Deck 25: Pregnancy-Related Complications

Question 1

What order should the nurse expect for a patient admitted with a threatened abortion?

A) Abstinence from sexual activity
B) Pitocin IV
C) NPO
D) Narcotic analgesia every 3 hours, prn

Answer 1

Abstinence from sexual activity

Question 2

A pregnant woman has been diagnosed with gestational hypertension and is crying.She asks the nurse if this means she has to take blood pressure medicine for the rest of her life.What answer by the nurse is best?

A) "Yes, you will have hypertension for the rest of your life."
B) "No, this always goes away after you deliver."
C) "Maybe, we have to wait and see at your 6-week postpartum checkup."
D) "I don't know. But if you need medicine you should take it."

Answer 2

"Maybe, we have to wait and see at your 6-week postpartum checkup."

Question 3

The student nurse is assessing a woman with abruptio placentae.The student reports to the registered nurse "I can't really palpate her abdomen,it's as hard as a board." What action by the nurse is the priority?

A) Tell the student to document the findings.
B) Have the student teach the woman relaxation techniques.
C) Assess the woman's fundal height and vital signs.
D) Administer a dose of opioid pain medication.

Answer 3

Assess the woman's fundal height and vital signs.

Question 4

The nurse is explaining how to assess edema to the nursing students working on the antepartum unit.Which score indicates edema of lower extremities,face,hands,and sacral area?

A) +1 edema
B) +2 edema
C) +3 edema
D) +4 edema

Question 5

Which clinical sign is not included in the symptoms of preeclampsia?

A) Hypertension
B) Edema
C) Proteinuria
D) Glycosuria

Question 6

A placenta previa in which the placental edge just reaches the internal os is called

A) total.
B) partial.
C) complete.
D) marginal.

Question 7

A nurse is assessing a woman receiving magnesium sulfate.The nurse assesses her deep tendon reflexes at 0 and 1+.What action by the nurse is best?

A) Hold the magnesium sulfate.
B) Ask the provider to order a 24-hour UA.
C) Assess the woman's temperature.
D) Take the woman's blood pressure.

Question 8

The labor of a pregnant woman with preeclampsia is going to be induced.The nurse reviews the woman's latest laboratory test findings,which reveal a low platelet count,an elevated aspartate transaminase (AST)level,and a falling hematocrit.What action by the nurse is most important?

A) Palpate the woman's abdomen for tenderness.
B) Document findings and begin the Pitocin infusion.
C) Instruct the woman to ask for help getting out of bed.
D) Assess the woman's drinking history.

Question 9

A patient with pregnancy-induced hypertension is admitted complaining of pounding headache,visual changes,and epigastric pain.Nursing care is based on the knowledge that these signs indicate

A) Anxiety due to hospitalization
B) Worsening disease and impending seizure
C) Effects of magnesium sulfate
D) Gastrointestinal upset

Question 10

The nursing student learns that spontaneous termination of a pregnancy is considered to be an abortion if

A) the pregnancy is less than 20 weeks.
B) the fetus weighs less than 1000 g.
C) the products of conception are passed intact.
D) no evidence exists of intrauterine infection.

Question 11

An abortion in which the fetus dies but is retained in the uterus is called ________ abortion.

A) inevitable
B) missed
C) incomplete
D) threatened

Question 12

The perinatal nurse is giving discharge instructions to a woman,status post suction and curettage secondary to a hydatidiform mole.The woman asks why she must take oral contraceptives for the next 12 months.The best response from the nurse is

A) "If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore, if you desire a future pregnancy, it would be better for you to use the most reliable method of contraception available."
B) "The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer more difficult."
C) "If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnancy is rare. Therefore, to improve your chance of a successful pregnancy, it is better not to get pregnant at this time."
D) "Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar pregnancy."

Question 13

A woman with severe preeclampsia is being treated with bed rest and intravenous magnesium sulfate.The drug classification of this medication is

A) tocolytic.
B) anticonvulsant.
C) antihypertensive.
D) diuretic.

Question 14

What is the only known cure for preeclampsia?

A) Magnesium sulfate
B) Antihypertensive medications
C) Delivery of the fetus
D) Administration of acetylsalicylic acid (ASA) every day of the pregnancy

Question 15

The prenatal clinic nurse monitored women for preeclampsia.If all four women were in the clinic at the same time,which one should the nurse see first?

A) Blood pressure increase to 138/86 mm Hg
B) Weight gain of 0.5 kg during the past 2 weeks
C) A dipstick value of 3+ for protein in her urine
D) Pitting pedal edema at the end of the day

Question 16

What data on a patient's health history places her at risk for an ectopic pregnancy?

A) Use of oral contraceptives for 5 years
B) Recurrent pelvic infections
C) Ovarian cyst 2 years ago
D) Heavy menstrual flow of 4 days' duration

Question 17

Which maternal condition always necessitates delivery by cesarean section?

A) Partial abruptio placentae
B) Total placenta previa
C) Ectopic pregnancy
D) Eclampsia

Question 18

In which situation is a dilation and curettage (D&C)indicated?

A) Complete abortion at 8 weeks
B) Incomplete abortion at 16 weeks
C) Threatened abortion at 6 weeks
D) Incomplete abortion at 10 weeks

Question 19

Rh incompatibility can occur if the woman is Rh negative and her

A) fetus is Rh positive.
B) husband is Rh positive.
C) fetus is Rh negative.
D) husband and fetus are both Rh negative.

Question 20

The priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to

A) assess fetal heart rate (FHR) and maternal vital signs.
B) perform a venipuncture for hemoglobin and hematocrit levels.
C) place clean disposable pads to collect any drainage.
D) monitor uterine contractions.

Question 21

A woman who is 8 months pregnant is brought to the emergency department after a serious motor vehicle crash.Although she has no apparent injuries,she is admitted to the hospital.Her partner is upset and wants to know why she just can't come home.What response by the nurse is best?

A) "This is standard procedure for all pregnant crash victims."
B) "She needs to be monitored for some potential complications."
C) "We may have to deliver the baby at any time now."
D) "We are giving her medicine to keep her from laboring."

Question 22

A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy.Nursing care is based on the knowledge that

A) bed rest and analgesics are the recommended treatment.
B) she will be unable to conceive in the future.
C) a D&C will be performed to remove the products of conception.
D) hemorrhage is the major concern.

Question 23

A woman has several relatives who had gestational hypertension and wants to decrease her risk for it.What information does the nurse provide this woman? (Select all that apply.)

A) There is no way to reduce risk factors for gestational hypertension.
B) Losing weight before you get pregnant will help prevent it.
C) Eating a diet high in protein and iron may help prevent it.
D) The father contributes no risk factors for hypertension in pregnancy
E) Waiting until you are 35 to get pregnant cuts the risk in half.

Question 24

A woman with preeclampsia has a seizure.What action by the nurse takes priority?

A) Insert an oral airway.
B) Suction the mouth to prevent aspiration.
C) Administer oxygen by mask.
D) Stay with the patient and call for help.

Question 25

What routine nursing assessment is contraindicated in the patient admitted with suspected placenta previa?

A) Monitoring FHR and maternal vital signs
B) Observing vaginal bleeding or leakage of amniotic fluid
C) Determining frequency, duration, and intensity of contractions
D) Determining cervical dilation and effacement

Question 26

The nurse learns that which is the most common cause of spontaneous abortion?

A) Chromosomal abnormalities
B) Infections
C) Endocrine imbalance
D) Immunologic factors

Question 27

What assessment findings indicate to the nurses that a woman's preeclampsia should now be considered severe? (Select all that apply.)

A) Urine output 40 mL/hour for the past 2 hours
B) Serum creatinine 3.1 mg/dL
C) Seeing "sparkly" things in the visual field
D) Crackles in both lungs
E) Soft, non-tender abdomen

Question 28

Which laboratory marker is indicative of disseminated intravascular coagulation (DIC)?

A) Positive KB test
B) Presence of fibrin split products
C) Thrombocytopenia
D) Positive drug screen

Question 29

The nurse caring for a woman hospitalized for hyperemesis gravidarum should expect that initial treatment involves

A) corticosteroids to reduce inflammation.
B) IV therapy to correct fluid and electrolyte imbalances.
C) an antiemetic, such as pyridoxine, to control nausea and vomiting.
D) enteral nutrition to correct nutritional deficits.

Question 30

A woman is in the emergency department with severe abdominal pain.When her pregnancy test comes back positive,she yells "I can't be pregnant! I had a tubal ligation two months ago!" What action by the nurse is the priority?

A) Provide emotional support to the woman.
B) Facilitate an ultrasound examination.
C) Call the lab to have them repeat the test.
D) Administer an opioid pain medication.

Question 31

What finding on a prenatal visit at 10 weeks might suggest a hydatidiform mole?

A) Complaint of frequent mild nausea
B) Blood pressure of 120/80 mm Hg
C) Fundal height measurement of 18 cm
D) History of bright red spotting for 1 day, weeks ago

Question 32

The nurse who suspects that a patient has early signs of ectopic pregnancy should be observing her for which symptoms? (Select all that apply.)

A) Pelvic pain
B) Abdominal pain
C) Unanticipated heavy bleeding
D) Vaginal spotting or light bleeding
E) Missed period

Question 33

A woman taking magnesium sulfate has respiratory rate of 10 breaths/min.In addition to discontinuing the medication,the nurse should

A) vigorously stimulate the woman.
B) instruct her to take deep breaths.
C) administer calcium gluconate.
D) increase her IV fluids.

Question 34

The primary symptom present in abruptio placentae that distinguishes it from placenta previa is

A) vaginal bleeding.
B) rupture of membranes.
C) presence of abdominal pain.
D) changes in maternal vital signs.

Question 35

Methotrexate is recommended as part of the treatment plan for which obstetric complication?

A) Complete hydatidiform mole
B) Missed abortion
C) Unruptured ectopic pregnancy
D) Abruptio placentae