Question 1

The nurse is assessing a woman at 10 weeks' gestation who is addicted to alcohol. The woman asks the nurse, "What is the point of stopping drinking now if my baby probably has been hurt by it already?" What is the best response by the nurse?

Accepted Answer

Stopping alcohol consumption at any point during pregnancy can still have a positive impact on the health of the baby. By stopping now, the woman can reduce the risk of further harm to her developing fetus and increase the chances of having a healthy pregnancy. It is important for the nurse to encourage the woman to stop drinking and provide support and resources for her to do so.

Question 2

A diabetic patient goes into labor at 36 weeks' gestation. Provided that tests for fetal lung maturity are successful, the nurse will anticipate:

Accepted Answer

C,D

Question 3

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

Accepted Answer

Babies born to mothers with well-controlled type 1 diabetes tend to be larger than average at birth. This is because the extra glucose in the mother's blood crosses the placenta, leading the baby to have high insulin levels, which can make the baby grow larger.

Question 4

The patient with insulin-dependent type 2 diabetes and an HbA1c of

Accepted Answer

The patient should be advised that insulin needs usually decrease in the first trimester and increase during the third trimester due to the hormonal changes that occur during pregnancy. It is important for the patient to monitor her blood glucose levels closely, adjust her insulin regimen as needed, and work closely with her healthcare team to ensure optimal blood glucose control during pregnancy.

Question 5

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

Accepted Answer

The correct statement regarding alcohol use during preconception and pregnancy is to stop drinking alcohol completely when trying to get pregnant. This is due to the risk of fetal alcohol syndrome and other negative health effects on the developing fetus. Choices A, C, and D are incorrect and show a lack of understanding of the risks associated with alcohol use during preconception and pregnancy.

Question 6

A woman asks her nurse what she can do before she begins trying to get pregnant to help her baby, since she is prone to anemia. The nurse correctly advises her to:

Accepted Answer

Folic acid is recommended for all women of childbearing age, but especially for those who are prone to anemia, as it helps prevent neural tube defects in the developing fetus. It is important for the woman to begin taking folic acid supplements daily before she becomes pregnant, as neural tube defects occur in the first few weeks of pregnancy, often before a woman even knows she is pregnant. Iron supplementation is also important for women who are prone to anemia, but this should be started before pregnancy as well. Having a hemoglobin baseline done is also a good idea, but not the most important recommendation in this case. Adding more carbohydrates to the diet is not specifically related to anemia or prenatal care.

Question 7

A woman is 32 weeks pregnant. She is HIV-positive but asymptomatic. What would be important in managing her pregnancy and delivery?

Accepted Answer

Weekly nonstress testing beginning at 32 weeks' gestation is important to monitor the well-being of the fetus in a high-risk pregnancy such as one complicated by maternal HIV infection.

Question 8

During the history, the patient admits to being HIV-positive and says she knows that she is about 16 weeks pregnant. Which statements made by the patient indicate an understanding of the plan of care both during the pregnancy and postpartally?

Accepted Answer

Both statements A and C show understanding of the plan of care during and after pregnancy. Statement B is incorrect as the dose of zidovudine (AZT) does not need to be doubled after delivery. Statement D is incorrect as the baby's zidovudine (AZT) is given orally, not in cream form. Statement E is incorrect as the baby will still need zidovudine (AZT) after delivery, even if the mother took it during pregnancy.

Question 9

The patient has just been diagnosed as diabetic. The nurse knows teaching was effective when the patient says:

Accepted Answer

Option D is correct because it correctly identifies that frequent hunger may be caused by the inability of sugar to get into the tissues as it should in diabetes. Option A is incorrect because ketones in the urine indicate that the body is using fat for energy instead of glucose, which can happen in uncontrolled diabetes. Option B is incorrect because frequent and excessive urination is a symptom of diabetes, not a recommended method of getting rid of excess sugar. Option C is incorrect because in diabetes, either the pancreas doesn't produce enough insulin or the body doesn't use it properly, so simply stating that the pancreas is making enough insulin is not accurate.

Question 10

A 26-year-old multigravida 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 patient?

Accepted Answer

Carrying hard candy or another form of simple sugar is important for individuals with gestational diabetes who are exercising. This is because physical activity can lower blood sugar levels, potentially leading to hypoglycemia (low blood sugar). Having a quick source of sugar available can help address sudden drops in blood sugar levels during or after exercise.

Question 11

A patient with type 1 diabetes is receiving preconception counseling. The nurse will emphasize that during the first trimester, the woman might experience:

Accepted Answer

During the first trimester, many women with type 1 diabetes experience a decrease in insulin requirements due to hormonal changes and the physiological effects of pregnancy on glucose metabolism.

Question 12

The nurse is working with a woman who abuses stimulants. The nurse is aware that the fetus is at risk for:

Accepted Answer

Stimulant use during pregnancy can lead to withdrawal symptoms, cardiac anomalies, sudden infant death syndrome, and being small for gestational age in the fetus.

Question 13

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

Accepted Answer

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

Question 14

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

Accepted Answer

The question does not provide any specific indication related to HIV retesting based on the given options. All the options (A, B, C) describe symptoms or conditions that can be associated with pregnancy but do not directly indicate a need for HIV retesting. HIV retesting might be considered due to the husband's risk factor as an intravenous drug user, but none of the provided options directly suggest retesting for HIV based on the medical conditions described.

Question 15

A 26-year-old multipara 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

A 100g, 3-hour glucose tolerance test is the most definitive test in diagnosing gestational diabetes, especially for a patient with a history of large-for-gestational-age babies and a previous stillbirth. This test evaluates the body's ability to use glucose over a longer period of time and provides more accurate results than the other options. Choice A is an initial screening test that may require further testing if abnormal. Choice B checks only the fasting glucose level and may miss postprandial hyperglycemia. Choice C is an older, less common test that may not provide enough information for diagnosis.

Question 16

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

Accepted Answer

Option B correctly explains that a positive HIV test during pregnancy does not necessarily mean the baby is infected. However, the baby may have anti-HIV antibodies due to passive transfer from the mother. It is important for HIV-positive pregnant women to take medications to control the virus to prevent mother-to-child transmission.Option A is incorrect because antiretroviral medications can be used during pregnancy to reduce the risk of mother-to-child transmission. Option C is incorrect because pregnancy does not increase the progression of HIV disease or reduce the CD4 counts. Option D is incorrect because HIV-positive pregnant women require additional testing and monitoring throughout the pregnancy to reduce the risk of mother-to-child transmission.

Question 17

The clinic nurse is teaching a pregnant patient about her iron supplement. Information in the teaching plan includes:

Accepted Answer

Iron supplements can cause constipation, so a stool softener might be needed. Starting with a low dose and gradually increasing it can help minimize gastrointestinal side effects. Iron absorption is better on an empty stomach, so taking it with meals can reduce its effectiveness.

Question 18

A woman's history and appearance suggest drug abuse. The nurse's best approach would be to:

Accepted Answer

Directly asking about street drug use is a straightforward approach that can help in assessing the situation accurately and providing appropriate care or referrals.

Question 19

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:

Accepted Answer

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

Question 20

The nurse has written the nursing diagnosis Risk for Injury for a diabetic pregnant patient. Interventions for this diagnosis include:

Accepted Answer

The answer of The nurse has written the nursing diagnosis...

Quiz 19: Pregnancy at Risk: Pregestational Problems