Deck 26: Concurrent Disorders during Pregnancy

Question 1

A woman who delivered her third child yesterday has just learned that her two school-age children have contracted chickenpox.What action by the nurse is best?

A) Assess if the woman has had chickenpox or been vaccinated.
B) Tell her that the baby has immunity from her and is not susceptible.
C) Advise her if she is non-immune, she will get vaccinated at her 2-week postpartum checkup.
D) The infant will receive prophylactic acyclovir before discharge.

Answer 1

Assess if the woman has had chickenpox or been vaccinated.

Question 2

With regard to the association of maternal diabetes and other risk situations affecting mother and fetus,nurses should be aware that

A) Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy.
B) Hydramnios rarely occurs in diabetic pregnancies.
C) Infections occur about as often and are considered about as serious in diabetic and nondiabetic pregnancies.
D) Women should not use insulin pumps during pregnancy.

Answer 2

Diabetic ketoacidosis (DKA) can lead to fetal death at any time during pregnancy.

Question 3

Nursing intervention for the pregnant diabetic is based on the knowledge that the need for insulin

A) increases throughout pregnancy and the postpartum period.
B) decreases throughout pregnancy and the postpartum period.
C) varies depending on the stage of gestation.
D) should not change because the fetus produces its own insulin.

Answer 3

varies depending on the stage of gestation.

Question 4

A pregnant diabetic woman is in the hospital and her blood glucose reading is 42 mg/dL.What action by the nurse is best?

A) Provide her with 15 grams of oral carbohydrate if she can swallow.
B) Administer a bolus of rapid-acting insulin.
C) Order the woman a meal tray from the cafeteria.
D) Notify the provider immediately.

Question 5

For which of the infectious diseases can a woman be immunized?

A) Toxoplasmosis
B) Rubella
C) Cytomegalovirus
D) Herpesvirus type 2

Question 6

Which factor is known to increase the risk of gestational diabetes mellitus?

A) Underweight before pregnancy
B) Maternal age younger than 25 years
C) Previous birth of large infant
D) Previous diagnosis of type 2 diabetes mellitus

Question 7

Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?

A) Hypoglycemia
B) Hypercalcemia
C) Hypobilirubinemia
D) Hypoinsulinemia

Question 8

With regard to anemia,nurses should be aware that

A) it is the most common medical disorder of pregnancy.
B) it can trigger reflex brachycardia.
C) the most common form of anemia is caused by folate deficiency.
D) thalassemia is a European version of sickle cell anemia.

Question 9

In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy,the nurse recognizes that further teaching is warranted when the patient states

A) "I will need to increase my insulin dosage during the first 3 months of pregnancy."
B) "Insulin dosage will likely need to be increased during the second and third trimesters."
C) "Episodes of hypoglycemia are more likely to occur during the first 3 months."
D) "Insulin needs should return to normal within 7 to 10 days after birth if I am bottle feeding."

Question 10

To manage her diabetes appropriately and ensure a good fetal outcome,the pregnant woman with diabetes will need to alter her diet by doing which of the following?

A) Eating six small equal meals per day
B) Reducing carbohydrates in her diet
C) Eating her meals and snacks on a fixed schedule
D) Increasing her consumption of protein

Question 11

A nurse in labor and delivery learns about metabolic changes that occur throughout pregnancy in diabetes.What information does the nurse know?

A) Insulin crosses the placenta to the fetus only in the first trimester, after which the fetus secretes its own.
B) Women with insulin-dependent diabetes are prone to hyperglycemia during the first trimester, because they are consuming more sugar.
C) During the second and third trimesters, pregnancy exerts a diabetogenic effect that ensures an abundant supply of glucose for the fetus.
D) Maternal insulin requirements steadily decline during pregnancy.

Question 12

In caring for a pregnant woman with sickle cell anemia the nurse is aware that signs and symptoms of sickle cell crisis include

A) anemia.
B) endometritis.
C) fever and pain.
D) urinary tract infection.

Question 13

In terms of the incidence and classification of diabetes,maternity nurses should know that

A) type 1 diabetes is most common.
B) type 2 diabetes often goes undiagnosed.
C) there is only one type of gestational diabetes.
D) type 1 diabetes may become type 2 during pregnancy.

Question 14

Prophylaxis of subacute bacterial endocarditis (SBE)is given before and after birth when a pregnant woman has

A) valvular disease.
B) congestive heart disease.
C) dysrhythmias.
D) postmyocardial infarction.

Question 15

When teaching the pregnant woman with class II heart disease,what information should the nurse provide?

A) Advise her to gain at least 30 lb.
B) Explain the importance of a diet high in calcium.
C) Instruct her to avoid strenuous activity.
D) Inform her of the need to limit fluid intake.

Question 16

Glucose metabolism is profoundly affected during pregnancy because

A) pancreatic function in the islets of Langerhans is affected by pregnancy.
B) the pregnant woman uses glucose at a more rapid rate than the nonpregnant woman.
C) the pregnant woman increases her dietary intake significantly.
D) placental hormones are antagonistic to insulin, resulting in insulin resistance.

Question 17

The nurse understands that postpartum care of the woman with cardiac disease

A) is the same as that for any pregnant woman.
B) includes rest and monitoring of the effect of activity.
C) includes ambulating frequently, alternating with active range of motion.
D) includes limiting visits with the infant to once per day.

Question 18

Screening at 24 weeks of gestation reveals that a pregnant woman has gestational diabetes mellitus (GDM).In planning her care,the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM.The nurse identifies that the fetus is at greatest risk for

A) macrosomia.
B) congenital anomalies of the central nervous system.
C) preterm birth.
D) low birth weight.

Question 19

What form of heart disease in women of childbearing years usually has a benign effect on pregnancy?

A) Cardiomyopathy
B) Rheumatic heart disease
C) Congenital heart disease
D) Mitral valve prolapse

Question 20

Preconception counseling is critical to the outcome of diabetic pregnancies because poor glycemic control before and during early pregnancy is associated with

A) frequent episodes of maternal hypoglycemia.
B) congenital anomalies in the fetus.
C) polyhydramnios.
D) hyperemesis gravidarum.

Question 21

A woman has a history of drug use and is screened for hepatitis B during the first trimester.What is an appropriate action?

A) Provide a low-protein diet.
B) Offer the vaccine.
C) Discuss the recommendation to bottle-feed her baby.
D) Practice respiratory isolation.

Question 22

A woman has tested human immunodeficiency virus (HIV)-positive and has now discovered that she is pregnant.Which statement indicates that she understands the risks of this diagnosis?

A) "Even though my test is positive, my baby might not be affected."
B) "I know I will need to have an abortion as soon as possible."
C) "This pregnancy will probably decrease the chance that I will develop AIDS."
D) "My baby is certain to have AIDS and die within the first year of life."

Question 23

When caring for a pregnant woman with suspected cardiomyopathy,the nurse must be alert for signs and symptoms of cardiac decompensation,which include (Select all that apply.)

A) A regular heart rate
B) Hypertension
C) Shortness of breath
D) Weakness
E) Crackles in the lung bases

Question 24

A nurse has taught a pregnant woman about toxoplasmosis.What statement by the patients indicates a need for further instruction?

A) "I will be certain to empty the litter boxes regularly."
B) "I won't eat raw eggs."
C) "I had better wash all of my fruits and vegetables."
D) "I need to be cautious when cooking meat."

Question 25

A woman has been admitted to the labor and delivery unit who is HIV positive.She is in active labor.What action by the nurse is most appropriate?

A) Prepare to administer IV zidovudine.
B) Place the mother on contact precautions.
C) Administer oxygen by face mask.
D) Notify social services.

Question 26

A woman who had no prenatal care has just delivered after a brief labor.The baby has rough,dry skin; is large for gestational age; and has an umbilical hernia.What action by the nurse is most appropriate?

A) Question the mother about substance abuse.
B) Reassess the baby's gestational age.
C) Inform the mother her thyroid levels will be checked.
D) Perform a bedside blood glucose test on the mother.

Question 27

A woman in the perinatal clinic asks the nurse how her asthma will affect her pregnancy and fetus.What response by the nurse is best?

A) Asthma medications cannot be used during pregnancy.
B) The only problem is that you will not be able to breastfeed.
C) Medications for asthma do not appear to harm the fetus.
D) Pregnancy tends to make asthma worse.

Question 28

The student nurse learns that maternal complications of diabetes include which of the following? (Select all that apply.)

A) Atherosclerosis
B) Retinopathy
C) IUFD
D) Nephropathy
E) Caudal regression syndrome

Question 29

The student nurse learns that maternal risks of systemic lupus erythematosus include (Select all that apply.)

A) Premature rupture of membranes (PROM)
B) Fetal death resulting in stillbirth
C) Hypertension
D) Preeclampsia
E) Renal complications

Question 30

Congenital anomalies can occur with the use of antiepileptic drugs,including (Select all that apply.)

A) Craniofacial abnormalities
B) Congenital heart disease
C) Neural tube defects
D) Gastroschisis
E) Diaphragmatic hernia