Chapter 20: High Risk Pregnancy Conditions Flashcards
What is the purpose of the classification system for heart disease in pregnant patients?
a) To evaluate the impact of cardiovascular disease on physical limitations and heart failure
b) To determine the necessity for surgical interventions during pregnancy
c) To establish whether cardiac disease was preexisting or pregnancy-induced
d) To categorize the risk of preterm delivery
a) To evaluate the impact of cardiovascular disease on physical limitations and heart failure
Rationale: The classification system assesses the extent of heart failure and the physical limitations caused by cardiovascular disease to guide clinical management.
Which classification describes a pregnant patient with symptoms of dyspnea or chest pain during activity but no symptoms at rest?
a) Class I
b) Class II
c) Class III
d) Class IV
b) Class II
Rationale: Class II heart disease is characterized by symptoms such as dyspnea or chest pain during ordinary activity, but the patient remains comfortable at rest.
What symptoms would be expected in a pregnant patient with Class IV heart disease?
a) Asymptomatic with no physical limitations
b) Symptoms only during vigorous physical activity
c) Symptoms during rest with severe limitations and angina
d) Symptoms during ordinary activity with no limitations at rest
c) Symptoms during rest with severe limitations and angina
Rationale: Class IV heart disease is the most severe, with symptoms such as dyspnea and angina occurring even at rest, causing significant physical limitations.
Which classification indicates the least severe form of heart disease in pregnant patients?
a) Class I
b) Class II
c) Class III
d) Class IV
a) Class I
Rationale: Class I heart disease is the least severe, with no symptoms, no physical limitations, and no evidence of cardiac disease during ordinary activity
Which of the following is true about Class III heart disease in pregnancy?
a) The patient has no symptoms during ordinary activity.
b) The patient experiences marked limitations and symptoms during normal activity but is comfortable at rest.
c) The patient has severe symptoms and angina even at rest.
d) The patient experiences dyspnea only during vigorous physical activity.
b) The patient experiences marked limitations and symptoms during normal activity but is comfortable at rest.
Rationale: Class III heart disease is marked by significant limitations, with symptoms such as dyspnea or chest pain occurring during normal activities, but the patient remains comfortable when resting.
A 28-year-old pregnant woman with a BMI of 32 kg/m² is seeking prenatal care. Which of the following complications is she at an increased risk for due to her obesity?
A) Gestational hypertension
B) Hyperthyroidism
C) Hypoglycemia
D) Anemia
A) Gestational hypertension
Rationale: Obesity during pregnancy increases the risk of gestational hypertension, preeclampsia, and other complications such as gestational diabetes and thromboembolism.
A nurse is educating a pregnant woman with obesity on the risks associated with excess weight gain during pregnancy. Which of the following outcomes is most strongly linked to excessive gestational weight gain?
A) Increased risk of childhood obesity in the offspring
B) Increased risk of gestational diabetes
C) Increased risk of cesarean birth
D) Lower incidence of preterm birth
A) Increased risk of childhood obesity in the offspring
Rationale: Excessive weight gain during pregnancy is strongly associated with an increased risk of childhood obesity in the offspring and postpartum weight retention for the mother.
A 32-year-old pregnant woman with obesity presents for her first prenatal visit. The nurse notes her BMI is 33 kg/m². Which of the following should the nurse emphasize during counseling?
A) Discontinuing exercise due to the increased risk of preterm birth
B) Avoiding physical activity to prevent excessive weight gain
C) Promoting gradual weight gain according to the recommended guidelines for her BMI
D) Advising weight loss during pregnancy to reduce risk of complications
C) Promoting gradual weight gain according to the recommended guidelines for her BMI
Rationale: The nurse should encourage the woman to follow the recommended weight gain guidelines for her BMI and emphasize the importance of gradual and controlled weight gain during pregnancy.
Which of the following pregnancy-related complications is most commonly associated with obesity?
A) Congenital anomalies
B) Hyperemesis gravidarum
C) Fetal macrosomia
D) Early pregnancy loss
C) Fetal macrosomia
Rationale: Obesity increases the risk of fetal macrosomia, which is a condition where the baby weighs over 4,000 g at birth.
A 35-year-old obese pregnant woman is at an increased risk for which of the following outcomes?
A) Higher rates of breastfeeding success
B) Increased risk of maternal mortality
C) Reduced risk of cesarean section
D) Decreased incidence of postpartum hemorrhage
B) Increased risk of maternal mortality
Rationale: Obesity during pregnancy increases the risk of maternal mortality due to complications such as preeclampsia, thromboembolism, and cesarean birth.
A nurse is providing care for an obese pregnant woman. Which of the following should the nurse include when discussing postpartum care?
A) Postpartum weight retention is a risk, and the woman should be encouraged to maintain a healthy diet and exercise plan
B) The woman should focus on strict calorie restriction to lose weight rapidly
C) The woman should avoid physical activity for at least six months postpartum
D) Weight loss is unnecessary if the woman exclusively breastfeeds
A) Postpartum weight retention is a risk, and the woman should be encouraged to maintain a healthy diet and exercise plan
Rationale: Postpartum weight retention is common among obese women, so encouraging a healthy diet and regular exercise plan is crucial for long-term health and preventing further weight gain.
Which of the following is an expected outcome for obese pregnant women who receive individualized nursing care and counseling regarding weight, diet, and exercise?
A) Reduced risk of fetal macrosomia and cesarean birth
B) Increased risk of preterm labor and birth
C) Lower incidence of gestational diabetes
D) Improved mental health and self-esteem
A) Reduced risk of fetal macrosomia and cesarean birth
Rationale: Individualized nursing care and counseling focusing on managing weight, diet, and exercise can reduce the risk of fetal macrosomia, cesarean birth, and other complications associated with obesity in pregnancy.
Which of the following is the most common harmful effect of heroin use during pregnancy?
A) Spontaneous abortion
B) Neonatal abstinence syndrome
C) Placental abruption
D) Fetal growth restriction
B) Neonatal abstinence syndrome
Rationale: Heroin use during pregnancy is most commonly associated with neonatal abstinence syndrome (NAS), which includes symptoms like irritability, vomiting, and seizures in the newborn.
Which of the following is a potential effect of nicotine use during pregnancy?
A) Neural tube defects
B) Hyperactivity in adulthood
C) Increased risk of uterine rupture
D) Increased risk of cleft lip and palate
D) Increased risk of cleft lip and palate
Rationale: Smoking during pregnancy increases the risk of cleft lip and palate in the newborn.
What effect does caffeine have on iron absorption during pregnancy?
A) Increases absorption of iron
B) No effect on iron absorption
C) Decreases absorption of iron
D) Increases iron deficiency anemia
C) Decreases absorption of iron
Rationale: Caffeine decreases iron absorption, which may increase the risk of anemia during pregnancy.
Which of the following substances is most commonly abused during pregnancy in the United States?
A) Heroin
B) Cocaine
C) Marijuana
D) Methamphetamine
D) Methamphetamine
What is the primary risk associated with smoking during pregnancy?
A) Increased risk of stillbirth
B) Fetal alcohol syndrome
C) Placenta previa
D) Neonatal abstinence syndrome
A) Increased risk of stillbirth
Rationale: Smoking during pregnancy significantly increases the risk of stillbirth.
Which of the following is a risk associated with maternal methamphetamine use during pregnancy?
A) Neural tube defects
B) Placental abruption
C) Increased amniotic fluid
D) Postpartum depression
B) Placental abruption
Rationale: Methamphetamine use during pregnancy is associated with an increased risk of placental abruption.
Which of the following drugs has been shown to reduce withdrawal symptoms in newborns exposed to narcotics in utero?
A) Naloxone
B) Buprenorphine
C) Methadone
D) Diazepam
C) Methadone
Rationale: Methadone maintenance therapy helps reduce withdrawal symptoms in newborns exposed to narcotics.
What condition is associated with neonatal exposure to marijuana?
A) Neonatal abstinence syndrome
B) Increased tremulousness and high-pitched cry
C) Low birth weight
D) Cognitive deficits
B) Increased tremulousness and high-pitched cry
Rationale: Infants exposed to marijuana in utero may show symptoms like increased tremulousness and a high-pitched cry.
Which of the following is a long-term consequence of smoking during pregnancy?
A) Increased risk of placental abruption
B) Behavioral problems in childhood
C) Increased risk of neural tube defects
D) Reduced maternal appetite
B) Behavioral problems in childhood
Rationale: Smoking during pregnancy increases the risk of childhood behavioral problems, such as ADHD and aggression.
Which substance is known to cause vasoconstriction during pregnancy and reduce blood flow to the fetus?
A) Marijuana
B) Caffeine
C) Alcohol
D) Nicotine
D) Nicotine
Rationale: Nicotine causes vasoconstriction, which reduces blood flow to the fetus, contributing to fetal hypoxia.
Which of the following substances is linked to increased risk of cognitive deficits, particularly in language and memory, in children exposed in utero?
A) Cocaine
B) Caffeine
C) Tobacco
D) Alcohol
C) Tobacco
Rationale: Tobacco use during pregnancy is linked to cognitive deficits in children, including language and memory issues.
What is a primary risk of using cocaine during pregnancy?
A) Low birth weight
B) Increased appetite
C) Increased risk of SIDS
D) Spontaneous abortion
A) Low birth weight
Rationale: Cocaine use during pregnancy increases the risk of low birth weight.
Which of the following is a possible long-term effect of prenatal methamphetamine exposure?
A) Decreased birth weight
B) Increased risk of intellectual disabilities
C) Increased risk of SIDS
D) Neonatal abstinence syndrome
B) Increased risk of intellectual disabilities
Rationale: Prenatal methamphetamine exposure is associated with an increased risk of developmental and intellectual disabilities.
Which of the following is a characteristic of babies exposed to opioids in utero?
A) Decreased irritability
B) High-pitched cry
C) Decreased sensitivity to pain
D) Improved muscle tone
B) High-pitched cry
Rationale: Babies exposed to opioids in utero often exhibit a high-pitched cry as part of neonatal abstinence syndrome (NAS).
Which of the following substances has been associated with an increased risk of cleft lip and palate in infants?
A) Marijuana
B) Caffeine
C) Nicotine
D) Alcohol
C) Nicotine
Rationale: Smoking during pregnancy increases the risk of cleft lip and palate.
What is the primary effect of opiate use during pregnancy on the fetus?
A) Preterm labor
B) Neonatal abstinence syndrome
C) Increased risk of neural tube defects
D) Increased risk of asthma
B) Neonatal abstinence syndrome
Rationale: Opiate use during pregnancy is primarily associated with neonatal abstinence syndrome (NAS) in newborns.
A pregnant woman presents to the clinic for her routine prenatal visit. She asks if it is safe to receive the live attenuated MMR vaccine during her pregnancy. Which of the following is the nurse’s best response?
A. “Yes, it is safe to receive the MMR vaccine during pregnancy.”
B. “The MMR vaccine is contraindicated during pregnancy due to the risk of fetal harm.”
C. “You should wait until after your baby is born to receive the MMR vaccine.”
D. “You should receive the MMR vaccine immediately, as it will protect both you and your baby.”
B. “The MMR vaccine is contraindicated during pregnancy due to the risk of fetal harm.”
Rationale: The MMR vaccine contains live viruses, which are contraindicated during pregnancy due to the potential risk of teratogenic effects on the fetus.
A pregnant woman in her first trimester is due for a flu shot. The nurse educates her on the importance of vaccination. Which of the following flu vaccines should be avoided during pregnancy?
A. Live attenuated influenza vaccine (LAIV)
B. Inactivated influenza vaccine (IIV)
C. Recombinant influenza vaccine (RIV)
D. Both IIV and RIV
A. Live attenuated influenza vaccine (LAIV)
Rationale: The live attenuated influenza vaccine (LAIV) should be avoided during pregnancy, especially in the first trimester, because it contains live viruses.
A pregnant woman asks if she should receive the varicella vaccine during her pregnancy. Which response is most appropriate?
A. “You should receive the varicella vaccine immediately to protect both you and your baby.”
B. “The varicella vaccine is safe during pregnancy and recommended if you have not had chickenpox.”
C. “You should wait until after delivery to receive the varicella vaccine.
D. “You should avoid the varicella vaccine during pregnancy, as it is a live vaccine.”
D. “You should avoid the varicella vaccine during pregnancy, as it is a live vaccine.”
Rationale: The varicella vaccine is a live vaccine and is contraindicated during pregnancy due to potential teratogenic effects on the fetus.
A pregnant woman in her second trimester asks about receiving the yellow fever vaccine for travel purposes. What is the nurse’s best response?
A. “The yellow fever vaccine is safe to take during pregnancy.”
B. “The yellow fever vaccine is contraindicated during pregnancy, unless travel is essential.”
C. “You should receive the yellow fever vaccine before becoming pregnant.”
D. “The yellow fever vaccine can be safely administered in any trimester.”
B. “The yellow fever vaccine is contraindicated during pregnancy, unless travel is essential.”
Rationale: The yellow fever vaccine is a live vaccine and is contraindicated during pregnancy due to potential harm to the fetus. It should only be given if absolutely necessary.
Which of the following vaccines should be administered during pregnancy to protect both the mother and fetus?
A. Live attenuated influenza vaccine (LAIV)
B. Measles, mumps, and rubella (MMR)
C. Tetanus, diphtheria, and acellular pertussis (Tdap)
D. Varicella
C. Tetanus, diphtheria, and acellular pertussis (Tdap)
Rationale: The Tdap vaccine is recommended during pregnancy to protect the newborn from pertussis (whooping cough) and is safe during pregnancy, typically administered between 27 and 36 weeks of gestation.
A pregnant woman comes into the clinic asking about the hepatitis A vaccine. She is concerned about contracting the virus during her pregnancy. Which of the following statements by the nurse is most appropriate?
A. “The hepatitis A vaccine is safe during pregnancy and should be given as soon as possible.”
B. “The hepatitis A vaccine is a live vaccine and should be avoided during pregnancy.”
C. “The hepatitis A vaccine is safe and recommended only if you are at high risk for exposure.”
D. “You should delay the hepatitis A vaccine until after you give birth.”
C. “The hepatitis A vaccine is safe and recommended only if you are at high risk for exposure.”
Rationale: The hepatitis A vaccine is considered safe during pregnancy, but it is typically only recommended for women at high risk of exposure.
A woman in her first trimester asks about the HPV vaccine. Which statement by the nurse is correct?
A. “The HPV vaccine is safe during pregnancy, and you should get vaccinated as soon as possible.”
B. “The HPV vaccine is a live vaccine and should be avoided during pregnancy.”
C. “The HPV vaccine is not recommended during pregnancy, but it is safe if needed.”
D. “You should delay the HPV vaccine until after your baby is born.”
D. “You should delay the HPV vaccine until after your baby is born.”
Rationale: The HPV vaccine is not recommended during pregnancy. If a woman becomes pregnant after starting the vaccination series, she should delay the remaining doses until after delivery.
