Question 1

A 33-year-old pregnant woman at 22 weeks' gestation is undergoing an amniocentesis to test for intrauterine growth restriction. Which condition may cause this concern?

Accepted Answer

Maternal diabetes can cause intrauterine growth restriction due to impaired placental function and fetal nutrient transport.

Question 2

The nurse is preparing a 38-year-old pregnant woman for an amniocentesis to determine if there are any congenital disorders or fetal abnormalities present. Which should the nurse consider before and during the testing?

Accepted Answer

Using an external fetal heart monitor is important to ensure the fetus is not in distress during the procedure.

Question 3

The birth attendant has ordered an ultrasound for a pregnant woman to determine the gestational age of the fetus. What other information may be obtained by this test? Select all that apply.

Accepted Answer

Ultrasound can determine the location of the placenta, the gender of the fetus, and the fetal head size. It does not directly measure oxygen supply, fetal heart rate related to activity, or detect neural tube defects.

Question 4

The birth attendant administers dinoprostone (Prostin E2) to a woman who is having a spontaneous abortion to expel the fetus. In which types of abortion would this drug be used? Select all that apply.

Accepted Answer

Dinoprostone is used to induce uterine contractions to help expel the fetus in cases of inevitable, incomplete, and missed abortions where the fetus or fetal tissue needs to be expelled from the uterus.

Question 5

A 25-year-old client has been diagnosed with a tubal pregnancy. Which factor predisposes a woman to this type of pregnancy? Select all that apply.

Accepted Answer

The answer of A 25-year-old client has been diagnosed with...

Question 6

The nurse is performing a physical assessment of a pregnant woman at 18 weeks' gestation and documents the following: vaginal bleeding, a uterus that is larger than expected for the weeks of pregnancy, anemia, excessive nausea and vomiting, and signs of pregnancy-induced hypertension. What complication is associated with these symptoms?

Accepted Answer

The symptoms described are characteristic of a hydatidiform mole (molar pregnancy), which is a type of gestational trophoblastic disease. It involves abnormal growth of trophoblasts, leading to a uterus that is larger than expected for gestational age, vaginal bleeding, excessive nausea and vomiting due to high levels of hCG, anemia, and can also be associated with early signs of pregnancy-induced hypertension.

Question 7

A pregnant woman is diagnosed with pregnancy-induced hypertension. Which condition characterizes this disorder?

Accepted Answer

Pregnancy-induced hypertension, also known as preeclampsia, is characterized by high blood pressure and often proteinuria, which is the presence of excess proteins in the urine.

Question 8

The nurse is assessing a pregnant woman who is in her third trimester and documents the following data: weight gain: 1 lb/week during 2nd and 3rd trimesters, 2+ proteinuria (0.3 g/L in 2-hour urine), BP: 150/95 mm Hg, edema in fingers, face, legs, feet, and hyperreflexia-no clonus. What condition is associated with this assessment data?

Accepted Answer

The assessment data is consistent with mild preeclampsia, which is characterized by weight gain of 1 lb/week during the 2nd and 3rd trimesters, proteinuria (0.3 g/L in 2-hour urine), BP of 150/95 mm Hg, and edema in fingers, face, legs, and feet.

Question 9

The HELLP syndrome indicates a potentially life-threatening complication of pregnancy-induced hypertension. Which finding represents a defining characteristic of this acronym?

Accepted Answer

HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count.

Question 10

A primipara client at 30 weeks of pregnancy is diagnosed with severe preeclampsia. What should the nurse keep in mind when caring for such a client?

Accepted Answer

The client with severe preeclampsia should be sedated and kept on bed rest to reduce the risk of seizures and to manage blood pressure.

Question 11

A pregnant woman at 4 weeks' gestation visits her primary care provider for a check-up to monitor her preexisting diabetes mellitus. Which fetal complications might occur because of this maternal condition? Select all that apply.

Accepted Answer

Preexisting diabetes in a pregnant woman can lead to several fetal complications, including congenital malformations due to high blood sugar levels during organ formation, macrosomia due to excess glucose leading to overgrowth, polyhydramnios due to fetal polyuria from high blood sugar, and an increased risk of preeclampsia or eclampsia in the mother, which can affect the fetus. Juvenile diabetes in the fetus (C) is not directly caused by maternal diabetes, and diabetes can actually increase the risk of a baby being larger than average rather than smaller (D).

Question 12

The nurse is assessing a pregnant woman with a history of malignant hypertension. Which teaching intervention is the priority for this client?

Accepted Answer

Avoiding activities that result in shortness of breath is crucial for a pregnant woman with malignant hypertension to prevent exacerbating her condition and to maintain both maternal and fetal well-being.

Question 13

The nurse delivering babies on an obstetrical unit checks the mother's blood type to assess for ABO incompatibility. Which client would be at risk for this hemolytic disease?

Accepted Answer

ABO incompatibility risk arises when the mother's blood type is different from the fetus's, particularly if the mother has type O or when the fetus has a blood type that includes antigens not present in the mother's blood. In option D, the mother is type A and the fetus is type AB, meaning the fetus has a B antigen which the mother lacks, potentially leading to ABO incompatibility.

Question 14

A pregnant client who is at term has painless vaginal bleeding and is diagnosed as having placenta previa. What are the predisposing factors for placenta previa?

Accepted Answer

Previous cesarean sections can lead to scarring in the uterus, which is a known risk factor for placenta previa.

Question 15

A nurse is caring for a client who had placenta previa delivery. Which is a nursing consideration for this client?

Accepted Answer

Placenta previa is a condition where the placenta covers the cervix, leading to a high risk of bleeding before or during delivery. Monitoring the client for hemorrhage is crucial due to the increased risk of bleeding associated with this condition.

Question 16

The nurse is caring for a client who is diagnosed with abruptio placentae based on the client's history, physical examination, and laboratory studies. What nursing interventions should be initiated immediately?

Accepted Answer

Abruptio placentae involves the premature separation of the placenta from the uterus, which can lead to bleeding and changes in the uterus. Observing the fundus for changes in shape or movement upward can indicate worsening of the condition, as it may suggest increasing uterine size due to concealed hemorrhage.

Question 17

The nurse explains to the student nurse what is meant by a client's diagnosis of placenta accreta. Which is a characteristic of this emergency situation?

Accepted Answer

Placenta accreta is a condition where the placenta attaches too deeply into the uterine wall and fails to detach and be expelled after childbirth, leading to potential severe bleeding and complications.

Question 18

The delivery nurse immediately takes action when a client experiences postpartum hemorrhage. Which symptom would the nurse report immediately?

Accepted Answer

A boggy uterus that does not respond to massage is a sign of postpartum hemorrhage and should be reported immediately.

Question 19

During a precipitous delivery, the client had a laceration, which the nurse documents as a second-degree laceration. What does a second-degree laceration indicate?

Accepted Answer

A second-degree laceration involves the perineal body and the deeper tissues, but does not extend to the anal sphincter or anal canal.

Question 20

A client delivers a child by breech presentation with both the feet as the presenting part. What type of breech presentation should the nurse document on the record?

Accepted Answer

In a footling breech presentation, one or both of the baby's feet point downward and will deliver before the rest of the body. This is the case described, where both feet are the presenting part.

Quiz 68: The High-Risk Newborn