EAQ Pregnancy, Labor, Childbirth, Postpartum - At Risk

Question 1

Answer 1

All the Above

Rational

Late-preterm infants are born between 34 0/7 weeks’ and 36 6/7 weeks’ gestation and are at increased risk for apnea, hyperbilirubinemia, feeding difficulties, and temperature instability. The late-preterm infant is not at risk for hyperglycemia but is instead at risk for hypoglycemia.

Question 2

Answer 2

D. Prolonged Labor

Rational

Prolonged labor is a factor that puts a client at risk for postpartum hemorrhage. This is because prolonged labor can lead to uterine atony, where the uterus fails to contract effectively after delivery, increasing the risk of excessive bleeding.

Question 3

Answer 3

D. Internal fetal scalp electrode

Rational

Internal fetal scalp electrode: This involves attaching an electrode to the baby’s scalp to monitor the heartbeat more accurately. It is invasive and creates a potential entry point for the virus, thereby increasing the risk of HIV transmission from mother to baby. Thus, it is usually avoided in HIV-positive clients.

Question 4

Answer 4

A,C,D,E

Rational

A. Diabetes: Pregnant individuals with diabetes need careful nutritional management to maintain stable blood sugar levels, which can pose a nutritional risk if not managed properly.

C. Adolescence: Teenage pregnancies carry nutritional risks due to the higher nutritional needs of adolescents, who are still growing themselves.

D. Use of tobacco: Smoking during pregnancy can affect nutrient absorption and increase the risk of nutritional deficiencies.

E. Frequent pregnancies: Having pregnancies close together can deplete nutritional reserves, leading to potential nutritional risks if adequate recovery time isn’t allowed between pregnancies.

Question 5

Answer 5

D. Hypoglycemia

Rational

A large-for-gestational-age (LGA) full-term infant is at increased risk for hypoglycemia. This is because these infants often have higher insulin levels due to increased glucose supply from the mother during pregnancy. After birth, the sudden drop in glucose supply, while insulin levels remain high, can lead to hypoglycemia. Monitoring and managing blood sugar levels are crucial for these infants.

Question 6

Answer 6

C. Legs extended

Rational

When swaddling, the positioning of an infant’s limbs is crucial to avoid injury. The method that can cause injury involves extending the legs. This is because extending the legs can lead to hip dysplasia or dislocation. Proper swaddling should allow the baby’s hips and knees to remain flexed and in a natural position to promote healthy hip development.

Question 7

Answer 7

All the above

Question 8

Answer 8

A,B,C,D

Rational

1. Language differences: Language barriers can prevent effective communication with healthcare providers, making it difficult for expectant mothers to receive appropriate care and understand medical advice.
2. Transportation barriers: Lack of transportation can prevent pregnant women, especially those in rural or underserved areas, from reaching healthcare facilities for prenatal care.
3. Lack of nurse practitioners: While the lack of nurse practitioners can limit healthcare availability, it is not as commonly cited as a barrier compared to others listed.
4. Lack of culturally sensitive care providers: Culturally insensitive care can discourage women from seeking care due to discomfort or mistrust, impacting their prenatal care access.

Question 9

Answer 9

B. Urinary tract infection

Rational

During pregnancy, the dilation of the renal pelves and ureters can lead to urinary stasis, which is a condition where urine flow is slowed or stopped. This stasis can increase the risk of urinary tract infections (UTIs) because bacteria can grow more easily in stagnant urine. Therefore, the pregnant client is at increased risk for UTIs due to the dilation of the renal pelves and ureters.

Question 10

Answer 10

C. Thromboembolic disease

Rational

Pregnant women are at a five-to-sixfold increased risk for thromboembolic disease. This is due to the hypercoagulable state that occurs during pregnancy, which is a natural adaptation to minimize bleeding during childbirth. This state increases the risk of blood clot formation, leading to conditions such as deep vein thrombosis (DVT) and pulmonary embolism (PE).

Question 11

Answer 11

A. Fetal Heart

Rational

After the rupture of membranes, the priority assessment is the fetal heart rate. This is crucial because the rupture of membranes can lead to cord prolapse or compression, which can affect the baby’s oxygen supply. Monitoring the fetal heart rate will help ensure the fetus is not in distress and allow for timely interventions if necessary.

Question 12

Answer 12

C. Staphylococcus aureus

Rational

Maternal mastitis is most commonly caused by the bacterium Staphylococcus aureus. This type of mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth, and redness. It often occurs in breastfeeding women due to bacteria entering the breast tissue through a cracked or sore nipple.

Question 13

Answer 13

D. Protecting her against extraneous stimuli.

Rational

For a client with severe preeclampsia, a primary concern is the prevention of seizures, which can be triggered by extraneous stimuli. Preeclampsia can lead to increased sensitivity to stimuli, including light and noise, which can exacerbate the condition and increase the risk of eclampsia (seizures). Therefore, protecting the client against extraneous stimuli is crucial.

Question 14

Answer 14

B. Applying sterile, moist nonadherent dressings to the sac

Rational

When caring for a newborn with a myelomeningocele, protecting the sac from infection and injury is a priority. Applying sterile, moist, nonadherent dressings to the sac is crucial to prevent it from drying out and to reduce the risk of infection. This is an essential part of immediate nursing care.

Question 15

Answer 15

A,B,C

Rational

Maternal complications associated with diabetes include preterm birth, hypertension, and cesarean birth. Placenta previa and placental abruption are not directly associated with diabetes.

Question 16

Answer 16

A. Pica

Rational

Anemia during pregnancy can be associated with pica, which is the craving and consumption of non-food substances like dirt, clay, or ice. These substances do not provide nutritional value and can interfere with the body’s ability to absorb essential nutrients, potentially worsening anemia.

While caffeine, alcohol, and artificial sweeteners can also pose risks during pregnancy, pica is specifically linked to anemia due to its impact on nutritional intake and absorption.

Question 17

Answer 17

A. Zinc

Rational

The nutritional deficiency in pregnant women that places the infant at risk for malformations of the central nervous system is actually folic acid deficiency, which is not listed in the options. However, if we consider the options provided, none of them directly relate to preventing central nervous system malformations. Folic acid, a B vitamin, is crucial for preventing neural tube defects.

That said, among the given choices, zinc is the closest option, as it plays a role in overall cellular growth and development, but it’s not as directly related to central nervous system malformations as folic acid.

Question 18

Answer 18

C. Cleft palate at 8 weeks’ gestation

Rational

The most critical period for the risk of malformations due to environmental teratogens is during organogenesis, which occurs in the first trimester of pregnancy. This is when the major organs are forming, and the embryo is most sensitive to external influences. For cleft palate, which is a result of incomplete fusion of the tissues forming the palate, the critical period is typically between 6 to 9 weeks of gestation. Thus, the cleft palate at 8 weeks’ gestation falls within this highly sensitive period, making it the correct choice.

Question 19

Answer 19

D. Has a history of multiple urinary tract infections

Rational

The risk factor that predisposes a woman to premature labor among the given options is a history of multiple urinary tract infections (UTIs). Recurrent UTIs can lead to inflammation and irritation, which may increase the risk of premature labor. The other options, such as being a primigravida (first-time pregnancy), having an android pelvis, or taking anticonvulsant medication, do not directly correlate with an increased risk of premature labor as strongly as recurrent UTIs do.

Question 20

Answer 20

D. No risk of infection

Rational

An external fetal monitor provides several benefits, but one of the key advantages is that it poses “No risk of infection.” Unlike internal fetal monitoring, which involves placing electrodes inside the uterus, external monitoring is non-invasive and does not penetrate the skin or the uterus, thus eliminating the risk of infection.