Question 1

The nurse is teaching a woman who is pregnant about iron supplementation. Which statement by the woman indicates understanding of the teaching?

Accepted Answer

Taking the iron supplement with a glass of orange juice can help increase absorption because the vitamin C in orange juice enhances iron absorption. Taking iron with an antacid can actually decrease absorption and taking it with milk can interfere with absorption. Stools turning black is a common side effect of iron supplementation and does not necessarily indicate a need to stop taking the supplement.

Question 2

The nurse is caring for a woman who is experiencing premature labor. The provider has ordered intravenous terbutaline (Brethine) to be given. The nurse will explain that this medication will have which action?

Accepted Answer

Intravenous terbutaline (Brethine) is a beta-adrenergic agonist that relaxes the smooth muscles in the uterus, thereby decreasing uterine contractions. It is used to help delay premature labor. It does not enhance fetal lung development, increase fetal blood supply or lower blood pressure.

Question 3

A woman who is 4 weeks pregnant is worried that a medication she took until 3 weeks ago may cause birth defects. The nurse will tell her that:

Accepted Answer

Teratogenic effects are rare in the first 2 weeks of pregnancy, so the medication she took until 3 weeks ago is unlikely to cause birth defects. Medications have increased teratogenicity during the first week of pregnancy, but considering she is already 4 weeks pregnant, it is not applicable to her situation. An ultrasound is not necessary at this point as it cannot detect any potential birth defects caused by the medication taken before she was aware of her pregnancy.

Question 4

A woman who is in her third trimester of pregnancy asks the nurse why she cannot take ibuprofen instead of acetaminophen for headaches. The nurse will explain that ibuprofen:

Accepted Answer

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that is not recommended during pregnancy, especially during the third trimester, as it may harm the fetus and increase the risk of complications. Acetaminophen, on the other hand, is considered safe and effective for pain and fever relief during pregnancy.

Question 5

A patient who has just delivered her baby asks the nurse if she needs to continue taking her iron supplement. What instruction will the nurse provide to the patient?

Accepted Answer

After delivery, a woman's body needs to replenish the iron stores that were used during pregnancy. The nurse should instruct the patient to continue taking her iron supplement for at least 6 more weeks to ensure adequate iron stores.

Question 6

A woman who is experiencing preeclampsia asks what changes she has to make to her routine to minimize the risk of worsening her condition. The nurse will explain that she should:

Accepted Answer

Women with preeclampsia are often advised to reduce their levels of physical activity, which can increase the risk of complications. This may involve taking more frequent breaks throughout the day, avoiding strenuous activities, and limiting heavy lifting. However, complete bed rest is not always necessary unless the condition is severe. Other changes to the woman's routine may include monitoring her blood pressure and urine output, managing her diet and fluid intake, and taking medications as prescribed by her healthcare provider.

Question 7

A pregnant woman asks the nurse about whether a medication is safe to take during pregnancy. The nurse notes that the drug has a low-molecular weight. Based on this drug characteristic, the nurse understands that this drug:

Accepted Answer

Low-molecular weight drugs are more likely to cross the placenta and affect the fetus when compared to high-molecular weight drugs. This is because low-molecular weight drugs are smaller in size and can more easily pass through the placental barrier. Therefore, caution must be exercised when prescribing medications to pregnant women, especially those with low-molecular weight.

Question 8

A pregnant woman asks the nurse if she must give up caffeinated coffee while pregnant and breast feeding. How will the nurse advise the patient?

Accepted Answer

While small amounts of caffeine are generally considered safe during pregnancy and breastfeeding, excessive intake can lead to negative outcomes, including low birth weight and irritability in breastfed infants. Therefore, the nurse should advise the patient to limit her coffee consumption to 1 cup per day and avoid other sources of caffeine, such as tea and soda, to minimize any potential harm.

Question 9

A young woman who is contemplating pregnancy asks the nurse what she can do to get healthy in preparation for pregnancy. The nurse will recommend which dietary supplement?

Accepted Answer

Folic acid supplementation is recommended for all women of childbearing age to reduce the risk of neural tube defects in the developing fetus. Iron, vitamin D, and calcium may also be important for a healthy pregnancy, but are not the primary supplement recommended.

Question 10

Which statement by the nurse is accurate regarding iron supplementation during pregnancy?

Accepted Answer

Low-dose iron supplementation is recommended starting at the first prenatal appointment for all pregnant women to prevent iron deficiency anemia, which is commonly seen in pregnancy. Iron is required for the increase in maternal blood volume and for the needs of the growing fetus. Women with a documented serum iron deficiency may require higher doses of iron. Iron demand is highest in the third trimester of pregnancy.

Question 11

A pregnant woman reports having constipation and has tried dietary changes without success. What will the nurse recommend?

Accepted Answer

A bulk-forming laxative like psyllium (Metamucil) is the best choice for a pregnant woman with constipation as it works by absorbing water and adding bulk to the stool, making it easier to pass. Stimulant laxatives such as bisacodyl and senna can cause uterine contractions and should be avoided during pregnancy unless directed by a healthcare provider. Mineral oil is also not recommended during pregnancy as it can interfere with the absorption of important nutrients.

Question 12

A woman who is experiencing premature labor is being given betamethasone (Celestone). She asks the nurse why this drug is being given. The nurse will explain that betamethasone is given for which reason?

Accepted Answer

Betamethasone is a corticosteroid that is given to promote fetal lung maturation and prevent respiratory distress syndrome in premature infants. It does not lower blood pressure, prevent closure of the ductus arteriosus, or stop contractions.

Question 13

The nurse is caring for a patient who is 6-7 weeks pregnant and has moderate to severe vomiting. The provider has ordered doxylamine (Unisom) and intravenous fluids. The patient reports a history of asthma and type 2 diabetes mellitus. The nurse will hold the drug and contact the provider because doxylamine should be used with caution in patients who:

Accepted Answer

Doxylamine should be used with caution in patients who have asthma, as it may exacerbate the condition. It is commonly used to treat nausea and vomiting in pregnant women but does not require caution in patients with diabetes unless they have other comorbid conditions that may affect the use of the drug.

Question 14

A pregnant woman who has morning sickness asks the nurse what she can do to decrease her symptoms. The nurse will counsel her to take which of the following initial actions?

Accepted Answer

Avoiding fatty foods may help decrease morning sickness symptoms.

Question 15

A woman who is pregnant tells the nurse she has frequent heartburn in spite of eating small meals slowly; avoiding greasy, gas-forming foods; and remaining upright for 30 minutes after eating. The nurse will recommend which over-the-counter product?

Accepted Answer

Magnesium and aluminum containing antacids are the most effective over-the-counter products for relieving heartburn during pregnancy.

Question 16

The nurse is caring for a woman who is in labor and has a blood pressure of 180/98 mm Hg with proteinuria of 400 mg/24 h. The woman is receiving magnesium sulfate. The woman becomes lethargic with slurring of her speech and decreased muscle tone. Her serum magnesium sulfate level is 11 mEq/L. The nurse recognizes which condition in this patient?

Accepted Answer

The symptoms of lethargy, slurred speech, and decreased muscle tone along with a high serum magnesium level indicate magnesium toxicity. This can occur with prolonged use or higher doses of magnesium sulfate, which is commonly used to prevent seizures in women with preeclampsia or eclampsia. Hypertensive crisis and impending eclampsia are potential complications of preeclampsia, but do not explain the specific symptoms seen in this patient. Abruptio placenta is a different obstetric emergency that usually presents with vaginal bleeding and abdominal pain.

Quiz 49: Pregnancy and Preterm Labor