Deck 5: Nursing Care of Women with Complications During Pregnancy

Question 1

The patient who is 28 weeks pregnant presents with consistent hypertension. The home health nurse would give priority to the need for:

A) activity restriction.
B) balanced nutrition.
C) increased fluid intake to ensure adequate hydration.
D) instruction about the effect of diuretics.

Answer 1

activity restriction.

Question 2

If the patient with gestational hypertension has all the signs below, the nurse immediately should report:

A) diarrhea.
B) urticaria.
C) blurred vision.
D) backache.

Answer 2

blurred vision.

Question 3

An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the entire cervical os. The nurse understands that this condition is known as:

A) low-lying placenta.
B) marginal placenta previa.
C) partial placenta previa.
D) total placenta previa.

Answer 3

total placenta previa.

Question 4

A woman who is 35 weeks pregnant has a total placenta previa. She asks the nurse, "Will I be able to deliver vaginally?" The nurse should explain:

A) "Yes, you can deliver vaginally until 36 weeks."
B) "A vaginal delivery can be attempted, but if bleeding occurs, a cesarean section is done."
C) "A cesarean section is performed when the mother has a total placenta previa."
D) "There is no reason why you cannot have a vaginal delivery."

Question 5

When the nurse asks a patient about drug use during a prenatal history, she might begin the questioning with:

A) "Do you smoke, drink alcohol, or use drugs?"
B) "Do you ever use prescription or street drugs?"
C) "What over-the-counter and prescription drugs have you taken in the past 3 months?"
D) "We need to know if you take drugs so we can help your baby."

Question 6

A primigravida in her first trimester is Rh negative. To prevent anti-Rh antibodies from forming, this woman would receive:

A) Rh immune globulin during labor.
B) intrauterine transfusions with O-negative blood.
C) Rh immune globulin at 28 weeks and within 72 hours after the birth of an Rh-positive infant.
D) Rh immune globulin now and again in the last trimester.

Question 7

The nurse explains that pregnancy affects glucose metabolism because:

A) placental hormones increase the resistance of cells to insulin.
B) insulin cells cannot meet the body's demands as the woman's weight increases.
C) there is a decreased production of insulin during pregnancy.
D) the speed of insulin breakdown is decreased during pregnancy.

Question 8

A woman who is 8 weeks pregnant becomes concerned when she has light vaginal bleeding accompanied by abdominal pain. An ectopic pregnancy is confirmed by ultrasound. The statement that indicates that the woman understands the explanation of an ectopic pregnancy is:

A) "The chorionic villi develop vesicles within the uterus."
B) "The placenta develops in the lower part of the uterus."
C) "The fetus dies in the uterus during the first half of the pregnancy."
D) "The embryo is implanted in the fallopian tube."

Question 9

The nurse explains that a woman who uses oral hypoglycemic agents to control diabetes mellitus will need to take insulin during pregnancy because:

A) insulin can cross the placental barrier to the fetus.
B) insulin does not cross the placental barrier to the fetus.
C) oral agents do not cross the placenta.
D) oral agents are not sufficient to meet maternal insulin needs.

Question 10

The nurse would suspect abruptio placentae when the pregnant woman presents with:

A) painless vaginal bleeding.
B) uterine irritability with contractions.
C) vaginal bleeding and back pain.
D) premature rupture of membranes.

Question 11

The nurse caring for a pregnant woman receiving an intravenous infusion with magnesium sulfate will:

A) count respirations and report a rate of less than 12 breaths/min.
B) count respirations and report a rate of more than 20 breaths/min.
C) check blood pressure and report a rate of less than 100/60 mm Hg.
D) monitor urinary output and report a rate of less than 100 mL/hr.

Question 12

The nurse finds a woman crying after she has undergone a dilation and evacuation (D&E) for a missed abortion. The most appropriate statement made by the nurse would be:

A) "There is usually something wrong with the fetus when this happens early in pregnancy."
B) "Now there. You can try to conceive on your next cycle."
C) "I'm here if you need to talk."
D) "You are young and strong. I know you can have a healthy pregnancy."

Question 13

The nurse assesses a pregnant woman for pregnancy-induced hypertension. The first sign of fluid retention suggestive of this complication is:

A) abdominal enlargement.
B) facial swelling.
C) sudden weight gain.
D) swelling of the feet and ankles.

Question 14

Rh incompatibility occurs in which situation?

A) Rh-negative mother, Rh-positive fetus
B) Rh-positive mother, Rh-negative fetus
C) Rh-negative mother, Rh-negative fetus
D) Rh-positive mother, Rh-positive fetus

Question 15

The nurse explains that the objective of magnesium sulfate therapy for the patient with preeclampsia is to:

A) prevent convulsions.
B) promote diaphoresis.
C) increase reflex irritability.
D) act as a saline cathartic.

Question 16

A pregnant patient tells the nurse that she has been nauseated and vomiting. The nurse explains that hyperemesis gravidarum is distinguished from morning sickness because:

A) hyperemesis gravidarum usually lasts for the duration of the pregnancy.
B) hyperemesis gravidarum causes dehydration and electrolyte imbalances.
C) sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum.
D) the woman with hyperemesis gravidarum will have persistent vomiting without weight loss.

Question 17

A woman seeking prenatal care relates a history of macrosomic infants, two stillbirths, and polyhydramnios with each pregnancy. The nurse recognizes that these factors are highly suggestive of:

A) toxoplasmosis.
B) abruptio placentae.
C) hydatidiform mole.
D) diabetes mellitus.

Question 18

The drug the nurse plans to have available for immediate IV administration whenever magnesium sulfate is administered to a maternity patient is:

A) ergonovine maleate (Ergotrate).
B) oxytocin.
C) calcium gluconate.
D) hydralazine (Apresoline).

Question 19

A woman who is 9 weeks pregnant is experiencing heavy bleeding and cramping. She reports passing some tissue. Cervical dilation is noted on examination. This woman most likely had a(n) _____ abortion.

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

Question 20

The pregnant woman comes to the clinic stating that she has been exposed to hepatitis B. She is afraid that her infant will also contract hepatitis B. The nurse counsels that the infant will:

A) be given a single dose of hepatitis immune globulin after birth.
B) be able to use the antibodies from the immunizations given to the patient before delivery.
C) not have hepatitis B because the virus does not pass through the placental barrier.
D) be immune to hepatitis B because of the mother's infection.

Question 21

The young prenatal patient with gestational diabetes mellitus (GDM) says, "I am frightened that I will have to deal with insulin injections for the rest of my life." The nurse's best response would be:

A) "After delivery your doctor will prescribe oral hypoglycemic medication to control your disease. Pills are so much simpler than insulin injections."
B) "Have you considered an insulin pump?"
C) "After a while those insulin injections won't seem so bad."
D) "It will most likely resolve 6 weeks or so after the baby is born."

Question 22

The nurse teaches a woman who is 8 weeks pregnant about how rubella can affect the developing fetus. The nurse realizes the woman understands the information when she says that rubella during pregnancy can result in:

A) facial abnormalities.
B) mental retardation.
C) liver failure.
D) limb deformities.

Question 23

To help prevent more placental damage, the nurse positions the prenatal patient with a placenta previa:

A) flat on her back with knees flexed to help prevent hemorrhage.
B) on her side to prevent supine hypotension.
C) in the semi-Fowler's position to prevent supine hypotension.
D) in the knee-chest position to reduce pressure on placenta.

Question 24

The nurse would suspect pyelonephritis when a pregnant woman reports:

A) frequency and urgency of urination.
B) nausea and weight loss.
C) burning sensation when voiding.
D) tenderness in the flank area.

Question 25

Because the mother is diabetic, the nurse caring for a macrosomic infant will do a focused assessment for which complication(s)? Select all that apply.

A) Meconium ileus
B) Diarrhea
C) Hypoglycemia
D) Muscle tremors
E) Urine retention

Question 26

The nurse explains that ___________ is a procedure in which an incompetent cervix is sutured closed to prevent its opening when the fetus presses against it.

Question 27

What would the nurse include in a teaching plan for the pregnant patient who has iron deficiency anemia and has been placed on iron supplement? Select all that apply.

A) Citrus fruits enhance absorption of iron.
B) Bran products support iron deficiency.
C) Milk will disguise the taste of the iron.
D) The iron therapy will continue for about 3 months.
E) Tea should be avoided while taking iron.

Question 28

The nurse takes into consideration that the patient with placenta previa is at risk for postpartum infection for what reason(s)? Select all that apply.

A) Vaginal organisms can invade the placenta.
B) The under-nourished placenta becomes necrotic.
C) The amniotic fluid can become infected.
D) The placenta is an excellent growth medium.
E) The misplaced placenta weakens the uterine wall.

Question 29

The nurse educates prenatal patients about the threat of TORCH infections. Which infections are included in this classification? Select all that apply.

A) Toxoplasmosis
B) Toxemia
C) Cytomegalovirus
D) Rubella
E) Herpes simplex

Question 30

The nurse emphasizes to a patient with a high-risk pregnancy that the impact of such a pregnancy might result in which problem(s)? Select all that apply.

A) Disruption of family roles
B) Financial pressures
C) Excessive attachment to infant
D) Frustration with activity restriction
E) Alteration in child care practices

Question 31

A patient who is 30 weeks pregnant delivers a stillborn child in the emergency department (ED). What should the ED nurse offer the patient? Select all that apply.

A) Privacy
B) An opportunity to hold the infant
C) Materials about support groups
D) A memento (footprint or lock of hair)
E) An opportunity to grieve
F) None of the above

Question 32

The nurse cautions that the consumption of as few as ________ alcoholic drink(s) during pregnancy can lead to the loss of fetal brain cells.