chap 20 prep-u questions

A pregnant client is reporting of a large amount of malodorous vaginal discharge that is foamy and yellow-green in color, vaginal itching and painful intercourse. When asked, she also reports that urination is somewhat painful. She is diagnosed with trichomoniasis. What treatment would the nurse anticipate the client receiving? A. oral erythromycin B. ceftriaxone IM C. oral metronidazole D. benzathine penicillin G IM

C. oral metronidazole rationale: Trichomoniasis is caused by a protozoan infection, which can cause preterm labor, low birth weight, and premature rupture of membranes. Treatment is oral metronidazole because it is more effective in treating the infection than the suppository or creams.

What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension? A. stressing the increased use of Vitamin D supplements B. stressing the positive benefits of a healthy lifestyle C. stressing the avoidance of dairy products D. stressing regular walks and exercise

B. stressing the positive benefits of a healthy lifestyle

A pregnant woman with diabetes is having a glycosylated hemoglobin (HgbA1C) level drawn. Which result would require the nurse to revise the client's plan of care? A. 7% B. 8.5% C. 5.5% D. 6.0%

B. 8.5% rationale: A glycosylated hemoglobin level of less than 7% indicates good control; a value of more than 8% indicates poor control and warrants intervention. Therefore, the nurse would need to revise the plan of care.

The nurse is providing care to a neonate. Review of the maternal history reveals that the mother is suspected of having a heroin use disorder. The nurse would be alert for which finding when assessing the neonate? A. vigorous sucking B. easy consolability C. hypertonicity D. low, feeble cry

C. hypertonicity rationale: Newborns of mothers with heroin or other opioid use disorder display irritability, hypertonicity, a high-pitched cry, vomiting, diarrhea, respiratory distress, disturbed sleeping, sneezing, diaphoresis, fever, poor sucking, tremors, and seizures.

A nurse is conducting a class on the effects of nicotine during pregnancy. Which complications will the nurse include in the teaching? Select all that apply. A. spontaneous abortion (miscarriage) B. placenta previa C. spontaneous rupture of membranes D. preterm labor and birth E. tubal ectopic pregnancy

A. spontaneous abortion (miscarriage) B. placenta previa C. spontaneous rupture of membranes D. preterm labor and birth E. tubal ectopic pregnancy rationale: Smoking during pregnancy increases the risk of spontaneous abortion, preterm labor and birth, maternal hypertension, placenta previa, and placental abruption (abruptio placentae). It has also been considered an important risk factor for low birth weight, sudden infant death syndrome, and cognitive defects.

The nurse is teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement. The nurse determines that the teaching was successful when the client states that she will take the supplement with: A. coffee. B. tea. C. milk. D. citrus juice.

D. citrus juice. rationale: Iron absorption is enhanced when taken with foods high in vitamin C, such as citrus juice. The nurse should advise clients to avoid consuming milk, antacids, high-fiber foods, and caffeine for 2 hours after taking iron for superior absorption.

A nurse is conducting a class for a group of pregnant women about ways to minimize the risk of infection during pregnancy. One of the infections that the nurse is discussing is toxoplasmosis. The nurse determines that the class was successful when the group identifies which action(s) as helpful in preventing this infection. Select all that apply. A. "Peeling any raw vegetables is a good idea before eating them." B. "It is important to cook any meat that we will eat to at least a temperature of 145°F (62.8°C)." C. "It is important to wear gardening gloves when digging in the soil." D. "Any cutting surface used for raw meats should be washed afterwards with hot, soapy water." E. "A house cat should be kept outside to prevent bringing things inside the house."

A. "Peeling any raw vegetables is a good idea before eating them." C. "It is important to wear gardening gloves when digging in the soil." D. "Any cutting surface used for raw meats should be washed afterwards with hot, soapy water."

A 17-year-old primigravida with type 1 diabetes is at 37 weeks' gestation comes to the clinic for an evaluation. The nurse notes her blood sugar has been poorly controlled and the health care provider is suspecting the fetus has macrosomia. The nurse predicts which step will be completed next? A. Scheduling the woman for induction of labor today. B. Preparing for amniocentesis and fetal lung maturity assessment C. Allowing her to continue without plans for delivery. D. Scheduling a cesarean delivery at 39 weeks.

B. Preparing for amniocentesis and fetal lung maturity assessment rationale: If the infant has macrosomia, is large for gestation age, and the mother has had poor blood-sugar control, the provider will want further information on the fetus and readiness for delivery before making any decisions on delivery. After determining the readiness of the fetus, then plans for delivery can be determined and scheduled.

Which change in insulin is most likely to occur in a woman during pregnancy? A. enhanced secretion from normal B. unavailable because it is used by the fetus C. less effective than normal D. not released because of pressure on the pancreas

C. less effective than normal rationale: Somatotropin released by the placenta makes insulin less effective. This is a safeguard against hypoglycemia.

The maternal health nurse is caring for a group of high-risk pregnant clients. Which client condition will the nurse identify as being the highest risk for pregnancy? A. Loud systolic murmur B. Secondary hypertension C. Pulmonary hypertension D. Repaired atrial septal defect

C. Pulmonary hypertension rationale: Pulmonary hypertension is considered the greatest risk to a pregnancy because of the hypoxia that is associated with the condition. The remaining conditions represent potential cardiac complications that may increase the client's risk in pregnancy; however, these do not present the greatest risk in pregnancy.

A 16-year-old girl comes to the public health office and tells the nurse she is pregnant. She is afraid to tell her parents. What is important for a nurse to know in order to properly inform this girl? A. who the mother's parents are B. who the father of the baby is C. community resources for the pregnant teen D. what school district she resides in

C. community resources for the pregnant teen rationale: The nurse should be knowledgeable regarding community resources for the pregnant teen. If the nurse refers the teen to another entity, following up to ensure the adolescent receives the services for which she was referred is critical. If she does not refer the teen, the nurse should try to determine the barriers that prevent her from following through with treatment and assist her to work through these barriers to obtain needed services.

A nurse is caring for a pregnant adolescent client, who is in her first trimester, during a visit to the maternal child clinic. Which important area should the nurse address during assessment of the client? A. whether sex was consensual B. sexual development of the client C. knowledge of child development D. options for birth control in the future

C. knowledge of child development rationale: The nurse should address the client's knowledge of child development during assessment of the pregnant adolescent client. The nurse need not address the sexual development of the client or whether sex was consensual. This would not be an opportune time to discuss birth control methods to be used after the pregnancy.

A nurse is caring for a newborn with fetal alcohol spectrum disorder. What characteristic of the fetal alcohol spectrum disorder should the nurse assess for in the newborn? A. poor breathing pattern B. decreased blood glucose level C. small head circumference D. wide eyes

C. small head circumference rationale: The nurse should assess for small head circumference in a newborn being assessed for fetal alcohol spectrum disorder. Fetal alcohol spectrum disorder does not cause decreased blood glucose level, a poor breathing pattern, or wide eyes.

Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client with chronic hypertension: week 16 - 130/86 mm Hg; week 20 - 138/88 mm Hg; week 24 - 136/82 mm Hg; and week 28 - 138/88 mm Hg. The nurse interprets these findings as indicating which classification of her blood pressure? A. stage 2 B hypertensive crisis C. stage 1 D. elevated

C. stage 1 rationale: elevated: Systolic between 120 and 129 mm Hg and diastolic less than 80 mm Hg; Stage 1: Systolic between 130 and 139 mm Hg or diastolic between 80 and 89 mm Hg; Stage 2: Systolic at least 140 mm Hg or diastolic at least 90 mm Hg; Hypertensive crisis: Systolic over 180 mm Hg and/or diastolic over 120 mm Hg (Alexander, 2019; Bakris, 2019). The client has stage 1 hypertension.