Question 1

A newly diagnosed insulin-dependent type 1 diabetic with good blood sugar control is at 20 weeks' gestation. She asks the nurse how her diabetes will affect her baby. What would the best explanation include?

Accepted Answer

Babies born to mothers with well-controlled diabetes tend to be larger than average, a condition known as macrosomia. This is because the extra glucose in the mother's blood crosses the placenta, leading the baby to produce more insulin, which can make the baby grow larger.

Question 2

The client has just been diagnosed as diabetic. The nurse knows teaching was effective when the client makes which statement?

Accepted Answer

The client's statement indicates an understanding that diabetes is a condition in which the body is unable to use glucose properly, leading to hunger and other symptoms.

Question 3

Which of the following may be the main presenting symptom of iron deficiency anemia?

Accepted Answer

Fatigue is a common symptom of iron deficiency anemia due to the reduced oxygen-carrying capacity of the blood.

Question 4

The maternal health nurse is caring for a pregnant client with obsessive-compulsive disorder (O C D). Which action will the nurse take when teaching the client, based on the client's psychological disorder?

Accepted Answer

Repeating instructions as needed helps accommodate the client's potential difficulty in processing information due to OCD, ensuring they understand the necessary information.

Question 5

A 26-year-old client is 26 weeks pregnant. Her previous births include two large-for-gestational-age babies and one unexplained stillbirth. Which tests would the nurse anticipate as being most definitive in diagnosing gestational diabetes?

Accepted Answer

The 100g, 3-hour glucose tolerance test is the most definitive in diagnosing gestational diabetes, especially in a patient with risk factors such as a history of large-for-gestational-age babies and an unexplained stillbirth. This test provides detailed information on how the body processes glucose over a period, which is crucial for an accurate diagnosis.

Question 6

During the history, the client admits to being H I V-positive and says she knows that she is about 16 weeks pregnant. Which statements made by the client indicate an understanding of the plan of care both during the pregnancy and postpartally?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Accepted Answer

Zidovudine (ZDV) is administered intravenously during labor to reduce the risk of HIV transmission. After birth, the newborn is given ZDV for six weeks to further decrease the risk of transmission.

Question 7

A 21-year-old at 12 weeks' gestation with her first baby has known cardiac disease, class Ⅲ, as a result of childhood rheumatic fever. During a prenatal visit, the nurse reviews the signs of cardiac decompensation with her. The nurse will know that the client understands these signs and symptoms if she states that she would notify her doctor if she had which symptom?

Accepted Answer

A frequent cough can be a sign of cardiac decompensation, especially in someone with a history of cardiac disease. It may indicate fluid accumulation in the lungs due to the heart's decreased ability to pump effectively.

Question 8

Women with H I V should be evaluated and treated for other sexually transmitted infections and for what condition occurring more commonly in women with H I V?

Accepted Answer

The answer of Women with H I V should be...

Question 9

A woman is 32 weeks pregnant. She is H I V-positive but asymptomatic. The nurse knows that what would be important in managing her pregnancy and delivery?

Accepted Answer

Weekly non-stress testing beginning at 32 weeks' gestation is important to monitor the well-being of the fetus in an HIV-positive pregnant woman.

Question 10

The client with thalassemia intermedia has a hemoglobin level of 9.0. The nurse is preparing an education session for the client. Which statement should the nurse include?

Accepted Answer

Thalassemia intermedia patients often have iron overload due to increased intestinal iron absorption and possibly from frequent blood transfusions, making it important to avoid additional iron intake through supplements.

Question 11

The nurse is caring for a pregnant woman who admits to using cocaine and ecstasy on a regular basis. The client states, "Everybody knows that alcohol is bad during pregnancy, but what's the big deal about ecstasy?" What is the nurse's best response?

Accepted Answer

Ecstasy can cause hyperthermia (high fever) in the mother, which can lead to harm to the developing fetus.

Question 12

The client at 9 weeks' gestation has been told that her H I V test was positive. The client is very upset, and tells the nurse, "I didn't know I had H I V! What will this do to my baby?" The nurse knows teaching has been effective when the client makes which statement?

Accepted Answer

The correct statement is "My baby can get H I V during the pregnancy and through my breast milk." This is accurate because HIV can be transmitted from mother to child during pregnancy, childbirth, or breastfeeding.

Question 13

A 26-year-old client is 28 weeks pregnant. She has developed gestational diabetes. She is following a program of regular exercise, which includes walking, bicycling, and swimming. What instructions should be included in a teaching plan for this client?

Accepted Answer

Carrying hard candy or another form of simple sugar is important for individuals with gestational diabetes when exercising to quickly address any episodes of hypoglycemia (low blood sugar) that may occur during physical activity. This is a safety measure to ensure they can quickly increase their blood sugar levels if they start to feel symptoms of hypoglycemia.

Question 14

A woman's history and appearance suggest drug abuse. What is the nurse's best approach?

Accepted Answer

Directly asking the woman if she uses street drugs is the most straightforward and non-judgmental approach, allowing for open communication and accurate assessment.

Question 15

A woman asks her nurse what she can do before she begins trying to get pregnant to help her baby, as she is prone to anemia. What would the nurse correctly advise her to do?

Accepted Answer

Folic acid supplementation is recommended for women trying to conceive to help prevent neural tube defects in the baby.

Question 16

A client is at 12 weeks' gestation with her first baby. She has cardiac disease, class Ⅲ. She states that she had been taking sodium warfarin (Coumadin), but her physician changed her to heparin. She asks the nurse why this was done. What should the nurse's response be?

Accepted Answer

Heparin is preferred over warfarin (Coumadin) during pregnancy because it does not cross the placenta, making it safer for the developing fetus. Warfarin can cause birth defects and other problems.

Question 17

A pregnant woman is married to an intravenous drug user. She had a negative H I V screening test just after missing her first menstrual period. What would indicate that the client needs to be retested for H I V?

Accepted Answer

Persistent candidiasis can indicate an immunocompromised state, such as an HIV infection, especially in the context of a high-risk partner.

Question 18

A 20-year-old woman is at 28 weeks' gestation. Her prenatal history reveals past drug abuse, and urine screening indicates that she has recently used heroin. The nurse should recognize that the woman is at increased risk for which condition?

Accepted Answer

The answer of A 20-year-old woman is at 28 weeks'...

Question 19

The client at 20 weeks' gestation has had an ultrasound that revealed a neural tube defect in her fetus. The client's hemoglobin level is 8.5. The nurse should include which statement when discussing these findings with the client?

Accepted Answer

Neural tube defects are associated with inadequate folic acid intake during pregnancy. Taking a folic acid supplement is recommended to reduce the risk of such defects.

Question 20

The nurse is doing preconception counseling with a 28-year-old woman with no prior pregnancies. Which statement made by the client indicates to the nurse that the client has understood the teaching?

Accepted Answer

Alcohol can harm a developing fetus, so it's recommended to stop drinking when trying to conceive to avoid any potential risks to the baby. Alcohol can affect the baby even before a woman knows she's pregnant.

Quiz 17: Pregnancy at Risk: Pregestational Problems