Practice Q's Flashcards
A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes, dark red vaginal bleeding, and a tense, painful abdomen. Which clinical change does the nurse anticipate?
- Eclamptic Seizure
- Rupture of the uterus
- Placenta Previa
- Placental Abruption
Placental Abruption
Which statement best describes chronic hypertension?
- Chronic hypertension is defined as hypertension that begins during pregnancy and lasts for the duration of the pregnancy
- Chronic hypertension is considered severe when the systolic BP is higher than 140 mmHg or the diastolic BP is higher than 90 mmHg
- Chronic hypertension is general hypertension plus proteinuria
- Chronic hypertension can occur independently of or simultaneously with preeclampsia
Chronic hypertension can occur independently of or simultaneously with preeclampsia
Which client exhibits the greatest number of risk factors associated with the development of preeclampsia?
- 30-year-old obese Caucasian with her third pregnancy
- 41-year-old Caucasian primigravida
- 19-year-old African American who is pregnant with twins
- 25-year-old African American whose pregnancy is the result of donor insemination
19-year-old African American who is pregnant with twins
AA ethnicity, younger in age, multiple pregnancy
Which neonatal complications are associated with hypertension in the mother?
- Intrauterine growth restriction (IUGR) and prematurity
- Seizures and cerebral hemorrhage
- Hepatic or renal dysfunction
- Placental abruption and DIC
Intrauterine growth restriction (IUGR) and prematurity
The nurse has evaluated a client with preeclampsia by assessing deep tendon reflexes (DTRs). The result is a grade of 3+. Which DTR response most accurately describes this score?
- Sluggish or diminished
- Brisk, hyperactive, with intermittent or transient clonus
- Active or expected response
- More brisk than expected, slightly hyperactive
More brisk than expected, slightly hyperactive
The client being cared for has severe preeclampsia and is receiving a magnesium sulfate infusion. Which new finding would give the nurse cause for concern?
- Sleepy, sedated affect
- Respiratory rate of 10 breaths per minute
- Deep tendon reflexes (DTRs) of 2+
- Absent ankle clonus
Respiratory rate of 10 breaths per minute
A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic procedure will the client most likely have performed?
- Amniocentesis for fetal lung maturity
- Transvaginal ultrasound for placental location
- Contraction stress test (CST)
- Internal fetal monitoring
Transvaginal ultrasound for placental location
A woman arrives for evaluation of signs and symptoms that include a missed period, adnexal fullness, tenderness, and dark red vaginal bleeding. On examination, the nurse notices an ecchymotic blueness around the woman’s umbilicus. What does this finding indicate?
- Normal integumentary changes associated with pregnancy
- Turner sign associated with appendicitis
- Cullen sign associated with a ruptured ectopic pregnancy
- Chadwick sign associated with early pregnancy
Cullen sign associated with a ruptured ectopic pregnancy
A woman who is 30 weeks of gestation arrives at the hospital with bleeding. Which differential diagnosis would not be applicable for this client?
- Placenta previa
- Abruption placentae
- Spontaneous abortion
- Cord insertion
Spontaneous abortion
Which maternal condition always necessitates delivery by cesarean birth?
- Marginal placenta previa
- Complete placenta previa
- Ectopic pregnancy
- Eclampsia
Complete placenta previa
What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy?
- Assessing fetal heart rate (FHR) and maternal vital signs
- Performing a venipuncture for hemoglobin and hematocrit levels
- Placing clean disposable pads to collect any drainage
- Monitoring uterine contractions
Assessing fetal heart rate (FHR) and maternal vital signs
A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Which information assists the nurse in developing the plan of care?
- Bed rest and analgesics are the recommended treatment
- She will be unable to conceive in the future
- A D&C will be performed to remove the products of conceptions
- Hemorrhage is the primary concern
Hemorrhage is the primary concern
Screening at 24 weeks of gestation reveals that a pregnant woman is experiencing gestational diabetes mellitus (GDM). In planning her care, the nurse and the client mutually agree that an expected outcome is to prevent injury to the fetus because of GDM. This fetus is at the greatest risk for which condition?
- Macrosomia
- Congenital anomalies of the CNS
- Preterm birth
- Low birth weight
Macrosomia
To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet?
- Eat six small equal meals per day
- Reduce the carbohydrates in her diet
- Eat her meals and snacks on a fixed schedule
- Increase her consumption of protein
Eat her meals and snacks on a fixed schedule
During a prenatal visit, the nurse is explaining dietary management to a woman diagnosed with pre-gestational diabetes. Which statement by the client reassures the nurse that teaching has been effective?
- I will need to eat 600 more calories per day because I am pregnant
- I can continue with the same diet as before pregnancy as long as it is well balances
- Diet and insulin needs change during pregnancy
- I will plan my diet based on the results of uterine glucose testing
Diet and insulin needs change during pregnancy
A woman arrives at the clinic for a pregnancy test. The first day of her LMP was September 10, 2014. Her expected date of birth (EDB) is __________.
June 17, 2015
A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 19. What is this client’s total recommended weight gain during pregnancy?
- 20 kg (44 lb)
- 16 kg (35 lb)
- 12.5 kg (27.5 lb)
- 10 kg (22 lb)
12.5 kg (27.5 lb)
While assessing the vital signs of a pregnant woman in her third trimester, the client reports feeling faint, dizzy, and agitated. Which nursing intervention is appropriate?
- Have the patient stand up, and then retake her BP
- Have the patient sit down, and then hold her arm in a dependent position
- Have the patient lie supine for 5 minutes, and then recheck her BP on both arms
- Have the patient turn to her left side, and then recheck her BP in 5 minutes
Have the patient turn to her left side, and then recheck her BP in 5 minutes
Which sign of a potential complication is the most important for the nurse to share with the client?
- Constipation
- Alteration in the pattern of fetal movement
- Heart palpitations
- Edema in the ankles and feet at the end of the day
Alteration in the pattern of fetal movement
A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding?
- Melasma
- Linea nigra
- Striae gravidarum
- Palmar erythema
Melasma (cholasma)
Usually fades after birth
A client arrives for her initial prenatal examination. This is her first child. She asks the nurse, “How does my baby get air inside my uterus?” What is the correct response by the nurse?
- The baby’s lungs work in utero to exchange oxygen and carbon dioxide
- The baby absorbs oxygen from your blood system
- the placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream
- The placenta delivers oxygen-rich blood through the umbilical artery to the baby’s abdomen
The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream
Which minerals and vitamins are usually recommended as a supplement in a pregnant client’s diet?
- Fat-soluble vitamins A + D
- Water-soluble vitamins C + B6
- Iron + folate
- Calcium + zinc
Iron and folate
The nurse has received a report regarding a client in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. What is the nurse’s interpretation of this assessment?
- Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm above the ischial spines
- Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines
- Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm below the ischial spines
- Cevix is dilated 3 cm and effaced 30%; the presenting part is 2 cm below the ischial spines
Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines
When assessing the fetus using Leopold’s maneuvers, the nurse feels a round, firm, and movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother’s right side close to midline. What is the position of the fetus?
- ROA
- LSP
- RSA
- LOA
RSA