Question 1

A client at 30 weeks' gestation is experiencing painless late vaginal bleeding. What should the nurse expect in the management of this client?

Accepted Answer

Painless late vaginal bleeding is a common symptom that signifies placenta previa or abruption. The nurse should monitor for blood loss, pain, and uterine contractibility. The assessment of blood pressure is important, but it is not directly related to this situation. Fetal heartbeat monitoring is important, but an internal monitor is not necessary for this situation. Limiting vaginal examinations to only one per 24-hour period is a standard care practice, but it is not specific to this situation.

Question 2

The nurse has received end of shift report in the high-risk maternity unit. Which client should the nurse see first?

Accepted Answer

C

Question 3

A client pregnant with twins asks if the pregnancy will be uncomplicated. How should the nurse respond to this client?

Accepted Answer

Spontaneously conceived twins are less likely to develop complications than are twins conceived with the use of fertility drugs.

Question 4

When caring for a client with oligohydramnios, on what should the nurse focus? Select all that apply.

Accepted Answer

The answer of When caring for a client with oligohydramnios,...

Question 5

A pregnant client diagnosed with hydramnios asks for more information about this health problem. What should the nurse include in this teaching? Select all that apply.

Accepted Answer

The answer of A pregnant client diagnosed with hydramnios asks...

Question 6

A pregnant client is scheduled for a transabdominal cerclage. What teaching information should the nurse prepare for this client? Select all that apply.

Accepted Answer

The answer of A pregnant client is scheduled for a...

Question 7

The home health nurse is visiting the home of a client who is 18 weeks pregnant with twins. Which nursing action is most important?

Accepted Answer

Teaching the client about foods that are good sources of protein is most important because adequate protein intake is crucial for the development of the fetuses and the health of the mother, especially in a twin pregnancy where nutritional needs are increased.

Question 8

The nurse is planning an educational program about disseminated intravascular coagulation (DIC) in pregnancy. What risk factors should the nurse include about this health problem? Select all that apply.

Accepted Answer

The nurse should include abruptio placentae and prolonged retention of a fetus after demise as risk factors for DIC in pregnancy. These conditions can cause significant tissue damage and release of procoagulant substances, leading to DIC. Multiparity, preterm labor, and diabetes mellitus are not specific risk factors for DIC in pregnancy.

Question 9

A client who weighed 60 kg before becoming pregnant with twins is having a routine prenatal examination at gestational week 24. What should be this client's weight in kilograms at this time? (Round to the nearest whole number.)

Accepted Answer

The answer of A client who weighed 60 kg before...

Question 10

A client with premature rupture of membranes received 4 g of magnesium sulfate at 1600 hours, followed by 2 g/hr beginning at 1700 hours. Birth occurred at 0130 hours. How many grams of magnesium sulfate did this client receive? Calculate to the nearest whole number.

Accepted Answer

The answer of A client with premature rupture of membranes...

Question 11

The nurse is caring for a client at 30 weeks' gestation who is experiencing preterm premature rupture of membranes (PPROM). Which statement indicates that the client needs additional teaching?

Accepted Answer

The statement "If I want to become pregnant again, I will have to plan on being on bed rest for the whole pregnancy" is incorrect and indicates that the client needs additional teaching. Bed rest is not always necessary in subsequent pregnancies following PPROM, and the client should be taught to discuss a plan of care with their healthcare provider. The other statements are true and indicate that the client has a good understanding of their condition.

Question 12

A multigravida client with suspected abruptio placentae is admitted in active labor. Which nursing diagnoses should the nurse identify as appropriate for this client? Select all that apply.

Accepted Answer

A multigravida client with suspected abruptio placentae in active labor is at risk for anxiety related to concern for own safety, fluid volume deficit related to hypovolemia, and altered tissue perfusion related to blood loss. Ineffective coping related to premature birth and knowledge deficit related to lack of information about inherited genetic defects are not pertinent nursing diagnoses in this scenario.

Question 13

The nurse is caring for the newborn of a client who received magnesium sulfate for preterm labor. Which fetal effects should the nurse attribute to the client's medication treatment? Select all that apply.

Accepted Answer

The answer of The nurse is caring for the newborn...

Question 14

The nurse selects the following diagram to instruct a pregnant client with placenta previa. What should the nurse specifically teach the client about this health problem?Shape_

Accepted Answer

The answer of The nurse selects the following diagram to...

Question 15

A pregnant client is diagnosed with cervical insufficiency. How should the nurse expect this client to explain symptoms of this condition?

Accepted Answer

Cervical insufficiency is painless and does not typically cause uterine contractions or labor. The cervix may begin to dilate or efface without the woman experiencing any pain or contractions.

Question 16

A client at 38 weeks' gestation is diagnosed with oligohydramnios. Which statement indicates that teaching has been effective?

Accepted Answer

Oligohydramnios, a condition characterized by low amniotic fluid, can increase the risk of complications during labor, necessitating prompt medical attention when labor begins.

Question 17

The clinical instructor reviews postoperative care of cerclage with a group of nursing students. Which student statement indicates the need for further information?

Accepted Answer

This statement is incorrect. If the client's amniotic sac is bulging, cerclage is contraindicated but the procedure can still be performed. Therefore, the nursing student needs further education on this topic.

Question 18

For which reason should the nurse suspect hydramnios in a pregnant client?

Accepted Answer

Hydramnios, also known as polyhydramnios, is a condition where the amount of amniotic fluid is excessive. One of the signs of this condition is a disproportionate increase in the fundal height of the uterus in relation to the gestational age of the fetus. Therefore, the nurse should suspect hydramnios if they observe this sign in the pregnant client. Option A (pregnancy with twins) is not a definitive sign of hydramnios, as the increased size of the uterus can be attributable to the presence of two fetuses rather than excess fluid. Option B (positive quadruple screen) is a test that assesses the risk of certain fetal anomalies and is not related to hydramnios. Option C (less amniotic fluid than normal for gestation) is a sign of oligohydramnios, not hydramnios.

Question 19

A pregnant client is diagnosed with central abruptio placentae. What can the nurse infer about the client's condition?

Accepted Answer

Central abruptio placentae involves the placenta detaching from the uterine wall, but the blood is often trapped between the placenta and the uterine wall, leading to concealed bleeding. This condition can be dangerous because the amount of blood loss is not immediately visible.

Question 20

The nurse is counseling a newly pregnant gravida 1 at 8 weeks' gestation with twins about the need for increased caloric intake. What should the nurse emphasize as being the minimum recommended intake?

Accepted Answer

The recommended caloric intake for a twin pregnancy is approximately 3500 kcal per day, with a minimum of 175 g of protein. This is necessary to support fetal growth and development, as well as maternal metabolic needs. Option A is too low, option B is slightly higher than the recommended intake, and option D is much higher than necessary and may lead to excessive maternal weight gain.

Quiz 20: Childbirth at Risk: Prelabor and Intrapartum Complications