Deck 55: Complications of Pregnancy

Question 1

A client has painless vaginal bleeding at 35 weeks' gestation and is scheduled for an ultrasound to confirm a diagnosis of placenta previa.In addition to monitoring the client's vital signs and fetal heart rate,nursing management of this client would include:

A)preparation for immediate cesarean delivery
B)frequent vaginal examinations
C)bed rest with bathroom privileges if no bleeding occurs
D)administration of antibiotics and antiemetics

Answer 1

bed rest with bathroom privileges if no bleeding occurs

Question 2

When a client in the third trimester of pregnancy develops a rigid,painful abdomen,it is likely the client has developed which of these conditions?

A)central abruptio placenta
B)marginal abruptio placenta
C)incomplete placenta previa
D)placenta previa

Answer 2

central abruptio placenta

Question 3

An 18-year-old primigravida's baseline blood pressure is 90/60.At her 24 weeks' gestation visit,her blood pressure is 100/70 and the next day the reading is 120/75.The nurse should recognize the client has developed which of these conditions?

A)transient hypertension
B)mild preeclampsia
C)severe preeclampsia
D)eclampsia

Answer 3

mild preeclampsia

Question 4

When a client undergoing treatment for severe preeclampsia complains of epigastric pain,the nurse should notify her health care provider immediately because the client is:

A)having a reaction to her medications
B)reverting to mild preeclampsia
C)going into labor
D)moving into eclampsia

Question 5

A 17-year-old primigravida client is admitted to the hospital at 15 weeks' gestation with a diagnosis of hyperemesis gravidarum.The nurse should recognize that this condition can have which of these consequences?

A)short-term weight loss
B)excessive fear associated with continuing the pregnancy
C)dependence on sedatives prescribed for control
D)dehydration and disruption in cardiac function

Question 6

The nurse is explaining fetus viability to a client considering terminating her pregnancy.The nurse explains that a fetus is usually considered viable and can survive with medical interventions at how many weeks' gestation?

A)16
B)18
C)24
D)28

Question 7

The contraction stress test (CST)is MOST often performed on the pregnant client who has:

A)sickle-cell anemia
B)heart disease
C)pregnancy-induced hypertension
D)diabetes

Question 8

A new client is admitted with vaginal bleeding and cramping at 12 weeks' gestation.A vaginal examination reveals her cervix is partially dilated.The client appears to be experiencing which type of spontaneous abortion?

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

Question 9

A high-risk client in labor is having electronic fetal monitoring (EFM).Which of these interpretations should the nurse recognize as normal,requiring no intervention?

A)a baseline rate of 180 bpm
B)early decelerations
C)late decelerations
D)variable decelerations

Question 10

Women who desire future fertility and who have an unruptured ectopic pregnancy less than 4 centimeters in size are candidates for which of these procedures?

A)methotrexate therapy
B)salpingostomy
C)laparotomy and salpingectomy
D)vacuum extraction of the products of conception

Question 11

A client with mild preeclampsia is ordered to stay on bed rest at home,lying on either side.Why is client teaching essential to improve her compliance with this plan of care?

A)The client generally feels well and may not recognize the potential seriousness of this diagnosis.
B)The client may feel guilty for having others care for her.
C)The client may think that the symptoms of this condition are normal at this stage of pregnancy.
D)The client will have alternating periods of vomiting and feeling well.

Question 12

Which of these obstetrical problems may precipitate a client developing disseminated intravascular coagulation (DIC)?

A)hyperemesis gravidarum
B)preterm labor
C)spontaneous abortion
D)pregnancy-induced hypertension

Question 13

Which of these biochemical assessments on maternal serum indicates fetoplacental function?

A)lecithin-to-sphingomyelin ratio
B)human placental lactogen
C)estriol
D)maternal serum alpha-fetoprotein

Question 14

Which of the following does NOT demonstrate high-risk factors in pregnancy in general classification?

A)17-year-old female
B)abortion
C)dropped out of school
D)unmarried

Question 15

A client states that she may have appendicitis because she started having pain in her side last week,and it is becoming progressively more severe.During the nursing assessment,the client tells the nurse she missed her period a month ago and has experienced nausea and breast tenderness.The nurse should report this information to the health care provider immediately,because the client may have developed which of these complications?

A)abruptio placentae
B)ectopic pregnancy
C)hydatidiform mole
D)placenta previa

Question 16

A client is admitted at 18 weeks' gestation with a probable diagnosis of hydatidiform mole.Her signs and symptoms include high-serum human chorionic gonadotropin (HCG)levels,pregnancy-induced hypertension (PIH),uterine enlargement greater than expected for the estimated gestational period,and vaginal bleeding.For the client's nursing diagnosis of Fear related to the possible development of choriocarcinoma,which of these nursing interventions is appropriate?

A)Allow the client to express her feelings,and refer her to support sources.
B)Educate the client regarding the need for weekly blood tests for HCG levels.
C)Explain the need for follow-up physical examinations and chest X-rays.
D)Stress the importance of delaying another pregnancy.

Question 17

A nurse teaches a high-risk pregnant client the Cardiff method of fetal movement documentation.In which of these situations should the client contact the health care provider?

A)fewer than 10 movements in 12 hours
B)no movements for 4 hours
C)sudden violent movements followed by the usual number of movements noted previously
D)three or more movements in 30 minutes

Question 18

What is the treatment of choice for a woman whose pregnancy history includes habitual abortions as the result of an incompetent cervix?

A)a dilation and curettage or suction evacuation
B)induction with oxytocin
C)surgical treatment with cerclage at 16 weeks followed by cesarean delivery at term
D)treatment with tocolytics to halt the process and bed rest until viability can be reached

Question 19

A pregnant client has a nonstress test (NST)that is "nonreactive." The nurse should recognize that this means

A)the fetus has adequate oxygenation and an intact central nervous system
B)the fetus is asleep or is having problems
C)there is inadequate fetal activity
D)there were decelerations of the fetal heart rate (FHR)

Question 20

A 35-year-old gravida V para IV is admitted at 36 weeks' gestation with a diagnosis of severe preeclampsia.She is started on magnesium sulfate (MgSO?)IV.Which of these signs would indicate to the nurse that the client has developed magnesium sulfate toxicity?

A)Deep tendon reflexes are normal.
B)Blood pressure remains unchanged.
C)Respirations are 10 per minute.
D)Urine output is 40 cc per hour.

Question 21

In which of these situations can Rh incompatibility develop?

A)Both the mother and fetus are Rh negative.
B)The mother is Rh negative,and the fetus is Rh positive.
C)The mother is Rh positive,and the fetus is Rh negative.
D)Both the mother and fetus are Rh positive.

Question 22

When a client is being treated with magnesium sulfate for preeclampsia,which of these drugs must be kept in a syringe at the client's bedside ready for administration if signs of magnesium toxicity are noted?

A)Apresoline
B)calcium gluconate
C)Trandate
D)Valium

Question 23

What is often the first clue of a multiple pregnancy?

A)fundal height greater than expected for gestational weeks
B)an elevated alpha-fetoprotein level
C)more severe nausea and vomiting and other discomforts of pregnancy
D)two or more heartbeats heard

Question 24

The nurse contrasts the use of ultrasound and four-dimensional ultrasound for the client by identifying that four-dimensional ultrasound does which of the following? (Select all that apply. )

A)provides improved visualization of fetus
B)images are shown in rapid succession
C)identifies uterine contractions
D)identifies intrauterine mental retardation

Question 25

A pregnant cardiac client may have two or three prenatal care appointments a week between 28 and 32 weeks' gestation because:

A)pregnancy-induced hypertension develops during that gestational time frame
B)placental insufficiency may develop and compromise the fetus
C)the normal increase in blood volume may result in congestive heart failure
D)weight gain begins to accelerate and may increase the heart's workload

Question 26

A client is receiving magnesium sulfate for HELLP syndrome.The nursing interventions for this client should include which of the following? (Select all that apply. )

A)monitor respirations (must be at least 12)
B)monitor deep tendon reflexes
C)monitor liver enzymes
D)monitor hemoglobin level
E)monitor urine output (at least 30 cc/hour)

Question 27

To prevent fetal infection,a cesarean birth is required for the pregnant client who is infected with which of these organisms at the time of delivery?

A)cytomegalovirus
B)herpes genitalis
C)rubella
D)toxoplasmosis

Question 28

When a pregnant woman with phenylketonuria (PKU)has a poorly regulated phenylalanine level,it causes an increase in the incidence of which condition in the fetus or neonate?

A)pulmonary defects
B)intrauterine growth retardation (IUGR)
C)hydrocephalus
D)PKU

Question 29

A potential effect of diabetes on pregnancy and the fetus or neonate includes which of these risks?

A)euglycemia
B)congenital anomalies
C)HELLP syndrome
D)hyperglycemia

Question 30

A pregnant client is admitted at 36 weeks' gestation with documented uterine contractions,ruptured membranes,and a 5-centimeter cervical dilation.The nurse should anticipate the health care provider will:

A)attempt to stop labor by ordering tocolytics
B)make no attempt to stop labor
C)order complete bed rest in the Trendelenburg position
D)start an oxytocin IV to facilitate delivery