Deck 25: Pregnancy-Related Complications

Question 1

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

Answer 1

Incomplete abortion at 10 weeks

Question 2

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.

Answer 2

Assess fetal heart rate (FHR) and maternal vital signs.

Question 3

Spontaneous termination of a pregnancy is considered to be an abortion ifg.

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

Answer 3

The pregnancy is less than 20 weeks.

Question 4

A primigravida is being monitored in her prenatal clinic for preeclampsia.What finding should concern her nurse?

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 5

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 6

What condition indicates concealed hemorrhage in an abruptio placentae?

A) Decrease in abdominal pain
B) Bradycardia
C) Hard, boardlike abdomen
D) Decrease in fundal height

Question 7

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 8

The labor of a pregnant woman with preeclampsia is going to be induced.Before initiating the Pitocin infusion,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.The nurse notifies the physician,because the lab results are indicative of

A) Eclampsia
B) Disseminated intravascular coagulation
C) HELLP syndrome
D) Rh incompatibility

Question 9

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 10

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 11

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

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

Question 12

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 13

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 convulsion
C) Effects of magnesium sulfate
D) Gastrointestinal upset

Question 14

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 15

Which maternal condition always necessitates delivery by cesarean section?

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

Question 16

Which assessment finding should convince the nurse to "hold" the next dose of magnesium sulfate?

A) Absence of deep tendon reflexes
B) Urinary output of 100 mL total for the previous 2 hours
C) Respiratory rate of 14 breaths/min
D) Decrease in blood pressure from 160/100 to 140/85

Question 17

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

A) Bed rest
B) Ritodrine IV
C) NPO
D) Narcotic analgesia every 3 hours, prn

Question 18

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 19

A pregnant woman is being discharged from the hospital after placement of a cerclage because of a history of recurrent pregnancy loss secondary to an incompetent cervix.Discharge teaching should emphasize that

A) Any vaginal discharge should be reported immediately to her care provider.
B) The presence of any contractions, rupture of membranes, or severe perineal pressure should be reported.
C) She will need to make arrangements for care at home, because her activity level will be restricted.
D) She will be scheduled for a cesarean birth.

Question 20

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

A) Total
B) Partial
C) Complete
D) Marginal

Question 21

A woman with preeclampsia has a seizure.The nurse's primary duty during the seizure is to

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 22

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 23

The antidote administered to reverse magnesium toxicity is ______________.

Question 24

Throughout the world the rate of ectopic pregnancy has increased dramatically over the past 20 years.This is believed to be due primarily to scarring of the fallopian tubes as a result of pelvic infection,inflammation,or surgery.The nurse who suspects that a patient has early signs of ectopic pregnancy should be observing her for symptoms such as (select all that apply)

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

Question 25

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 26

A patient who has undergone a D&C for early pregnancy loss is likely to be discharged the same day.The nurse must ensure that vital signs are stable,that bleeding has been controlled,and that the woman has adequately recovered from the administration of anesthesia.In order to promote an optimal recovery,discharge teaching should include (select all that apply)

A) Iron supplementation
B) Resumption of intercourse at 6 weeks post-procedure
C) Referral to a support group if necessary
D) Expectation of heavy bleeding for at least 2 weeks
E) Emphasizing the need for rest

Question 27

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 28

Approximately 12% to 26% of all clinically recognized pregnancies end in miscarriage.Which is the most common cause of spontaneous abortion?

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

Question 29

The condition in which the placenta is implanted in the lower uterine segment near or over the internal cervical os is _____________.

Question 30

Recurrent spontaneous abortion refers to a condition in which a woman experiences three or more consecutive abortions or miscarriages.This is also known as ________ abortion.

Question 31

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

Question 32

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 33

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 34

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

A) Bleeding time of 10 minutes
B) Presence of fibrin split products
C) Thrombocytopenia
D) Hyperfibrinogenemia

Question 35

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