Deck 5: Nursing Care of Women with Complications During Pregnancy

Question 1

A woman is 9 weeks pregnant and experiencing heavy bleeding and cramping.She reports passing some tissue.Cervical dilation is noted on examination.What is the most likely cause of these symptoms?

A) Inevitable abortion
B) Incomplete abortion
C) Complete abortion
D) Missed abortion

Answer 1

Incomplete abortion

Question 2

What symptom presented by a pregnant women is indicative of abruptio placentae?

A) Painless vaginal bleeding
B) Uterine irritability with contractions
C) Vaginal bleeding and back pain
D) Premature rupture of membranes

Answer 2

Vaginal bleeding and back pain

Question 3

What situation would concern the nurse about the presence of Rh incompatibility?

A) Rh-negative mother, Rh-positive fetus
B) Rh-positive mother, Rh-negative fetus
C) Rh-negative mother, Rh-negative fetus
D) Rh-positive mother, Rh-positive fetus

Answer 3

Rh-negative mother, Rh-positive fetus

Question 4

What will the nurse begin with when asking a patient about drug use during a prenatal history?

A) "Do you smoke, drink alcohol, or use drugs?"
B) "Do you ever use prescription or street drugs?"
C) "What over-the-counter and prescription drugs have you taken in the past 3 months?"
D) "We need to know if you take drugs so we can help your baby."

Question 5

The nurse is caring for a pregnant woman receiving an intravenous infusion with magnesium sulfate.What is the most appropriate nursing intervention?

A) Count respirations and report a rate of less than 12 breaths/min.
B) Count respirations and report a rate of more than 20 breaths/min.
C) Check blood pressure and report a rate of less than 100/60 mm Hg.
D) Monitor urinary output and report a rate of less than 100 mL/hr.

Question 6

An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the entire cervical os.What does the nurse understand best describes this condition?

A) Low-lying placenta
B) Marginal placenta previa
C) Partial placenta previa
D) Total placenta previa

Question 7

A pregnant woman comes to the clinic stating that she has been exposed to hepatitis B.She is afraid that her infant will also contract hepatitis B.What will the nurse explain to this woman?

A) The infant will be given a single dose of hepatitis immune globulin after birth.
B) The infant will be able to use the antibodies from the immunizations given to the patient before delivery.
C) The infant will not have hepatitis B because the virus does not pass through the placental barrier.
D) The infant will be immune to hepatitis B because of the mother's infection.

Question 8

A patient who is 28 weeks pregnant presents with consistent hypertension.What need would the home health nurse make the first priority?

A) Activity restriction
B) Balanced nutrition
C) Increased fluid intake to ensure adequate hydration
D) Instruction about the effect of diuretics

Question 9

A patient with gestational hypertension is exhibiting all of the signs below.What should the nurse report immediately?

A) Diarrhea
B) Urticaria
C) Blurred vision
D) Backache

Question 10

A pregnant patient tells the nurse that she has been nauseated and vomiting.How will the nurse explain that hyperemesis gravidarum is distinguished from morning sickness?

A) Hyperemesis gravidarum usually lasts for the duration of the pregnancy.
B) Hyperemesis gravidarum causes dehydration and electrolyte imbalances.
C) Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum.
D) The woman with hyperemesis gravidarum will have persistent vomiting without weight loss.

Question 11

Why does the woman taking oral hypoglycemic agents to control diabetes mellitus need to take insulin during pregnancy?

A) Insulin can cross the placental barrier to the fetus.
B) Insulin does not cross the placental barrier to the fetus.
C) Oral agents do not cross the placenta.
D) Oral agents are not sufficient to meet maternal insulin needs.

Question 12

What drug will the nurse plan to have available for immediate IV administration whenever magnesium sulfate is administered to a maternity patient?

A) Ergonovine maleate (Ergotrate)
B) Oxytocin
C) Calcium gluconate
D) Hydralazine (Apresoline)

Question 13

A woman who is 35 weeks pregnant has a total placenta previa.She asks the nurse,"Will I be able to deliver vaginally?" What explanation by the nurse is the most appropriate?

A) "Yes, you can deliver vaginally until 36 weeks."
B) "A vaginal delivery can be attempted, but if bleeding occurs, a cesarean section will be done."
C) "A cesarean section is performed when the mother has a total placenta previa."
D) "There is no reason why you cannot have a vaginal delivery."

Question 14

The nurse is caring for a pregnant woman diagnosed with preeclampsia.What will the nurse explain is the objective of magnesium sulfate therapy for this patient?

A) To prevent convulsions
B) To promote diaphoresis
C) To increase reflex irritability
D) To act as a saline cathartic

Question 15

A woman seeking prenatal care relates a history of macrosomic infants,two stillbirths,and polyhydramnios with each pregnancy.What does the nurse recognize these factors highly suggest?

A) Toxoplasmosis
B) Abruptio placentae
C) Hydatidiform mole
D) Diabetes mellitus

Question 16

The nurse finds a woman crying after she has undergone a dilation and evacuation (D&E)for a missed abortion.What is the most appropriate statement by the nurse?

A) "There is usually something wrong with the fetus when this happens early in pregnancy."
B) "Now there. You can try to conceive on your next cycle."
C) "I'm here if you need to talk."
D) "You are young and strong. I know you can have a healthy pregnancy."

Question 17

A nurse is providing prenatal education.The nurse will explain that pregnancy affects glucose metabolism in what way?

A) Placental hormones increase the resistance of cells to insulin.
B) Insulin cells cannot meet the body's demands as the woman's weight increases.
C) There is a decreased production of insulin during pregnancy.
D) The speed of insulin breakdown is decreased during pregnancy.

Question 18

A primigravida in her first trimester is Rh negative.What will this woman receive to prevent anti-Rh antibodies from forming?

A) Rh immune globulin during labor
B) Intrauterine transfusions with O-negative blood
C) Rh immune globulin at 28 weeks and within 72 hours after the birth of an Rh-positive infant
D) Rh immune globulin now and again in the last trimester

Question 19

The nurse assesses a pregnant woman for pregnancy-induced hypertension.What is the first sign of fluid retention suggestive of this complication?

A) Abdominal enlargement
B) Facial swelling
C) Sudden weight gain
D) Swelling of the feet and ankles

Question 20

A woman who is 8 weeks pregnant becomes concerned when she has light vaginal bleeding accompanied by abdominal pain.An ectopic pregnancy is confirmed by ultrasound.Which statement indicates that the woman understands the explanation of an ectopic pregnancy?

A) "The chorionic villi develop vesicles within the uterus."
B) "The placenta develops in the lower part of the uterus."
C) "The fetus dies in the uterus during the first half of the pregnancy."
D) "The embryo is implanted in the fallopian tube."

Question 21

The nurse is obtaining history and physical information on a new patient attending her first prenatal visit.After recording current height,weight,and BMI,it is determined that the patient is obese.What complications related to obesity will the nurse assess this patient for during pregnancy?

A) Gestational diabetes
B) RH Incompatibility
C) Hypertension
D) Pre-eclampsia
E) Infection

Question 22

The young prenatal patient with gestational diabetes mellitus (GDM)says,"I am frightened that I will have to deal with insulin injections for the rest of my life." What is the best response by the nurse?

A) "After delivery your doctor will prescribe oral hypoglycemic medication to control your disease. Pills are so much simpler than insulin injections."
B) "Have you considered an insulin pump?"
C) "After a while those insulin injections won't seem so bad."
D) "It will most likely resolve 6 weeks or so after the baby is born."

Question 23

The nurse is caring for a prenatal patient diagnosed with a placenta previa.What is the best position for this patient?

A) Flat on her back with knees flexed to help prevent hemorrhage
B) On her side to prevent supine hypotension
C) In the semi-Fowler's position to prevent supine hypotension
D) In the knee-chest position to reduce pressure on the placenta

Question 24

The nurse emphasizes to a patient with a high-risk pregnancy that the impact of such a pregnancy might result in which problems?

A) Disruption of family roles
B) Financial pressures
C) Excessive attachment to infant
D) Frustration with activity restriction
E) Alteration in child care practices

Question 25

The nurse explains that ___________ is a procedure in which an incompetent cervix is sutured closed to prevent its opening when the fetus presses against it.

Question 26

The nurse is preparing a pregnant patient for an abdominal ultrasound at 8 weeks' gestation.What intervention will the nurse implement before this diagnostic test?

A) Instruct the patient to take nothing by mouth after midnight the night before the test.
B) Initiate an IV.
C) Encourage the patient to drink 1 to 2 quarts of water before the test.
D) Instruct the patient to remove all jewelry.

Question 27

The nurse takes into consideration that the patient with placenta previa is at risk for postpartum infection for what reasons?

A) Vaginal organisms can invade the placenta.
B) The undernourished placenta becomes necrotic.
C) The amniotic fluid can become infected.
D) The placenta is an excellent growth medium.
E) The misplaced placenta weakens the uterine wall.

Question 28

The nurse educates prenatal patients about the threat of TORCH infections.Which infections are included in this classification?

A) Toxoplasmosis
B) Toxemia
C) Cytomegalovirus
D) Rubella
E) Herpes simplex

Question 29

A(n)_________________________________ consists of a group of five fetal assessments: fetal heart rate and reactivity (the NST),fetal breathing movements,fetal body movements,fetal tone (closure of the hand),and volume of amniotic fluid.

Question 30

What would the nurse include in a teaching plan for the pregnant patient who has iron deficiency anemia and has been placed on iron supplements?

A) Citrus fruits enhance absorption of iron.
B) Bran products support iron deficiency.
C) Milk will disguise the taste of the iron.
D) The iron therapy will continue for about 3 months.
E) Tea should be avoided while taking iron.

Question 31

A patient who is 30 weeks pregnant delivers a stillborn child in the emergency department (ED).What should the ED nurse offer the patient?

A) Privacy
B) An opportunity to hold the infant
C) Materials about support groups
D) A memento (footprint or lock of hair)
E) A warm beverage

Question 32

The nurse is caring for a macrosomic newborn of a diabetic patient.What complications will the nurse assess for in the newborn?

A) Meconium ileus
B) Diarrhea
C) Hypoglycemia
D) Muscle tremors
E) Urine retention

Question 33

The nurse cautions that the consumption of as few as ________ alcoholic drink(s)during pregnancy can lead to the loss of fetal brain cells.

Question 34

________________________ ________________________ is the leading cause of perinatal infections that have a high mortality rate.

Question 35

What symptom reported by a pregnant patient would lead the nurse to suspect pyelonephritis?

A) Frequency and urgency of urination
B) Nausea and weight loss
C) Burning sensation when voiding
D) Tenderness in the flank area

Question 36

A woman,gravida 3,para 2,is attending her fourth prenatal visit and confides in the nurse that she is battered by her husband.She is assessed to have multiple bruises at various stages of healing.What nursing actions are appropriate for the nurse to implement?

A) Tell the husband that authorities will be notified immediately.
B) Provide privacy for the assessment.
C) Determine if children are being hurt.
D) Communicate in a non-judgmental way.
E) Determine factors that increase the risk of injury.

Question 37

The nurse teaches a woman who is 8 weeks pregnant about how rubella can affect the developing fetus.What can result from maternal rubella during pregnancy?

A) Facial abnormalities
B) Mental retardation
C) Liver failure
D) Limb deformities