While providing care in an obstetric setting,the nurse should understand that postpartum care of the woman with cardiac disease

Accepted Answer

Postpartum care of a woman with cardiac disease includes rest, stool softeners to prevent straining during bowel movements, and monitoring the effect of activity. Ambulation should be gradual and increasing, not frequent and alternating with active range of motion. Visits between the mother and infant should not be restricted unless medically necessary. Therefore, option B is the correct answer.

Question 15

To manage her diabetes appropriately and ensure a good fetal outcome,the pregnant woman with diabetes will need to alter her diet by

Accepted Answer

Having a fixed meal schedule will provide the woman and the fetus with a steadier blood sugar level,provide better balance with insulin administration,and help prevent complications.It is more important to have a fixed meal schedule than equal division of food intake.Approximately 45% of the food eaten should be in the form of carbohydrates.

Question 16

Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?

Accepted Answer

Infants of diabetic mothers are at risk of hypoglycemia due to high insulin levels during fetal development. After birth, they may continue to produce high levels of insulin, leading to low blood sugar levels. This is carefully monitored and managed to prevent potential neurological damage.

Question 17

Which factor is known to increase the risk of gestational diabetes mellitus?

Accepted Answer

Previous birth of a large infant suggests gestational diabetes mellitus.Obesity (BMI of 30 or greater)creates a higher risk for gestational diabetes.A woman younger than 25 years generally is not at risk for gestational diabetes mellitus.The person with type 2 diabetes mellitus already has diabetes and will continue to have it after pregnancy.Insulin may be required during pregnancy because oral hypoglycemia drugs are contraindicated during pregnancy.

Question 18

In terms of the incidence and classification of diabetes,maternity nurses should know that

Accepted Answer

Type 2 diabetes often goes undiagnosed, which means that many women may not be aware that they have the condition until they become pregnant. Type 1 diabetes is less common than type 2, and gestational diabetes is a type of diabetes that occurs during pregnancy and typically goes away after delivery. Diabetes does not change from type 1 to type 2 during pregnancy.

Question 19

Preconception counseling is critical to the outcome of diabetic pregnancies because poor glycemic control before and during early pregnancy is associated with

Accepted Answer

Poor glycemic control before and during early pregnancy is associated with congenital anomalies in the fetus. Therefore, preconception counseling is critical to the outcome of diabetic pregnancies.

Question 20

When caring for a pregnant woman with suspected cardiomyopathy,the nurse must be alert for signs and symptoms of cardiac decompensation,which include

Accepted Answer

Dyspnea, crackles, and an irregular, weak pulse are all signs of cardiac decompensation in a pregnant woman with suspected cardiomyopathy. A regular heart rate and hypertension (A) may not necessarily indicate decompensation, and an increased urinary output, tachycardia, and dry cough (B) are not specific signs of cardiac decompensation. Shortness of breath, bradycardia, and hypertension (C) may be contradictory as bradycardia is a slowing of the heart rate, which is opposite to tachycardia.

Quiz 26: Concurrent Disorders During Pregnancy