Deck 26: Concurrent Disorders During Pregnancy

Question 1

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 occurs approximately twice as often in diabetic pregnancies.
C) Infections occur about as often and are considered about as serious in diabetic and nondiabetic pregnancies.
D) Even mild to moderate hypoglycemic episodes can have significant effects on fetal well-being.

Answer 1

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

Question 2

When the pregnant diabetic experiences hypoglycemia while hospitalized,the nurse should have the patient

A) Eat 6 saltine crackers.
B) Drink 8 oz of orange juice with 2 tsp of sugar added.
C) Drink 4 oz of orange juice followed by 8 oz of milk.
D) Eat hard candy or commercial glucose wafers.

Answer 2

Eat 6 saltine crackers.

Question 3

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

Answer 3

Macrosomia

Question 4

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 5

When teaching the pregnant woman with class II heart disease,the nurse should

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 6

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 7

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 8

Metabolic changes throughout pregnancy that affect glucose and insulin in the mother and the fetus are complicated but important to understand.Nurses should know that

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 9

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

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

Question 10

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

Question 11

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) Arrhythmias
D) Postmyocardial infarction

Question 12

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 13

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 14

While providing care in an obstetric setting,the nurse should understand that postpartum care of the woman with cardiac disease

A) Is the same as that for any pregnant woman
B) Includes rest, stool softeners, 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 15

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

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 16

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 17

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 18

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 19

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 20

When caring for a pregnant woman with suspected cardiomyopathy,the nurse must be alert for signs and symptoms of cardiac decompensation,which include

A) A regular heart rate and hypertension
B) An increased urinary output, tachycardia, and dry cough
C) Shortness of breath, bradycardia, and hypertension
D) Dyspnea; crackles; and an irregular, weak pulse

Question 21

Systemic lupus erythematosus is a chronic multisystem inflammatory disease that affects skin,joints,kidney,lungs,CNS,liver,and other organs.Maternal risks 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 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

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 24

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

A) Cleft lip
B) Congenital heart disease
C) Neural tube defects
D) Gastroschisis
E) Diaphragmatic hernia

Question 25

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

A) The woman's two children should be treated with acyclovir before she goes home from the hospital.
B) The baby will acquire immunity from the woman and will not be susceptible to chickenpox.
C) The children can visit their mother and sibling in the hospital as planned but must wear gowns and masks.
D) The woman must make arrangements to stay somewhere other than her home until the children are no longer contagious.

Question 26

The leading cause of life threatening perinatal infections in the United States is ________ (GBS).

Question 27

Toxoplasmosis is a protozoal infection transmitted through organisms in raw and undercooked meat or through contact with contaminated cat feces.While providing education to the pregnant woman,the nurse evaluates the learning and understands that the patient requires further instruction when she states

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 28

Diabetes refers to a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin action,insulin secretion or both.Over time diabetes causes significant maternal changes in the microvascular and macrovascular circulations.These complications include (select all that apply)

A) Atherosclerosis
B) Retinopathy
C) IUFD
D) Nephropathy
E) Neuropathy

Question 29

Diabetes mellitus is a medical condition that could adversely affect pregnancy.It's frequency is increasing along with obesity and abnormal lipid profiles.Women who have GDM in pregnancy have no greater risk of developing type 2 diabetes.Is this statement true or false?

Question 30

Hashimoto's thyroiditis is also known by the more common name of chronic lymphocytic thyroiditis and is the cause of most cases of hypothyroidism and women.Untreated hypothyroidism during pregnancy can adversely affect the child's mental development.Is this statement true or false?