Deck 4: Gestational Trophoblastic Disease Molar Pregnancy and Advanced Maternal Age

Question 1

After teaching a woman who has had an evacuation for a hydatidiform mole (molarpregnancy. about her condition, which of the following statements indicates that the nurses teaching was successful?

A) I will be sure to avoid getting pregnant for at least 1 year.
B) My intake of iron will have to be closely monitored for 6 months.
C) My blood pressure will continue to be increased for about 6 more months.
D) I wont use my birth control pills for at least a year or two.

Answer 1

I will be sure to avoid getting pregnant for at least 1 year.

Question 2

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication?

A) Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendons reflexes 2+
D) Difficulty in arousing

Answer 2

Deep tendons reflexes 2+

Question 3

Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which of the following responses by the nurse would be most appropriate?

A) Why are you crying?
B) Will a pill help your pain?
C) Im sorry you lost your baby.
D) A baby still wasnt formed in your uterus.

Answer 3

Im sorry you lost your baby.

Question 4

In a woman who is suspected of having a ruptured ectopic pregnancy, the nurse would expect to assess for which of the following as a priority?

A) Hemorrhage
B) Jaundice
C) Edema
D) Infection

Question 5

Which of the following findings would the nurse interpret as suggesting a diagnosis of gestational trophoblastic disease?

A) Elevated hCG levels, enlarged abdomen, quickening
B) Vaginal bleeding, absence of FHR, decreased hPL levels
C) Visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen
D) Gestational hypertension, hyperemesis gravidarum, absence of FHR

Question 6

It is determined that a clients blood Rh is negative and her partners is positive. To help prevent Rh isoimmunization, the nurse anticipates that the client will receive RhoGAM at which time

A) At 34 weeks gestation and immediately before discharge
B) 24 hours before delivery and 24 hours after delivery
C) In the first trimester and within 2 hours of delivery
D) At 28 weeks gestation and again within 72 hours after delivery

Question 7

The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes interventions focusing on which of the following because of the womans increased risk?

A) Oligohydramnios
B) Preeclampsia
C) Post-term labor
D) Chorioamnionitis

Question 8

A woman hospitalized with severe preeclampsia is being treated with hydralazine tocontrol blood pressure. Which of the following would the lead the nurse to suspectthat the client is having an adverse effect associated with this drug?

A) Gastrointestinal bleeding
B) Blurred vision
C) Tachycardia
D) Sweating

Question 9

After reviewing a clients history, which factor would the nurse identify as placing her at risk for gestational hypertension?

A) Mother had gestational hypertension during pregnancy.
B) Client has a twin sister.
C) Sister-in-law had gestational hypertension.
D) This is the clients second pregnancy

Question 10

A client with hyperemesis gravidarum is admitted to the facility after being cared for athome without success. Which of the following would the nurse expect to include in the clients plan of care?

A) Clear liquid diet
B) Total parenteral nutrition
C) Nothing by mouth
D) Administration of labetalol

Question 11

The nurse is reviewing the laboratory test results of a pregnant client. Which one of the following findings would alert the nurse to the development of HELLP syndrome?

A) Hyperglycemia
B) Elevated platelet count
C) Leukocytosis
D) Elevated liver enzymes

Question 12

Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia?

A) Calcium gluconate
B) Potassium chloride
C) Ferrous sulfate
D) Calcium carbonate

Question 13

Which assessment finding would lead the nurse to suspect infection as the cause of aclients PROM?

A) Yellow-green fluid
B) Blue color on Nitrazine testing
C) Ferning
D) Foul odor

Question 14

While assessing a pregnant woman, the nurse suspects that the client may be at risk forhydramnios based on which of the following? (Select all that apply.)

A) History of diabetes
B) Complaints of shortness of breath
C) Identifiable fetal parts on abdominal palpation
D) Difficulty obtaining fetal heart rate
E) Fundal height below that for expected gestataional age

Question 15

After teaching a group of nursing students about the possible causes of spontaneous abortion, the instructor determines that the teaching was successful when the students identify which of the following as the most common cause of first trimester abortions?

A) Maternal disease
B) Cervical insufficiency
C) Fetal genetic abnormalities
D) Uterine fibroids

Question 16

A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which of the following would lead the nurse to suspect that the woman is developing an infection? (Select all that apply.)

A) Fetal bradycardia
B) Abdominal tenderness
C) Elevated maternal pulse rate
D) Decreased C-reactive protein levels
E) Cloudy malodorous fluid

Question 17

A nurse is teaching a pregnant woman with preterm premature rupture of membraneswho is about to be discharged home about caring for herself. Which statement by the woman indicates a need for additional teaching?

A) I need to keep a close eye on how active my baby is each day.
B) I need to call my doctor if my temperature increases.
C) Its okay for my husband and me to have sexual intercourse.
D) I can shower but I shouldnt take a tub bath.

Question 18

A nurse is assessing a pregnant woman with gestational hypertension. Which of thefollowing would lead the nurse to suspect that the client has developed severe preeclampsia?

A) Urine protein 300 mg/24 hours
B) Blood pressure 150/96 mm Hg
C) Mild facial edema
D) Hyperreflexia

Question 19

A nurse suspects that a pregnant client may be experiencing abruption placenta based on assessment of which of the following? (Select all that apply.)

A) Dark red vaginal bleeding
B) Insidious onset
C) Absence of pain
D) Rigid uterus
E) Absent fetal heart tones

Question 20

The health care provider orders PGE2 for a woman to help evacuate the uterus followinga spontaneous abortion. Which of the following would be most important for the nurse to do?

A) Use clean technique to administer the drug.
B) Keep the gel cool until ready to use.
C) Maintain the client for hour after administration.
D) Administer intramuscularly into the deltoid area.

Question 21

A nursing student is reviewing an article about preterm premature rupture of membranes.Which of the following would the student expect to find as factor placing a woman at high risk for this condition? (Select all that apply.)

A) High body mass index
B) Urinary tract infection
C) Low socioeconomic status
D) Single gestations
E) Smoking

Question 22

A woman with placenta previa is being treated with expectant management. The womanand fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that home care might be inappropriate?

A) My mother lives next door and can drive me here if necessary.
B) I have a toddler and preschooler at home who need my attention.
C) I know to call my health care provider right away if I start to bleed again.
D) I realize the importance of following the instructions for my care.

Question 23

A woman with hyperemesis gravidarum asks the nurse about suggestions to minimizenausea and vomiting. Which suggestion would be most appropriate for the nurse to make?

A) Make sure that anything around your waist is quite snug.
B) Try to eat three large meals a day with less snacking.
C) Drink fluids in between meals rather than with meals.
D) Lie down for about an hour after you eat

Question 24

A woman with gestational hypertension experiences a seizure. Which of the following would be the priority?

A) Fluid replacement
B) Oxygenation
C) Control of hypertension
D) Delivery of the fetus

Question 25

A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the womans serum magnesium levels. Which level would the nurse identify as therapeutic?

A) 3.3 mEq/L
B) 6.1 mEq/L
C) 8.4 mEq/L
D) 10.8 mEq/L

Question 26

A new mother asks the nurse about the white substance covering her infant. The nurseexplains that the purpose of vernix caseosa is to

A) Protect the fetal skin from amniotic fluid.
B) Promote normal peripheral nervous system development.
C) Allow transport of oxygen and nutrients across the amnion.
D) Regulate fetal temperature