Question 1

What complication of delivery should the nurse expect with the birth of multiple fetuses?

Accepted Answer

Delivery of multiple fetuses is often complicated by loss of uterine tone. Oftentimes multiple fetuses are delivered by cesarean. An ectopic tendency would present before delivery. While it can be difficult to breastfeed multiple infants, this does not relate to the delivery.

Question 2

A patient in her second trimester of pregnancy arrives at the hospital complaining of bright red, painless vaginal bleeding. What condition should the nurse immediately suspect?

Accepted Answer

Placenta previa is a serious condition that consists of bright red painless vaginal bleeding occurring after 20 weeks of pregnancy. The major symptoms of abruptio placentae are severe abdominal pain and uterine rigidity.

Question 3

A patient with hyperemesis gravidarum asks the nurse what would have happened if she had not come to the hospital. What result is the best response by the nurse?

Accepted Answer

If untreated, hyperemesis gravidarum can result in maternal or fetal death.

Question 4

What is a major complication of gestational diabetes that affects the infant?

Accepted Answer

A result of gestational diabetes is neonatal hypoglycemia.

Question 5

A patient with a history of rheumatic heart disease is being admitted to the labor and delivery unit. To prevent further stress on the heart, what should the nurse anticipate to be ordered?

Accepted Answer

Oxygen is administered to increase blood oxygen saturation and decrease the stress on the heart. IV fluid administration is kept to a minimum to prevent fluid overload. The patient would be positioned in a semi-Fowler position to improve circulation. The patient should be encouraged to rest between contractions to conserve energy.

Question 6

A pregnant patient who has type 2 diabetes (NIDDM) may require insulin. Why is the insulin necessary?

Accepted Answer

Oral hypoglycemics are discontinued because of teratogenic effects.

Question 7

What should the nurse hope to identify by keeping a record of a patient's blood pressure during prenatal visits?

Accepted Answer

Blood pressure should be assessed routinely during pregnancy, because symptoms of gestational hypertension include hypertension.

Question 8

A 14-year-old pregnant adolescent arrives at the hospital in early labor. The nurse should recognize that the adolescent is at a greater risk for which problem?

Accepted Answer

There are several physiological concerns for pregnant adolescents, including cephalopelvic disproportion.

Question 9

What is the cause of gestational hypertension?

Accepted Answer

The cause of gestational hypertension is unknown.

Question 10

A patient is admitted to the hospital with hyperemesis gravidarum. The patient is malnourished and severely dehydrated. The care plan should be altered to include which interventions?

Accepted Answer

Medical treatment is aimed at meeting fluid and electrolyte replacement.

Question 11

How should twins who share a placenta and come from one fertilized ovum be identified?

Accepted Answer

Monozygotic twins, also known as identical twins, originate from one fertilized ovum and share a placenta. Monozygotic twins carry the same genetic code. Dizygotic twins are the result of two separate ova being fertilized at the same time.

Question 12

The nurse is assessing a "kick count" for a patient with gestational hypertension. What result should be a cause for concern?

Accepted Answer

A kick count of fewer than three per hour is considered serious and a cause for concern.

Question 13

A patient is admitted to the hospital with signs of an ectopic pregnancy. What should the plan of care include for the patient?

Accepted Answer

An ectopic implantation occurs somewhere outside the uterus and either resolves itself in a spontaneous abortion or requires surgical intervention.

Question 14

Why is the fetus dependent on the mother for glucose control?

Accepted Answer

Insulin will not cross the placenta, but high glucose levels do. Therefore, it is imperative that the mother control glucose levels.

Question 15

When discussing toxoplasmosis infection during pregnancy, what should the nurse caution the patient to avoid?

Accepted Answer

A pregnant woman should wear gloves whenever having contact with cat feces as this is a possible source of toxoplasmosis infection.

Question 16

A pregnant woman visits a clinic visit during her 21st week of pregnancy. The nurse identifies edema, hypertension, and proteinuria. What condition does the nurse suspect?

Accepted Answer

Gestational hypertension (GH), formerly referred to as pregnancy-induced hypertension (PIH), is a disease encountered during pregnancy or early in the puerperium, characterized by increasing hypertension, proteinuria, and generalized edema. These signs generally appear after the 20th week of pregnancy.

Question 17

A pregnant woman comes to the hospital 3 weeks before her estimated date of birth (EDB) complaining of severe pain and a rigid abdomen. What should the nurse immediately suspect as the cause of the pain?

Accepted Answer

The major symptoms of abruptio placentae are severe pain and a rigid abdomen. Placenta previa consists of painless bleeding. Appendicitis is not usually accompanied by a rigid abdomen. Symptoms of an ectopic pregnancy would usually occur in the first trimester.

Question 18

A patient presents with symptoms of abruptio placentae. To facilitate uterine-placental perfusion, in what position would the nurse place the patient?

Accepted Answer

A modified side-lying position facilitates uterine-placental perfusion.

Question 19

What symptom, no matter what stage of pregnancy, should be reported immediately?

Accepted Answer

Women should be instructed to contact their physician if any bleeding occurs during pregnancy.

Question 20

What percent of first-trimester pregnancies spontaneously abort?

Accepted Answer

It is estimated that 10% to 15% of first-trimester pregnancies end in spontaneous abortion.

Quiz 28: Care of the High-Risk Mother, Newborn, and Family with Special Needs