MCHN QUIZLET Flashcards
1
Q
A 42-year-old is at the clinic for her first prenatal visit. The nurse is doing the initial assessment and is aware that the woman is at risk for
A. Having a spontaneous abortion prior to 12 weeks
B. Having a sexually transmitted disease
C. Developing abnormalities of the reproductive organs
D. Not obtaining adequate prenatal care
A
A. Having a spontaneous abortion prior to 12 weeks
2
Q
When comparing threatened abortion to inevitable abortion, inevitable abortion has
A. increased cramping
B. increased nausea
C. cervical dilation
D. lower levels of beta-human chorionic gonadotropin
A
C. cervical dilation
3
Q
A woman is seeing her primary physician for complaints of frequent nosebleeds. She states she thought she was pregnant about 3 months ago, but her periods started and the symptoms disappeared. The health care provider should be alert for what complication of a missed abortion?
A. infection
B. infertility
C. disseminated intravascular coagulation
D. thrombocytopenia
A
C. disseminated intravascular coagulation
4
Q
When doing an initial assessment on a newly diagnosed pregnant woman, she tells the nurse, “In my younger days, I did some stupid things and had different types of STDs and once had a pelvic inflammatory disease.” The nurse is aware that the woman is at risk for
A. more STDS
B. preeclampsia
C. ectopic pregnancy
D. gestational diabetes
A
C. ectopic pregnancy
5
Q
A woman has been admitted to the birthing unit with a diagnosis of spontaneous abortion. She has increased bleeding and is having her pads weighed to estimate the blood loss. The weight of an unused pad is 1.5 grams, the pads used between 7 AM and 9 AM weigh 4.5, 6.5, 10, 15, and 11.5 grams. What is the estimated blood loss?
A. 20 ml
B. 40 ml
C. 60 ml
D. unable to determine with information provided
A
B. 40 ml
6
Q
When taking an initial prenatal history on a woman, she admitted to cocaine use during the early days of the pregnancy. The nurse is aware that this would put her at risk for
A. placenta previa
B. abruptio placentae
C. large for gestational age baby
D. both a and b
A
D. both a and b
7
Q
A woman is admitted with a diagnosis of hyperemesis gravidarum. The nurse is assessing for deficient fluid and signs of dehydration. (Choose all that apply.)
A. decreased urinary output
B. urine specific gravity of 1.015
C. nonelastic skin turgor
D. constipation
A
A. decreased urinary output
C. nonelastic skin turgor
D. constipation
8
Q
A woman with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is
A. tocolytic
B. anticonvulsant
C. antihypertensive
D. diuretic
A
B. anticonvulsant
9
Q
What is the only known cure for preeclampsia?
A. magnesium sulfate
B. antihypertensive medications
C. delivery of the fetus
D. administration of ASA every day of the pregnancy
A
C. delivery of the fetus
10
Q
The classic sign of placenta previa is the sudden onset of _____ uterine bleeding in the latter half of pregnancy.
A
painless
11
Q
choose the primary distinction between threatened and inevitable abortion
A. presence of cramping
B. rupture of membranes
C. vaginal bleeding
D. pelvic pressure
A
B. rupture of membranes
12
Q
a woman is admitted to the ED with a possible ectopic pregnancy. choose the sign/ symptom that should be immediately reported to her physician
A. low level of B-hGC
B. hemoglobin of 11.5; hematocrit of 34%
C. light vaginal bleeding
D. pulse increase from 78 to 100
A
D. pulse increase from 78 to 100
13
Q
when caring for the woman who has hydatidiform mole evacuated, the clinic nurse should primarily:
A. reinforce the need to delay a new pregnancy for 1 year
B. ask the woman whether she has any cramping or bleeding
C. observe return of her blood pressure to normal
D. palpate the uterus for return to its normal size
A
A. reinforce the need to delay a new pregnancy for 1 year
14
Q
the woman who is receiving methotrexate for an ectopic pregnancy should be cautioned to avoid:
A. driving or operating machinery
B. eating raw vegetables or fruits
C. using latex condoms for intercourse
D. taking vitamins with folic acid
A
D. taking vitamins with folic acid
15
Q
a woman who is 34 weeks pregnant is admitted with contractions every 2 minutes, lasting 60 second and high uterine resting tone. she says she had some vaginal bleeding at home and there is a small amount on her perineal pad. the priority action of the nurse is to:
A. establish whether she is in labor by performing a vaginal examination
B. ask her whether she has had recent intercourse or vaginal examination
C. evaluate the maternal and fetal circulation and oxygen
D. determine whether this is the first episode of pain she has had
A
C. evaluate the maternal and fetal circulation and oxygen
16
Q
nursing teaching for the woman who has hyperemesis gravidarum should include;
A. adding favorite seasonings to foods while cooking
B. eating simple foods such as breads and fruits
C. lying down on the right side after eating
D. eating creamed soup with every meal
A
B. eating simple foods such as breads and fruits
17
Q
the nurse makes the following assessments on a woman who is receiving IV magnesium sulfate:
FHR: 148-158 bpm
HR: 88 bpm
RR: 10 breaths per min
BPL: 158/96
The priority nursing action is to:
A. increase rate of magnesium
B. maintain the rate of the magnesium
C. slow the rate of the magnesium
D. stop the magnesium
A
D. stop the magnesium
18
Q
when providing intrapartal care for the woman with severe preeclampsia, priority nursing care is to:
A. maintain the ordered rate of anticonvulsant medications
B. promote placental blood flow and prevent maternal injury
C. give IV fluids and observe urine output
D. reduce the maternal blood pressure to the prepregnancy level
A
B. promote placental blood flow and prevent maternal injury
19
Q
clonus indicates that the:
A: CNS is very irritable
B. renal blood flow is severely reduced
C. lungs are filling with interstitial fluid
D. muscles of the foot are inflamed
A
A: CNS is very irritable
20
Q
the feature that distinguishes preeclampsia from eclampsia is:
A. amount of blood pressure elevation
B. edema of the face and fingers
C. presence of proteinuria
D. onset of convulsions
A
D. onset of convulsions
21
Q
which woman should receive RhoGAM?
A. Rh neg mother; Rh pos infant; pos direct Coombs test
B. Rh pos mother; Rh neg infant; neg direct Coombs test
C. Rh neg mother; Rh pos infant; neg direct Coombs test
D. Rh pos mother; Rh pos infant; pos direct Coombs test
A
C. Rh neg mother; Rh pos infant; neg direct Coombs test
22
Q
Choose the primary distinction between threatened and inevitable abortion.
a. Presence of cramping
b. Rupture of membranes
c. Vaginal bleeding
d. Pelvic pressure
A
b. Rupture of membranes
23
Q
A woman is admitted to the emergency department with a possible ectopic pregnancy. Choose the sign or symptom that should be immediately reported to her physician.
a. Low level of beta-hCG (human chorionic gonadotropin)
b. Hemoglobin level, 11.5 g/dL; hematocrit level, 34%
c. Light vaginal bleeding
d. Pulse rate increases from 78 to 112 beats per minute (bpm)
A
d. Pulse rate increases from 78 to 112 beats per minute (bpm)
24
Q
When caring for a woman who has had gestational trophoblastic tissue evacuated, the clinic nurse’s priority intervention is to:
a. Reinforce the need to delay a new pregnancy for 1 year.
b. Ask the woman whether she has any cramping or bleeding.
c. Observe return of her blood pressure to normal.
d. Palpate the uterus for return to its normal size.
A
a. Reinforce the need to delay a new pregnancy for 1 year.
25
The woman who is receiving methotrexate for an ectopic pregnancy should be cautioned to avoid:
a. Driving or operating machinery.
b. Eating raw vegetables or fruits.
c. Using latex condoms for intercourse.
d. Taking vitamins with folic acid.
d. Taking vitamins with folic acid.
26
A woman who is 34 weeks pregnant is admitted with contractions every 2 minutes, lasting 60 seconds, and a high uterine resting tone. She says she had some vaginal bleeding at home, and there is a small amount of blood on her perineal pad. The priority action of the nurse is to:
a. Establish whether she is in labor by performing a vaginal examination.
b. Ask her whether she has had recent intercourse or a vaginal examination.
c. Evaluate the maternal and fetal circulation and oxygenation.
d. Determine whether this is the first episode of pain that she has had.
c. Evaluate the maternal and fetal circulation and oxygenation.
27
Nursing teaching for the woman who has hyperemesis gravidarum should include which of the following?
a. Adding favorite seasonings to foods while cooking
b. Eating simple foods, such as breads and fruits
c. Lying down on her right side after eating d. Eating creamed soup with every meal
b. Eating simple foods, such as breads and fruits
28
The nurse makes the following assessments of a woman who is receiving intravenous magnesium sulfate: fetal heart rate (FHR), 148 to 158 bpm; pulse, 88 bpm; respirations, 9 breaths/min; blood pressure, 158/96 mm Hg. The woman is drowsy. The priority nursing action is to:
a. Increase the rate of the magnesium infusion.
b. Maintain the magnesium infusion at the current rate.
c. Slow the rate of the magnesium infusion.
d. Stop the magnesium infusion.
d. Stop the magnesium infusion.
29
When providing intrapartum care for the woman with severe preeclampsia, priority nursing care is to:
a. Maintain the ordered rate of anticonvulsant medications.
b. Promote placental blood flow
and prevent maternal injury.
c. Give intravenous fluids and observe urine output.
d. Reduce maternal blood pressure to the pregnancy level.
b. Promote placental blood flow
and prevent maternal injury.
30
Clonus indicates which of the following?
a. The central nervous system is very irritable.
b. Renal blood flow is severely reduced.
c. Lungs are filling with interstitial fluid
d. Muscles of the foot are inflamed.
a. The central nervous system is very irritable.
31
The feature that distinguishes preeclampsia from eclampsia is the:
a. Amount of blood pressure elevation.
b. Edema of the face and fingers.
c. Presence of 41 proteinuria.
d. Onset of one or more seizures.
d. Onset of one or more seizures.
32
Which woman should receive Rho(D) immune globulin after birth?
a. Rh-negative mother, Rh-positive infant, positive direct Coombs' test
b. Rh-positive mother, Rh-negative infant, negative direct Coombs' test
c. Rh-negative mother, Rh-positive infant, negative direct Coombs' test
d. Rh-positive mother, Rh-positive infant, positive direct Coombs' test
c. Rh-negative mother, Rh-positive infant, negative direct Coombs' test
33
The nursing student doing a clinical obstetrics rotation correctly picks which term to label a pregnancy that continues past the end of the 42nd week of gestation?
a. Term pregnancy
b. Post-term pregnancy
c. Preterm pregnancy
d. Full term pregnancy
b. Post-term pregnancy
34
A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client's history, which information would the nurse expect to find?
a. Preterm pregnancy
b. Small BMI for mother
c. Maternal rickets
d. Gestational diabetes
d. Gestational diabetes
35
A multigravida client at 31 weeks gestation is admitted with confirmed preterm labor. As the nurse continues to monitor the client now receiving magnesium sulfate, which assessment findings will the nurse prioritize and report immediately to the provider?
a. Low potassium, elevated glucose, tachycardia, chest pain
b. Respiratory depression, hypotension, absent tendon reflexes
c. Severe lower back pain, leg cramps, sweating
d. Abdominal pain, back pain
b. Respiratory depression, hypotension, absent tendon reflexes
36
Hypertonic labor is labor characterized by short, irregular contractions without complete relaxation of the uterine wall in between contractions. Hypertonic labor can be caused by an increased sensitivity to oxytocin. What would the nurse do for a client who is in hypertonic labor because of oxytocin augmentation?
a. Increase oxytocin
b. Turn off oxytocin
c. Increase methotrexate
d. Turn off methotrexate
b. Turn off oxytocin
37
A woman in active labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly, the woman grabs the nurse's hand and states "something inside me is tearing." The nurse notes her BP is 80/50 mmHg, pulse is 130 bpm and weak, skin is cool and clammy and the fetal monitor shows bradycardia. The nurse suspects the client may be experiencing which complication?
a. Compression on the inferior vena cava
b. Amniotic embolism to the lungs
c. Undiagnosed abdominal aorta aneurysm
d. Uterine rupture
d. Uterine rupture
38
When educating a post-term mother in the clinic, what should the nurse be sure to include to prevent fetal complications?
a. Increase fluid intake to prevent fetal complications
b. Be sure to measure 24-hour urine output daily
c. Be sure to monitor fetal movements daily
d. Monitor bowel movements
c. Be sure to monitor fetal movements daily
39
A G3P2 woman at 39 weeks gestation presents highly agitated, reporting something "came out" when her membranes just ruptured. Which action should the nurse prioritize after noting the umbilical cord is hanging out of the vagina?
a. Put her in bed immediately, call for help and hold the presenting part off the cord
b. With the woman in lithotomy position, hold her legs and sharply flex them toward her shoulders
c. Go find the provider to care for patient
d. Prep the woman for emergent vaginal birth
a. Put her in bed immediately, call for help and hold the presenting part off the cord
40
A client is experiencing shoulder dystocia during birth. The nurse would place priority on performing which assessment post-birth?
a. Extensive lacerations
b. Monitor for cardiac anomaly
c. Assess for cleft palate
d. Brachial plexus assessment
d. Brachial plexus assessment
41
A woman is admitted through the emergency department with a medical diagnosis of ruptured ectopic pregnancy. The primary nursing diagnosis at this time is:
a. Acute pain related to irritation of the peritoneum with blood
b. Risk for infection related to tissue trauma
c. Deficient fluid volume related to blood loss associated with rupture of the uterine tube
d. Anticipatory grieving related to unexpected pregnancy outcome
c. Deficient fluid volume related to blood loss associated with rupture of the uterine tube
42
A pregnant woman at 32 weeks of gestation comes to the emergency department because she has begun to experience bright red vaginal bleeding. She reports that she has no pain. The admission nurse suspects that the woman is experiencing:
a. Abruptio placentae
b. Disseminated intravascular coagulation
c. Placenta previa
d. Preterm labor
c. Placenta previa
43
A pregnant woman at 38 weeks of gestation and diagnosed with marginal placenta previa has just given birth to a healthy newborn male. The nurse recognizes that the immediate focus for the care of this woman is:
a. Preventing hemorrhage
b. Relieving acute pain
c. Preventing infection
d. Fostering attachment of the woman with her new son
a. Preventing hemorrhage
44
The nurse should recognize that a complication of pregnancy associated with the intravenous use of cocaine is:
a. Prolonged, difficult labor
b. Premature separation of the placenta
c. Increased risk for vaginal and urinary tract infections
d. Severe fetal/neonatal central nervous system (CNS) depression
b. Premature separation of the placenta
45
A nurse is caring for a pregnant woman at 30 weeks of gestation in preterm labor. The woman's physician orders betamethasone 12 mg IM for two doses, with the first dose to begin at 11 am. In implementing this order the nurse should:
a. Consult the physician, because the dose is too high
b. Explain to the woman that this medication will reduce her heart rate and help her to breathe easier
c. Prepare to administer the medication intravenously between contractions
d. Schedule the second dose for 11 am on the next day
d. Schedule the second dose for 11 am on the next day
46
__14. Abruptio placentae
__15. Hydramnios
__16. Placenta accreta
__17. Shoulder dystocia
__18. Tocolytic
a. Delayed or difficult birth of the shoulders after the head has emerged
b. Premature separation of a normally implanted placenta
c. Excessive volume of amniotic fluid
d. Placenta that is abnormally adherent to the uterine muscle
e. Medication to stop preterm or hypertonic labor contractions
B 14. Abruptio placentae
C 15. Hydramnios
D 16. Placenta accreta
A 17. Shoulder dystocia
E 18. Tocolytic
47
The best way for the nurse to evaluate the quality of a pregnant adolescent's diet is to:
a. ask her how well she eats in a non-threatening manner.
b. assume it is inadequate and give her advice.
c. ask her to describe what she ate the previous day.
d. have her record everything she eats for 1 week
d. have her record everything she eats for 1 week
48
Correct advice for women who ask about using alcohol during pregnancy is that it is:
a. safest if taken during the last trimester.
b. best to avoid consumption during the first 12 weeks.
c. unknown if there is any fetal harm from its use.
d. important to avoid it entirely throughout pregnancy.
d. important to avoid it entirely throughout pregnancy.
49
Choose the primary distinction between a threatened and inevitable abortion.
a. Presence of cramping
b. Rupture of membranes
c. Vaginal bleeding
d. Pelvic pressure
b. Rupture of membranes
50
When caring for a woman who had a hydatidiform mole evacuated, the clinic nurse should primarily:
a. reinforce the need to delay a new pregnancy for 1 year.
b. ask the woman whether she has any cramping or bleeding.
c. observe the return of her blood pressure to normal.
d. palpate the uterus for the return to its normal size.
a. reinforce the need to delay a new pregnancy for 1 year.
51
The feature that distinguishes preeclampsia from eclampsia is the:
a. amount of blood pressure elevation.
b. edema of the face and fingers.
c. presence of proteinuria
d. onset of generalized seizures.
d. onset of generalized seizures
52
The nurse is caring for a patient diagnosed with HELLP syndrome. The nurse knows that the hypertension disorder is characterized by the following (select all that apply):
a. Elevated liver enzymes
b. Elevated white blood cells
c. Low platelet count
d. Low creatinine levels
e. Hemolysis of red blood cells
a. Elevated liver enzymes
c. Low platelet count
e. Hemolysis of red blood cells
53
A cervical cerclage is a treatment for:
a. Hydatidiform mole
b. Placenta accreta
c. Cervical incompetency
d. Cervical cancer
c. Cervical incompetency
54
The best treatment for a woman in labor with a positive group B streptococcus (GBS) status would be to
a. Give betamethasone
b. Give antibiotic (ampicillin/ penicillin)
c. Start on intravenous Pitocin
d. Give the rubella vaccine
b. Give antibiotic (ampicillin/ penicillin)
55
Cigarette smoking during pregnancy is associated with a higher rate of this in the newborn.
a. Large for gestational age infant
b. Diarrhea
c. Sudden infant death syndrome
d. Colic
c. Sudden infant death syndrome
56
The nurse in a birthing room is monitoring a client with dysfunctional labor for signs of fetal or maternal compromise. Which assessment finding should alert the nurse to a compromise?
a. Spontaneous rupture of membranes
b. Coordinated uterine contractions
c. Progressive changes in the cervix
d. Persistent non-reassuring fetal heart rate
d. Persistent non-reassuring fetal heart rate
57
The nurse has created a plan of care for a client experiencing dystocia and includes several nursing actions in the plan of care. What is the priority nursing action?
a. Providing comfort measures
b. Monitoring the fetal heart rate
c. Changing the client's position frequently
d. Keeping the significant other informed of the progress of the labor
b. Monitoring the fetal heart rate
58
The home care nurse visits a pregnant client who has a diagnosis of preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the primary health care provider (PHCP)?
a. Urinary output has increased
b. Dependent edema has resolved.
c. Blood pressure reading is at the prenatal baseline.
d. The client complains of a headache and blurred vision.
d. The client complains of a headache and blurred vision.
59
A stillborn baby was delivered in the birthing suite a few hours ago. After the delivery, the family remained together, holding and touching the baby. Which statement by the nurse would assist the family in their period of grief?
a. "What can I do for you?"
b. "Now you have an angel in heaven."
c. "Don't worry, there is nothing you could have done to prevent this from happening."
d. "We will see to it that you have an early discharge so that you don't have to be reminded of this experience."
a. "What can I do for you?"
60
The nurse is performing an assessment on a pregnant client in the last trimester with a diagnosis of preeclampsia. The nurse reviews the assessment findings and determines that which finding is most closely associated with a complication of this diagnosis?
a. Enlargement of the breasts
b. Complaints of feeling hot when the room is cool
c. Periods of fetal movement followed by quiet periods
d. Evidence of bleeding, such as in the gums, petechiae, and purpura
d. Evidence of bleeding, such as in the gums, petechiae, and purpura
61
The nurse is assessing a pregnant client with type 1 diabetes mellitus about her understanding regarding changing insulin needs during pregnancy. The nurse determines that further teaching is needed if the client makes which statement?
a. "I will need to increase my insulin dosage during the first 3 months of pregnancy."
b. "My insulin dose will likely need to be increased during the second and third trimesters."
c. "Episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy."
d. "My insulin needs should return to pre-pregnant levels within 7 to 10 days after birth if I am bottle-feeding."
a. "I will need to increase my insulin dosage during the first 3 months of pregnancy."
62
The nurse is assessing a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which assessment finding should the nurse expect to note if this condition is present?
a. Soft abdomen
b. Uterine tenderness
c. Absence of abdominal pain
d. Painless, bright red vaginal bleeding
b. Uterine tenderness
63
The maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the primary health care provider's prescriptions and should question which prescription?
a. Prepare the client for an ultrasound.
b. Obtain equipment for a manual pelvic examination.
c. Prepare to draw a hemoglobin and hematocrit blood sample.
d. Obtain equipment for external electronic fetal heart rate monitoring.
b. Obtain equipment for a manual pelvic examination.
64
Which of the following women should receive RhoGAM postpartum?
a) Nonsensitized Rh-negative mother with an Rh-negative newborn
b) Nonsensitized Rh-negative mother with an Rh-positive newborn
c) Sensitized Rh-negative mother with an Rh-positive newborn
d) Sensitized Rh-negative mother with an Rh-negative newborn
b) Nonsensitized Rh-negative mother with an Rh-positive newborn
65
A woman is suspected of having abruptio placentae. Which of the following would the nurse expect to assess as a classic symptom?
a) Painless, bright-red bleeding
b) "Knife-like" abdominal pain
c) Excessive nausea and vomiting
d) Hypertension and headache
b) "Knife-like" abdominal pain
66
RhoGAM is given to Rh-negative women to prevent maternal sensitization. In addition to pregnancy, Rh-negative women would also receive this medication after which of the following?
a) Therapeutic or spontaneous abortion
b) Head injury from a car accident
c) Blood transfusion after a hemorrhage
d) Unsuccessful artificial insemination procedure
a) Therapeutic or spontaneous abortion
67
After teaching a woman about hyperemesis gravidarum and how it differs from the typical nausea and vomiting of pregnancy, which statement by the woman indicates that the teaching was successful?
a) "I can expect the nausea to last through my second trimester."
b) "I should drink fluids with my meals instead of in between them."
c) "I need to avoid strong odors, perfumes, or flavors."
d) "I should lie down after I eat for about 2 hours."
c) "I need to avoid strong odors, perfumes, or flavors."
68
A pregnant woman, approximately 12 weeks' gestation, comes to the emergency department after calling her health care provider's office and reporting moderate vaginal bleeding. Assessment reveals cervical dilation and moderately strong abdominal cramps. She reports that she has passed some tissue with the bleeding. The nurse interprets these findings to suggest which of the following?
a) Threatened abortion
b) Inevitable abortion
c) Incomplete abortion
d) Missed abortion
b) Inevitable abortion
69
A woman is being discharged after receiving treatment for a hydatidiform molar pregnancy. The nurse should include which of the following in her discharge teaching?
a) Do not become pregnant for at least a year; use contraceptives to prevent it
b) Have the client's blood
pressure checked weekly in the clinic
c) RhoGAM must be given within the next month to her at the clinic
d) An amniocentesis can detect a recurrence of this disorder in the future
a) Do not become pregnant for at least a year; use contraceptives to prevent it
70
When administering magnesium sulfate to a client with preeclampsia, the nurse explains to her that this drug is given to:
a) Reduce blood pressure
b) Increase the progress of labor
c) Prevent seizures
d) Lower blood glucose levels
c) Prevent seizures
71
Which of the following would the nurse include when teaching a pregnant woman about the pathophysiologic mechanisms associated with gestational diabetes?
a) Pregnancy fosters the development of carbohydrate cravings.
b) There is progressive resistance to the effects of insulin.
c) Hypoinsulinemia develops early in the first trimester.
d) Glucose levels decrease to accommodate fetal growth.
b) There is progressive resistance to the effects of insulin.
72
When providing prenatal education to a pregnant woman with asthma, which of the following would be important for the nurse to do?
a) Explain that she should avoid steroids during her pregnancy.
b) Demonstrate how to assess her blood glucose levels.
c) Teach correct administration of subcutaneous bronchodilators.
d) Ensure she seeks treatment for any acute exacerbation.
d) Ensure she seeks treatment for any acute exacerbation.
73
Which of the following conditions would most likely cause a pregnant woman with type 1 diabetes the greatest difficulty during her pregnancy?
a) Placenta previa
b) Hyperemesis gravidarum
c) Abruptio placentae
d) Rh incompatibility
b) Hyperemesis gravidarum
74
Women who drink alcohol during pregnancy:
a) Often produce more alcohol dehydrogenase.
b) Usually become intoxicated faster than before.
c) Can give birth to an infant with fetal alcohol spectrum disorder.
d) Gain fewer pounds throughout the gestation.
c) Can give birth to an infant with fetal alcohol spectrum disorder.
75
When explaining to a pregnant woman about HIV infection and transmission, which of the following would the nurse include?
a) It primarily occurs when there is a large viral load in the blood.
b) HIV is most commonly transmitted via sexual contact.
c) It affects the majority of infants of mothers with HIV infection.
d) Nurses are most frequently affected due to needle sticks.
b) HIV is most commonly transmitted via sexual contact.
76
Women who are obese have a greater risk of developing which of the following during pregnancy?
a) Type 1 diabetes
b) Hypotension
c) Low birth weight infant
d) Gestational hypertension
d) Gestational hypertension
77
Maintenance on methadone or buprenorphine is the most common medical treatment for which of the following drug addictions?
a) Alcohol
b) Nicotine
c) Opiates
d) Marijuana
c) Opiates
78
When reviewing the medical record of a client, the nurse notes that the woman has a condition in which the fetus cannot physically pass through the maternal pelvis. The nurse interprets this as:
a) Cervical insufficiency
b) Contracted pelvis
c) Maternal disproportion
d) Fetopelvic disproportion
d) Fetopelvic disproportion
79
The nurse would anticipate a cesarean birth for a client who has which active infection present at the onset of labor?
a) Hepatitis
b) Herpes simplex virus
c) Toxoplasmosis
d) Human papillomavirus
b) Herpes simplex virus
80
After a vaginal examination, the nurse determines that the client's fetus is in an occiput posterior position. The nurse would anticipate that the client will have:
a) Intense back pain
b) Frequent leg cramps
c) Nausea and vomiting
d) A precipitous birth
a) Intense back pain
81
When assessing the following women, which would the nurse identify as being at the greatest risk for preterm labor?
a) Woman who had twins in a previous pregnancy
b) Client living in a large city close to the subway
c) Woman working full time as a computer programmer
d) Client with a history of a previous preterm birth
d) Client with a history of a previous preterm birth
82
The rationale for using a prostaglandin gel for a client prior to the induction of labor is to:
a) Stimulate uterine contractions
b) Numb cervical pain receptors
c) Prevent cervical lacerations
d) Soften and efface the cervix
d) Soften and efface the cervix
83
A client who was in active labor and whose cervix had dilated to 4 cm experiences a weakening in the intensity and frequency of her contractions and exhibits no further progress in labor. The nurse interprets this as a sign of:
a) Hypertonic labor
b) Precipitate labor
c) Hypotonic labor
d) Dysfunctional labor
c) Hypotonic labor
84
The nurse is developing a plan of care for a woman experiencing dystocia. Which of the following nursing interventions would be the nurse's high priority?
a) Changing the woman's position frequently
b) Providing comfort measures to the woman
c) Monitoring the fetal heart rate patterns
d) Keeping the couple informed of the labor progress
c) Monitoring the fetal heart rate patterns
85
The nurse is caring for a woman experiencing hypertonic uterine dystocia. The woman's contractions are erratic in their frequency, duration, and of high intensity. The priority nursing intervention would be to:
a) Encourage ambulation every 30 minutes
b) Provide pain relief measures
c) Monitor the Pitocin infusion rate closely
d) Prepare the woman for an amniotomy
b) Provide pain relief measures
86
Which information on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy?
A. recurrent pelvic infections
B. use of oral contraceptives for 5 years
C. ovarian cyst 2 years ago
D. heavy, irregular menses
A. recurrent pelvic infections
87
A woman pregnant with twins comes to the clinic for an evaluation. The nurse closely assesses the client for which potential problem?
A. preeclampsia
B. oligohydramnios
C. chorioamnionitis
D. post-term labor
A. preeclampsia
88
A nurse is conducting an assessment of a woman who has experienced PROM. Which finding would lead the nurse to suspect infection as the cause of a client's PROM?
A. foul odor
B. ferning
C. yellow-green fluid
D. blue color on Nitrazine testing
A. foul odor
89
A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which findings would lead the nurse to suspect that the woman is developing an infection? Select all that apply.
A. abdominal tenderness
B. elevated maternal pulse rate
C. cloudy malodorous fluid
D. decreased C-reactive protein levels
E. fetal bradycardia
A. abdominal tenderness
B. elevated maternal pulse rate
C. cloudy malodorous fluid
90
After teaching a group of nurses working at the women's health clinic about the impact of pregnancy on the older woman, which statement by the group indicates that the teaching was successful?
A. "Women over age 35 and are pregnant have an increased risk for spontaneous abortions."
B. "The majority of women who become pregnant over age 35 experience complications."
C. "Women over the age of 35 who become pregnant require a specialized type of assessment."
D. "Women over age 35 are more likely to have a substance use disorder."
A. "Women over age 35 and are pregnant have an increased risk for spontaneous abortions."
91
A nurse is conducting an in-service presentation to a group of perinatal nurses about sexually transmitted infections and their effect on pregnancy. The nurse determines that the teaching was successful when the group identifies which two infections as being responsible for ophthalmia neonatorum? Choose two.
A. gonorrhea
B. syphilis
C. chlamydia
D. HPV
A. gonorrhea
C. chlamydia
92
After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse determines that the teaching was successful when the woman identifies which foods as being good sources of iron in her diet? Select all that apply.
A. dried fruits
B. peanut butter
C. meats
D. white bread
E. milk
A. dried fruits
B. peanut butter
C. meats
93
A nurse is providing care to several pregnant women at different weeks of gestation. The nurse would expect to screen for group B streptococcus infection in the client who is at:
A. 36 weeks' gestation.
B. 32 weeks' gestation.
C. 28 weeks' gestation.
D. 16 weeks' gestation.
A. 36 weeks' gestation
94
The nurse would be alert for possible placental abruption during labor when assessment reveals which finding?
A. gestational hypertension
B. macrosomia
C. gestational diabetes
D. low parity
A. gestational hypertension
95
The nurse would be alert for possible placental abruption during labor when assessment reveals which finding?
A. gestational hypertension
B. macrosomia
C. gestational diabetes
D. low parity
A. gestational hypertension
96
A nurse is reviewing the medical record of a pregnant client. The nurse suspects that the client may be at risk for dystocia based on which factors? Select all that apply.
A. short maternal stature
B. plan for pudendal block anesthetic use
C. multiparity
D. maternal age over 35
E. breech fetal presentation
A. short maternal stature
D. maternal age over 35
E. breech fetal presentation
97
A woman with a history of crack cocaine use disorder is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also reports acute abdominal pain that is continuous. Which condition would the nurse suspect?
A. uterine rupture
B. amniotic fluid embolism
C. shoulder dystocia
D. umbilical cord prolapse
A. uterine rupture
98
A nurse is conducting an in-service program for a group of labor and birth unit nurses about cesarean birth. The group demonstrates understanding of the information when they identify which conditions as absolute indications? Select all that apply.
A. active genital herpes infection
B. placenta previa
C. fetal distress
D. prolonged labor
A. active genital herpes infection
B. placenta previa
C. fetal distress
99
The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours. Why would the nurse do this?
A. Pulmonary edema
B. Pulmonary hypertension
C. Pulmonary emboli
D. Pulmonary atelectasis
A. Pulmonary edema
100
A woman at 8 weeks' gestation is admitted for ectopic pregnancy.
She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy?
A. use of IUD for contraception
B. high number of pregnancies
C. multiple gestation pregnancy
D. use of oral contraceptives
A. use of IUD for contraception
101
The nurse is preparing the plan of care for a woman hospitalized for hyperemesis gravidarum. Which interventions would the nurse most likely include? Select all that apply.
A. maintaining NPO status for the first day or two
B. preparing the woman for insertion of a feeding tube
C. administering antiemetic agents
D. obtaining baseline blood electrolyte levels
E. monitoring intake and output
A. maintaining NPO status for the first day or two
C. administering antiemetic agents
D. obtaining baseline blood electrolyte levels
E. monitoring intake and output
102
A pregnant client is admitted to a health care unit with disseminated intravascular coagulation (DIC). Which prescription is the nurse most likely to receive regarding the therapy for such a client?
A. Administer cryoprecipitate and platelets
B. Administer a ratio of 1 unit of blood to 4 units of frozen plasma.
C. Aim at keeping the client's hematocrit above 20%.
D. Give each unit of blood to raise the hematocrit by 3 g/dL.
A. Administer cryoprecipitate and platelets
103
A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply.
A. hemolysis
B. elevated liver enzymes
C. low platelet count
D. hyperthermia
E. leukocytosis
A. hemolysis
B. elevated liver enzymes
C. low platelet count
104
During a routine prenatal visit, a client is found to have proteinuria and a blood pressure rise to 140/90 mm Hg. The nurse recognizes that the client has which condition?
A. mild preeclampsia
B. gestational hypertension
C. severe preeclampsia
D. eclampsia
A. mild preeclampsia
105
After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between abruptio placentae and placenta previa. Which statement should the nurse include in the teaching?
A. "Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placentae is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor."
B. "Placenta previa causes painful, dark red bleeding during pregnancy due to an abnormally implanted placentae that is too close to or covers the cervix; abruptio placenta is associated with bright red painless bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor."
C. "Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the fundus; abruptio placentae is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor."
D. "Placenta previa causes painful, dark red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the fundus; abruptio placentae is associated with right red painless bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor."
A. "Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placentae is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor."
106
When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in the client's pulse. What should the nurse do next?
A. Assess the client's temperature.
B. Monitor the client for preterm labor.
C. Assess for cord compression.
D. Monitor the fetus for respiratory distress.
A. Assess the client's temperature.
