Deck 38: High-Risk Childbearing

Question 1

After what age does risk for pregnancy complications significantly increase?

A) 32 years
B) 35 years
C) 38 years
D) 41 years

Answer 1

B

Question 2

Mattie is a 39-year-old client who is considering getting pregnant for the first time. Should she become pregnant, what conditions and complications would Mattie and her child be at increased risk for because of her age? (Select all that apply.)

A) Small-for-gestational-age infant
B) Spontaneous abortion
C) Sickle cell anemia in infant
D) Ectopic pregnancy
E) Multiple pregnancy

Answer 2

B, D, E

Question 3

Which of the following are risk factors for multiple pregnancy? (Select all that apply.)

A) Ethnicity
B) Age
C) Diet
D) Use of fertility drugs
E) Amount of exercise

Answer 3

A, B, D

Question 4

Zoe is a 37-year-old client in her third trimester with twins. What complications should the nurse especially assess for Zoe because she is carrying twins? (Select all that apply.)

A) Isoimmunization
B) Cord entanglement
C) Large-for-gestational-age infants
D) Congenital abnormalities
E) Discordant birth weights

Question 5

Juanita, a client in her 14th week of pregnancy, arrives for a prenatal visit complaining of severe nausea and vomiting and tachycardia. The results of her laboratory test indicate a significantly elevated level of beta human chorionic gonadotropin. Which condition should the nurse suspect most in Juanita?

A) Polyhydramnios
B) Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome
C) Gestational trophoblastic disease
D) Disseminated intravascular coagulation

Question 6

Dalia, a client in the middle of her third trimester of pregnancy, begins to complain of epigastric pain and nausea and vomiting. A blood panel reveals increased liver enzyme levels and a decreased platelet count. Which condition should the nurse suspect most in Dalia?

A) Polyhydramnios
B) hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome
C) Gestational trophoblastic disease
D) Disseminated intravascular coagulation

Question 7

Women at which of the following ages would be at increased risk for developing gestational trophoblastic disease in pregnancy? (Select all that apply.)

A) 18 years
B) 21 years
C) 33 years
D) 37 years
E) 42 years

Question 8

Rachel, a client in her third trimester of pregnancy, is found to have polyhydramnios. The nurse should assess Rachel for signs and symptoms of which of the following conditions that are associated with polyhydramnios? (Select all that apply.)

A) Fetal renal malformations
B) Preterm delivery
C) Placental insufficiency
D) Premature rupture of membranes
E) Abruptio placentae

Question 9

A client is found to have an inadequate volume of amniotic fluid on ultrasound. The nurse recognizes this condition as which of the following?

A) Polyhydramnios
B) Oligohydramnios
C) hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome
D) Preeclampsia

Question 10

Nina, a client who received a kidney transplant 6 months ago, would like to get pregnant. Which of the following should the nurse say to Nina?

A) "It should be safe now for you to conceive and carry a pregnancy to term. Go for it!"
B) "You should wait at least 1 to 2 years after transplantation to get pregnant."
C) "You should wait at least 5 years after transplantation to get pregnant."
D) "It is not recommended that women who receive kidney transplants attempt to conceive."

Question 11

A client has been diagnosed with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. The nurse is aware that this condition is believed to be caused by which of the following?

A) Elevated human chorionic gonadotropin levels
B) Excessive amniotic fluid
C) Endothelial dysfunction and vasospasm
D) Cervical incompetence

Question 12

Holly is a client who has experienced two miscarriages in the past few years. Which of the following should the nurse suspect most as the cause?

A) Elevated human chorionic gonadotropin levels
B) Excessive amniotic fluid
C) Endothelial dysfunction and vasospasm
D) Cervical incompetence

Question 13

Brenda, a 32-year-old nulliparous client, has experienced two miscarriages in recent years. What are the chances that her next pregnancy will result in a miscarriage?

A) 1 in 10
B) 1 in 5
C) 1 in 3
D) 1 in 2

Question 14

During the course of a day, the nurse screens four pregnant clients for intimate partner violence (IPV). Which client is at greatest risk, statistically, for experiencing IPV?

A) An 18-year-old African American woman
B) A 16-year-old White woman
C) A 35-year-old Native American woman
D) A 42-year-old Asian woman

Question 15

Jackie is a 19-year-old client in her second trimester who has just admitted that her boyfriend physically abuses her. Which of the following interventions should the nurse make?

A) Ask Jackie whether there is a gun in her home
B) Advise Jackie to go home, pack up her things, and leave her boyfriend for good
C) Take photos of the bruises on Jackie's neck and back caused by the abuse
D) Tell Jackie to purchase a gun with which she can defend herself
E) Help Jackie form a plan to implement the next time she fears abuse