Ascent Mid Flashcards
Rina has an Rh-negative blood type. Her electronic record shows she had a previous miscarriage at 16 weeks into her last pregnancy. What medication should the nurse check of what she received
following her miscarriage to minimize isoimmunization.
A) Packed RBC transfusion
B) RhIG
C) Ferrous sulfate
D) Misoprostol
RhIG
Hana is brought to the hospital and admitted with a diagnosis
of hyperemesis gravidarum. She is 28 weeks pregnant. Which
is the priority nursing intervention, until the hyperemesis can be
resolved?
A) Increase vitamin and iron intake
B) Decrease gastrointestinal hypermotility
C) Maintain hydration and electrolyte levels
D) Encourage unlimited visitors
Maintain hydration and electrolyte levels
A client, G2 P1001, telephones the gynecology office complaining of left-sided pain. Which of the following questions by the triage nurse would help to determine whether the one-sided pain is due to an ectopic pregnancy
A. “When was the first day of your last menstrual period?”
B. “How old were you when you first got your period?”
C. “When did you have your pregnancy test done?”
D. “Did you have any complications with your first pregnancy?”
“When was the first day of your last menstrual period”
A 25-year-old client is admitted with the following history: 12
weeks pregnant, vaginal bleeding, no fetal heartbeat seen on ultrasound. The nurse would expect the doctor to write an order to prepare the client for which of the following?
A. Nonstress testing.
B. Cervical cerclage.
C. Dilation and curettage.
D. Amniocentesis
Dilatation and Curettage
A client, 12 weeks of gestation, comes to the prenatal clinic complaining of severe nausea and frequent vomiting the nurse suspect
hyperemesis gravidarum. Which of the following manifestation is
frequently associated with this type of condition?
A) Slowed secretion of free hydrochloric acid
B) Excessive amniotic fluid
C) High levels of human chorionic gonadotropin
D) A GI history of cholecystitis
High levels of chorionic gonadotropin
Nausea and vomiting that continues past the first trimester and is
severe in nature is termed
A) Toxoplasmosis
B) Toxemia of pregnancy
C) Morning sickness
D) Hyperemesis gravidarum
Hyperemesis gravidarum
A few hours after being admitted with a diagnosis of inevitable abortion, a client begins to experience bearing-down sensations and suddenly expels the products of conception in bed. To give safe nursing care, the nurse should first:
A) Immediately notify the physician
B) Give her the sedation ordered
C) Check the fundus for firmness
D) Take her immediately to the DR
Immediately notify the physician
client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected and the nurse instructs the client regarding management of care. Which statement if made by the client indicated a need for furthers instructions?
A) “I will maintain strict bed rest throughout the remainder of the pregnancy.”
B) “I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding.”
C) “I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad.”
D) “I will watch for the evidence of the passage of tissue.”
“I will maintain strict bed rest throughout the remainder of the
pregnancy”
To which of the following nursing diagnosis should the nurse assign highest priority for the client with hyperemesis gravidarum?
A. Risk for fatigue
B. Altered health maintenance
C. Risk for infection
D. Potential fluid volume deficit
Potential fluid volume deficit
A nurse is caring for a 25-year-old client who has just had a spontaneous first trimester abortion. Which of the following comments by the nurse is appropriate?
A. “It is probably better this way.”
B. “I’m here to talk if you would like.”
C. “You can try again very soon.”
D. “At least you weren’t very far along.”
“I’m here to talk if you would like.”
Ester a 27 y/o who is in her early trimester with OB score of G2P0
was admitted due to abdominal pain and spotting. She ask the
nurse “What did I do wrong that time”, what is the best response
of the nurse?
A. Avoid sexual intercourse.
B. Early miscarriage is largely not preventable because of abnormal chromosome formation and poor uterine implantation.
C. Avoid cigarette smoking
D. Avoid alcohol intake
Early miscarriage is largely not preventable because of abnormal chromosome formation and poor uterine implantation.
A client comes into the labor and delivery suite stating that her membranes ruptured 5 hours ago and not having labor contractions. She wants to examine to see if she is dilating. She states that her baby has stopped moving, but she wants to return to work if she is not in labor. What will be the nurse priority action?
A. The client should be sent home to rest in a familiar environment until she is in true labor
B. Following a vaginal examination to check for dilation, the client will most likely be allowed to return to work until her contractions
are in a regular pattern.
C. The client will be routinely admitted because she will most likely develop a regular contraction pattern soon.
D. She should be evaluated for fetal heart rate and check for
prolapsed cord.
She should be evaluated for fetal heart rate and check for
prolapsed cord
Ms. Cruz is admitted to the ER complaining of a sharp lower right abdominal pain. During the nursing history, she reports that her last menstrual period was 7 weeks ago. A question the nurse would ask is:
A) “Are you experiencing any shoulder pain?”
B) “Can you feel a hard mass on your right side?”
C) “How many children do you have?”
D) “Have you ever been pregnant before?”
“Are you experiencing any shoulder pain?”
Myrna had a miscarriage when she was younger, after addressing her immediate psychosocial needs, the nurse identifies which nursing education is best for a woman who says she is miscarrying?
A. Save any clots or material passed for your health care provider to examine.
B. Continue light activity as usual because most spotting during pregnancy is harmless
C. Use tampon to put pressure on your cervix and stop the
bleeding
D. Lie down and remain on bed rest for 24 hours to stop the
bleeding.
Save any clots or material passed for your health care provider to examine.
What is the most appropriate nursing diagnosis for a client with a ruptured ectopic pregnancy would be?
A. Altered health maintenance
B. Fluid volume excess
C. Decreased cardiac output
D. Risk for infection
Decreased cardiac output
Absence of cessation of menstrual flow.
Abdominal pain during ovulation.
Painful menstruation.
Abnormally heavy menstrual flow greater than 80ml per menses.
Bleeding between menstrual periods
mittelschmerz
Amenorrhea
Metrorrhagia
Menorrhagia
Dysmenorrhea
Absence of cessation of menstrual flow. - Amenorrhea
Abdominal pain during ovulation. - mittelschmerz
Painful menstruation.
Abnormally heavy - Dysmenorrhea
menstrual flow greater than 80ml per menses. - Menorrhagia
Bleeding between menstrual periods - Metrorrhagia
client in the 28th week of gestation comes to the emergency department because she thinks that she’s in labor. To confirm the diagnosis of PRETERM LABOR, the nurse would expect the physical examinations to reveal:
A. irregular uterine contractions with no cervical dilation
B. regular uterine contractions with cervical dilation
C. painful contractions with no cervical dilation
D. irregular uterine contractions without cervical dilation
regular uterine contractions with cervical dilation
A client is admitted to the obstetrical unit at 36 weeks gestation. Which of the following symptoms would indicate a concealed
abruption placenta?
- Decreased fundal height
- A hard, board like abdomen
- A fetal heart rate of 180 bpm
- Painless, bright red vaginal bleeding
- A hard, board like abdomen
A sonogram shows Lorna who is beginning preterm labor, has a placenta previa. The nurse identifies which measure as the priority to ensure her safety?
- Keep her physically active to avoid a deep vein thrombosis.
- Keep her nothing by mouth (NPC) as she will need an emergency cesarean birth.
- Assess for vaginal bleeding and clear fluid leakage every shift.
- Perform a daily vaginal exam to assess the extent of the previa.
Assess for vaginal bleeding and clear fluid leakage every shift.
When assessing a pregnant client, which question should be
asked by the student nurse to rule out preterm labor in a client reporting back pain?
- Is the back pain worse when you urinate?
- Is the back pain coming and going at regular time intervals?
- Is the back pain constant?
- Is the back pain worse when you change positions?
Is the back pain coming and going at regular time intervals?
Which of the following statement is TRUE about abruptio placenta?
- Fetal distress is not common in this condition as it is in placenta previa.
- A marginal abruptio placenta occurs when the placenta is located near the edge of the cervical opening.
- Nursing interventions for this condition includes measuring the fundal height.
- This condition occurs due to an abnormal attachment of the
placenta in the uterus near or over the cervical opening.
Nursing interventions for this condition includes measuring the fundal height.
A 36 year old woman is 38 weeks pregnant, reports having dark red bleeding. The patient experienced abruptio placentae with her
last pregnancy at 29 weeks. What other signs and symptoms can present with abruptio placentae? SELECT ALL THAT APPLY
Decrease in fundal height
Tender uterus
Hard, rigid abdomen
Fetal distress
Abnormal fetal position
- Tender uterus
- Hard, rigid abdomen
- Fetal distress
Which drug is used to manage preterm labor by causing smooth muscle relaxation?
oxytocin
estrogen
prostaglandin
ritodrine
ritodrine
A woman, who is on her mid-pregnancy, has a routine ultrasound performed. The ultrasound shows that the placenta is located at the edge of the cervical opening. As the nurse you know that which of the following statement is FALSE about this finding?
- The placenta may move upward as the pregnancy progresses and needs to be re-evaluated with another ultrasound at about 32
weeks gestation. - This is known as marginal placenta previa.
- The patient will need to have a c-section and cannot deliver
vaginally. - The woman should report any bleeding immediately to the doctor.
The patient will need to have a c-section and cannot deliver
vaginally
A woman who is at 32 weeks gestation has had ruptured membranes for 26 hours. A nurse should assess the woman for which of the following manifestations?
Proteinuria
Dependent edema
Constipation
Elevated temperature
Elevated temperature
A nurse is assessing a pregnant client in the 2nd trimester of pregnancy who was admitted to the obstetrics unit with a suspected diagnosis of abruptio placentae. Which of the following assessment findings would the nurse expect to note if this condition is
present?
- Uterus is tender to palpate
- Painless, bright red vaginal bleeding
- Absence of abdominal pain
- A soft abdomen
Uterus is tender to palpate
Infection in the uterus may cause PROM and may also be a complication following PROM.
TRUE OR FALSE
True
Which of the following drugs is given to a patient in preterm labor to specifically prevent surfactant deficiency?
Magnesium
Corticosteroids
Terbutaline
Surfactant
Surfactant
PROM may occur if the uterus is over-stretched by malpresentation of the fetus, multiple pregnancy or excess amniotic fluid.
TRUE OR FALSE
True
What are the expected signs and symptoms are expected of
pregnant client with placenta previa? SELECT ALL THAT APPLY
- Painless bright red bleeding
- Hard, tender uterus
- Normal fetal heart rate
- Abnormal fetal position
- Abnormal fetal position
- Rigid abdomen
- Painless bright red bleeding
- Normal fetal heart rate
- Abnormal fetal position
- Abnormal fetal position
A pregnant woman arrives at the emergency room with abruptio placentae at 36 weeks’ gestation. She’s at risk for which of the following blood disorder?
- Disseminated intravascular coagulation (DIC).
-Thrombocytopenia
-Heparin-associated thrombosis and thrombocytopenia (HATT).
-Idiopathic thrombocytopenic purpura (ITP).
Disseminated intravascular coagulation (DIC)
