Question 1

The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse's teaching was successful?

Accepted Answer

Pregnancy can affect insulin production and sensitivity due to hormonal changes, necessitating adjustments in diet (and often insulin dosage) for women with type 1 diabetes to manage their blood glucose levels effectively.

Question 2

A nurse is developing a program for pregnant women with diabetes about reducing complications. Which factor would the nurse identify as being most important in helping to reduce the maternal/fetal/neonatal complications associated with pregnancy and diabetes?

Accepted Answer

The degree of glycemic control achieved during pregnancy is crucial in reducing maternal/fetal/neonatal complications associated with pregnancy and diabetes. Good glycemic control helps prevent or minimize complications such as congenital anomalies, preeclampsia, and macrosomia.

Question 3

Because a pregnant client's diabetes has been poorly controlled throughout her pregnancy, the nurse would be alert for which of the following in the neonate at birth?

Accepted Answer

Poorly controlled diabetes in a pregnant client often leads to macrosomia, which is a condition where the baby is significantly larger than average, due to the excess glucose from the mother being transferred to the baby, leading to increased insulin and growth.

Question 4

A woman with diabetes is considering becoming pregnant. She asks the nurse whether she will be able to take oral hypoglycemics when she is pregnant. The nurse's response is based on the understanding that oral hypoglycemics:

Accepted Answer

The answer of A woman with diabetes is considering becoming...

Question 5

A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1C. level of 13%. At this time the nurse should be most concerned about which of the following possible fetal outcomes?

Accepted Answer

Congenital anomalies are more likely in infants of mothers with poorly controlled diabetes, especially with high HbA1C levels early in pregnancy.

Question 6

After teaching a group of students about the use of antiretroviral agents in pregnant women who are HIV-positive, the instructor determines that the teaching was successful when the group identifies which of the following as the underlying rationale?

Accepted Answer

The primary rationale for using antiretroviral agents in pregnant women who are HIV-positive is to reduce viral loads in the blood. This helps to decrease the risk of mother-to-child transmission of the virus during pregnancy, childbirth, and breastfeeding.

Question 7

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

Accepted Answer

Cocaine use during pregnancy can lead to tachycardia, hypertension, and vasoconstriction due to its stimulant effects on the body.

Question 8

When teaching a class of pregnant women about the effects of substance abuse during pregnancy, which of the following would the nurse most likely include?

Accepted Answer

Substance abuse during pregnancy is associated with several adverse outcomes, including low-birth-weight infants. This is due to the harmful effects of substances on fetal development and placental function.

Question 9

A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which of the following statements by the nurse would be most appropriate?

Accepted Answer

Antiretroviral medications are an effective way to reduce the risk of mother-to-child transmission of HIV during pregnancy, labor, and delivery. These medications can significantly lower the viral load in the mother's blood, thereby reducing the risk of the virus being passed on to the baby.

Question 10

When assessing a pregnant woman with heart disease throughout the antepartal period, the nurse would be especially alert for signs and symptoms of cardiac decompensation at which time?

Accepted Answer

During 28 to 32 weeks' gestation, the blood volume and cardiac output reach their peak, increasing the workload on the heart, which can lead to cardiac decompensation in women with heart disease.

Question 11

When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which of the following would be most appropriate?

Accepted Answer

Pregnant women with chronic hypertension require more frequent monitoring as the pregnancy progresses to manage potential complications. Starting with bi-monthly visits and then increasing to weekly visits after 28 weeks allows for closer monitoring during the critical later stages of pregnancy when the risk of complications such as preeclampsia is higher.

Question 12

Which medication would the nurse question if ordered to control a pregnant woman's asthma?

Accepted Answer

Oral prednisone is generally considered a last resort for controlling asthma in pregnant women due to potential side effects and risks to the fetus. Inhaled medications like budesonide, albuterol, and salmeterol are preferred for their localized effect and lower systemic absorption.

Question 13

After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicates successful teaching?

Accepted Answer

Iron supplements can cause constipation, so eating foods high in fiber can help alleviate this side effect.

Question 14

A nurse is providing care to several pregnant women at the clinic. The nurse would screen for group B streptococcus infection in a client at:

Accepted Answer

Group B streptococcus (GBS) screening is recommended for pregnant women between 35 and 37 weeks of gestation. This timing allows for accurate identification of GBS colonization near the time of delivery, so appropriate antibiotic prophylaxis can be administered to prevent neonatal infection. Therefore, 36 weeks' gestation is the correct time for screening.

Question 15

The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion?

Accepted Answer

A thin upper lip is a characteristic feature of fetal alcohol syndrome, which can occur in newborns exposed to alcohol in utero.

Question 16

After teaching a group of nursing students about the impact of pregnancy on the older woman, the instructor determines that the teaching was successful when the students state which of the following?

Accepted Answer

Women over the age of 35 have an increased risk for spontaneous abortions, among other complications, due to various factors including chromosomal abnormalities and decreased fertility. This is a recognized concern in obstetrics.

Question 17

A group of students are reviewing information about sexually transmitted infections and their effect on pregnancy. The students demonstrate understanding of the information when they identify which infection as being responsible for ophthalmia neonatorum?

Accepted Answer

Gonorrhea is responsible for ophthalmia neonatorum, a severe conjunctivitis that occurs in newborns after exposure to the bacteria during delivery.

Question 18

A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world?

Accepted Answer

Cytomegalovirus (CMV) is recognized as the most common congenital and perinatal viral infection worldwide, affecting a significant number of pregnancies with potential for causing serious fetal and neonatal health issues.

Question 19

A pregnant woman asks the nurse, "I'm a big coffee drinker. Will the caffeine in my coffee hurt my baby?" Which response by the nurse would be most appropriate?

Accepted Answer

Current research suggests that moderate caffeine consumption, defined as less than 300 mg per day, is not associated with significant adverse outcomes in pregnancy, such as birth defects or growth restriction. This recommendation allows for some caffeine intake without completely avoiding it, which is a more balanced and evidence-based approach compared to the other options.

Question 20

A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which of the following would the nurse assess? (Select all that apply.)

Accepted Answer

The answer of A neonate born to a mother who...

Quiz 20: Nursing Management of the Pregnancy at Risk