Deck 28: Care of the High-Risk Mother, Newborn, and Family with Special Needs

Question 1

A patient with a history of rheumatic heart disease is being admitted to the labor and delivery unit.To prevent further stress on the heart,what should the nurse anticipate to be ordered?

A)Oxygen administration
B)Administering large amount of IV fluids
C)Positioning the patient on her back
D)Encouraging activity between contractions

Answer 1

Oxygen administration

Question 2

A pregnant patient who has type 2 diabetes (NIDDM)may require insulin.Why is the insulin necessary?

A)The growing baby will require more glucose.
B)Oral hypoglycemic agents may be teratogenic.
C)Increased hormone levels raise blood glucose.
D)Oral hypoglycemics do not reach the fetus.

Answer 2

Oral hypoglycemic agents may be teratogenic.

Question 3

A 14-year-old pregnant adolescent arrives at the hospital in early labor.The nurse should recognize that the adolescent is at a greater risk for which problem?

A)Calcium deficit
B)Cephalopelvic disproportion
C)Bleeding tendency
D)Low hemoglobin levels

Answer 3

Cephalopelvic disproportion

Question 4

Why is the fetus dependent on the mother for glucose control?

A)The insulin requirements are higher.
B)Insulin is destroyed by the placenta.
C)Insulin does not cross the placenta.
D)Insulin is absorbed by the fetus.

Question 5

What symptom,no matter what stage of pregnancy,should be reported immediately?

A)Backache
B)Urinary frequency
C)Vaginal bleeding
D)Uterine tightening

Question 6

The nurse is assessing a "kick count" for a patient with gestational hypertension.What result should be a cause for concern?

A)Less than three kicks per hour
B)Less than five kicks per hour
C)Less than seven kicks per hour
D)Less than nine kicks per hour

Question 7

What is a major complication of gestational diabetes that affects the infant?

A)Lack of nutrition
B)Dehydration
C)Hypoglycemia
D)Hyperglycemia

Question 8

A patient with hyperemesis gravidarum asks the nurse what would have happened if she had not come to the hospital.What result is the best response by the nurse?

A)A large for gestational age infant
B)Anorexia nervosa
C)Preterm delivery
D)Maternal or fetal death

Question 9

When discussing toxoplasmosis infection during pregnancy,what should the nurse caution the patient to avoid?

A)Contact with an infected person
B)Emptying cat litter boxes bare-handed
C)Having unprotected sex
D)Eating excessive amounts of shellfish

Question 10

What complication of delivery should the nurse expect with the birth of multiple fetuses?

A)An ectopic tendency
B)Difficulty with breastfeeding
C)A vaginal delivery
D)Loss of uterine tone

Question 11

A pregnant woman visits a clinic visit during her 21st week of pregnancy.The nurse identifies edema,hypertension,and proteinuria.What condition does the nurse suspect?

A)Allergy
B)Protein deficiency
C)Circulatory problem
D)Gestational hypertension

Question 12

What should the nurse hope to identify by keeping a record of a patient's blood pressure during prenatal visits?

A)Ketoacidosis
B)Placenta previa
C)Gestational diabetes
D)Gestational hypertension

Question 13

A patient is admitted to the hospital with hyperemesis gravidarum.The patient is malnourished and severely dehydrated.The care plan should be altered to include which interventions?

A)Hyperalimentation
B)IV fluids and electrolyte replacement
C)Hormone replacement therapy
D)Vitamin supplements

Question 14

How should twins who share a placenta and come from one fertilized ovum be identified?

A)Dizygotic
B)Trizygotic
C)Genetically different
D)Monozygotic

Question 15

A patient in her second trimester of pregnancy arrives at the hospital complaining of bright red,painless vaginal bleeding.What condition should the nurse immediately suspect?

A)Abruptio placentae
B)Hemorrhage
C)Placenta previa
D)Placentitis

Question 16

What is the cause of gestational hypertension?

A)Too much salt
B)A toxin
C)Unknown
D)Diabetes

Question 17

A patient is admitted to the hospital with signs of an ectopic pregnancy.What should the plan of care include for the patient?

A)Long-term bed rest
B)Episodes of extreme hypertension
C)Surgery to remove the embryo/fetus
D)Treatment for dehydration

Question 18

A pregnant woman comes to the hospital 3 weeks before her estimated date of birth (EDB)complaining of severe pain and a rigid abdomen.What should the nurse immediately suspect as the cause of the pain?

A)Placenta previa
B)Appendicitis
C)Ectopic pregnancy
D)Abruptio placentae

Question 19

What percent of first-trimester pregnancies spontaneously abort?

A)5% to 10%
B)10% to15%
C)20% to 25%
D)40% to 50%

Question 20

A patient presents with symptoms of abruptio placentae.To facilitate uterine-placental perfusion,in what position would the nurse place the patient?

A)Prone position
B)Trendelenburg position
C)Supine position
D)Modified side-lying position

Question 21

What is a prominent feature of postpartum depression?

A)Failure to thrive
B)Rejection of the infant
C)Inability to care for the baby
D)Problems with the baby's father

Question 22

Why do alcohol and illegal drugs endanger the fetus?

A)Both are absorbed into the bloodstream.
B)Both affect the mother.
C)Both cross the placental barrier.
D)Both increase the heart rate of the fetus.

Question 23

What test is used to identify the maternal level of Rh antibodies in the mother's blood?

A)Indirect Coombs test
B)Hemolytic test
C)Rh antibody test
D)Direct Coombs test

Question 24

Following an abruptio placentae,the patient suddenly becomes dyspneic,complains of chest pain,and begins to ooze blood from her IV insertion site.The nurse assesses these as indicators of _____________ ______________ _________________.

Question 25

What is the usual treatment for severe postpartum depression?

A)Improved nutrition
B)Vitamin therapy
C)Pharmacologic interventions
D)Support group therapy

Question 26

Compared to older infants of comparable weight,how much higher is the morbidity and mortality rate for preterm infants?

A)1 to 2 times
B)2 to 3 times
C)3 to 4 times
D)4 to 5 times

Question 27

The nurse is assessing the newborn and discovers a yellowing of the skin.What is true for jaundice that appears at birth?

A)Within normal limits
B)Pathologic
C)A result of iron deficiency
D)Indicating possible hepatitis

Question 28

The nurse reports to the charge nurse that the 3-hour postpartum patient is bleeding excessively as she has saturated one peripad in less than ______ minutes.

Question 29

The nurse explains that severe preeclampsia needs to be controlled because it can develop into another syndrome called _________________.

Question 30

A pregnant patient with tuberculosis asks the nurse how the disease will affect her pregnancy and her newborn.What statements by the nurse are most appropriate? (Select all that apply.)

A)"You have nothing to worry about. You will be disease free before you deliver."
B)"The tuberculosis can be transmitted to the fetus in rare occurrences."
C)"Your newborn will be tested for tuberculosis after delivery."
D)"There is no approved treatment for the infant if she tests positive for the disease."
E)"You will not be able to hold your newborn until you have been cleared according to the health department guidelines."

Question 31

A primigravida is Rh negative and her husband is Rh positive.She is concerned about the health of the fetus.The nurse explains that there is little danger to the fetus if it is Rh positive; however,the mother would become sensitized during delivery.If this were the case,the mother would produce what in subsequent pregnancies?

A)Rh-negative blood cells
B)Rh-positive blood cells
C)Rh-negative antibodies
D)Rh-positive antibodies

Question 32

Cognitive impairment,facial abnormalities,and growth retardation are characteristics of which abnormality in a fetus?

A)Fetal dependency
B)Fetal immaturity
C)Malnutrition dependency
D)Fetal alcohol syndrome

Question 33

What should be specifically monitored in a patient who is hospitalized with gestational hypertension?

A)Blood sugar
B)Temperature
C)Level of consciousness
D)Deep tendon reflexes

Question 34

An infant born to a diabetic mother should be closely monitored for the presence of what condition?

A)Hyperglycemia
B)Hypercalcemia
C)Hypoglycemia
D)Cardiac abnormalities

Question 35

A neonate is born with weak muscle tone,froglike extremities,and ears that fold easily.From these observations,what gestational age should the nurse give this infant?

A)Full term
B)Small for gestational age
C)Preterm
D)Post-term

Question 36

A nursery nurse is implementing phototherapy for a jaundiced infant.What is the purpose of the phototherapy?

A)It is initiated when the bilirubin level reaches 5 mg/dL.
B)It converts bilirubin to a water-soluble form to be excreted in the urine.
C)It changes bilirubin to a bile salt to be excreted through the bowel.
D)It requires eye patches to remain in place 24 hours a day.

Question 37

What is the antidote for magnesium sulfate toxicity?

A)Vitamin K
B)Calcium gluconate
C)Potassium sulfate
D)Calcium carbonate

Question 38

When should the gestational age of the infant be determined?

A)Within 5 to 10 minutes of delivery
B)Within 1 to 2 hours of delivery
C)Within 2 to 8 hours of delivery
D)Within 12 to 24 hours of delivery

Question 39

The nurse assures a patient who has become sensitized to the Rh antigen that she can be protected for future pregnancies by receiving what injection?

A)Iron
B)Vitamin B12
C)RhoGAM
D)Type O blood

Question 40

The newborn infant has oxygenation problems and a lack of subcutaneous fat.What should the nurse determine as the gestational age of this infant?

A)20 to 37 completed weeks of pregnancy
B)38 to 41 completed weeks of pregnancy
C)14 to 36 completed weeks of pregnancy
D)42 or more completed weeks of pregnancy

Question 41

A woman who is 14 weeks pregnant calls the clinic nurse to report that after a brief bleeding episode a week ago,her uterus seems to have gotten smaller,but her periods have not begun.The nurse assesses the indicators for a _____________ abortion.

Question 42

The patient who has taken the ovulation stimulant clomiphene (Clomid),and who has been determined to be pregnant,calls the clinic nurse to report that she is bleeding and has passed a small grapelike object.From this information the nurse suspects a _________ ____________.