OB week six chpt 19

A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable abortion? a. no passage of fetal tissue b. slight vaginal bleeding c. strong abdominal cramping d. closed cervical os

c. strong abdominal cramping

During pregnancy a woman's blood volume increases to accommodate the growing fetus to the point that vital signs may remain within normal range without showing signs of shock until the woman has lost what percentage of her blood volume? a. 40% b. 50% c. 20% d. 30%

a. 40%

A nurse is providing discharge teaching for a pregnant client with preeclampsia who will be managed at home on bedrest. The nurse determines that the teaching was successful based on which client statement? a. "I will check how often my baby kicks once per week." b. "I need to drink about 8 glasses of water a day." c. "I should check my blood pressure about 3 times per week." d. "I should lie on my back as much as I can."

b. "I need to drink about 8 glasses of water a day."

A nurse is reviewing the medical record of a pregnant client. The physical exam reveals that the placenta is implanted near the internal os but does not reach it. The nurse interprets this as which condition? a. Placenta percreta b. Low-lying placenta c. Placenta accreta d. Placenta increta

b. Low-lying placenta

A nurse is conducting a refresher program for a group of perinatal nurses. Part of the program involves a discussion of HELLP. The nurse determines that the group needs additional teaching when they identify which aspect as a part of HELLP? a. hemolysis b. elevated lipoproteins c. low platelet count d. liver enzyme elevation

b. elevated lipoproteins

A client has been admitted with placental abruption. She has lost 1,200 mL of blood, is normotensive, and ultrasound indicates approximately 30% separation. The nurse documents this as which classification of abruptio placentae? a. grade 4 b. grade 2 c. grade 1 d. grade 3

b. grade 2

A client has come to the office for a prenatal visit during her 24th week of gestation. On examination, it is noted that her blood pressure has increased to 146/94 mm Hg. Her urine is negative for proteinuria. Blood pressure assessment at 20 weeks' gestation was 142/92 mm Hg and urine was negative for protein. Blood pressure readings at previous visits ranged from 120/76 mm Hg to 126/80 mm Hg. The nurse suspects which condition? a. preeclampsia b. chronic hypertension c. HELLP d. gestational hypertension

d. gestational hypertension

A woman has presented to the emergency department with symptoms that suggest an ectopic pregnancy. Which finding would lead the nurse to suspect that the fallopian tube has ruptured? a. referred shoulder pain b. vaginal spotting c. breast tenderness d. nausea

a. referred shoulder pain

A pregnant woman is being evaluated for HELLP. The nurse reviews the client's diagnostic test results. An elevation in which result would the nurse interpret as helping to confirm this diagnosis? a. LDH b. platelet count c. white blood cells d. hematocrit

a. LDH

A nurse is assessing a pregnant client for the possibility of preexisting conditions that could lead to complications during pregnancy. The nurse suspects that the woman is at risk for hydramnios based on which preexisting condition? a. diabetes b. isoimmunization c. hypertension d. late maternal age

a. diabetes

A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client? a. diminished reflexes b. seizures c. elevated liver enzymes d. serum magnesium level of 6.5 mEq/L

a. diminished reflexes

A woman with an incomplete abortion is to receive misoprostol. The woman asks the nurse, "Why am I getting this drug?" The nurse responds to the client, integrating understanding that this drug achieves which effect? a. ensures passage of all the products of conception b. suppresses the immune response to prevent isoimmunization c. alleviates strong uterine cramping d. halts the progression of the abortion

a. ensures passage of all the products of conception

A pregnant woman is diagnosed with abruptio placentae. When reviewing the woman's physical assessment in her medical record, which finding would the nurse expect? a. firm, rigid uterus on palpation b. fetal heart rate within normal range c. absence of pain d. bright red vaginal bleeding

a. firm, rigid uterus on palpation

A high-risk pregnant client is determined to have gestational hypertension. The nurse suspects that the client has developed preeclampsia with severe features based on which finding? a. proteinuria of 300 mg per 24 hours b. blurred vision c. mild facial edema d. blood pressure of 150/100 mm Hg

b. blurred vision

A pregnant client diagnosed with hyperemesis gravidarum is prescribed intravenous fluids for rehydration. When preparing to administer this therapy, which solution would the nurse anticipate being prescribed initially? a. Dextrose 5% and water b. Albumin c. 0.45% sodium chloride d. Normal saline

d. Normal saline

A nurse is describing the use of Rho(D) immune globulin as the therapy of choice for isoimmunization in Rh-negative women and for other conditions to a group of nurses working at the women's health clinic. The nurse determines that additional teaching is needed when the group identifies which situation as an indication for Rho(D) immune globulin? a. maternal trauma b. amniocentesis c. molar pregnancy d. STIs

d. STIs

A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this as: a. placenta accrete. b. hydatidiform mole. c. hydramnios. d. ectopic pregnancy.

b. hydatidiform mole.

A nurse is providing care to a multiparous client. The client has a history of cesarean births. The nurse anticipates the need to closely monitor the client for which condition? a. oligohydramnios b. placenta accreta c. preeclampsia d. placenta abruption

b. placenta accreta

Which medication would the nurse prepare to administer if prescribed as treatment for an unruptured ectopic pregnancy? a. oxytocin b. ondansetron c. methotrexate d. promethazine

c. methotrexate

The nurse recognizes that documenting accurate blood pressures is vital in the diagnosing of preeclampsia and eclampsia. The nurse suspects preeclampsia based on which finding? a. BP of 140/90 mm Hg last week and at current visit b. BP of 140/90 mm Hg on three occasions after 20 weeks' gestation c. BP of 130/90 mm Hg on three occasions 3 hours apart d. BP of 160/110 mm Hg on two occasions after 28 weeks' gestation

a. BP of 140/90 mm Hg last week and at current visit

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. obtaining baseline blood electrolyte levels b. monitoring intake and output c. administering antiemetic agents d. maintaining NPO status for the first day or two e. preparing the woman for insertion of a feeding tube

a. obtaining baseline blood electrolyte levels b. monitoring intake and output c. administering antiemetic agents d. maintaining NPO status for the first day or two

A nurse is providing care to a pregnant woman with preterm prelabor rupture of membranes (PPROM). On admission, the client's baseline information was as follows: temperature, 97.6°F (36.5°C); pulse, 76 beats/minute; fetal heart rate, 136 beats/minute; white blood cell count, 7 x 103cells/mm3 (7.0 x 109/L). Now, 8 hours later, assessment reveals the following: temperature, 99.6°F (37.7°C); pulse, 82 beats/minute; fetal heart rate, 180 beats/minute; white blood cell count, 8.5 x 103 cells/mm3 (8.5 X 109/L). The nurse suspects a possible infection based on the change in which parameter? a. White blood cell count b. Fetal heart rate c. Temperature d. Pulse rate

b. Fetal heart rate

A pregnant woman has been admitted to the hospital due to preeclampsia with severe features. Which measure will be important for the nurse to include in the care plan? a. Plan for immediate induction of labor. b. Institute and maintain seizure precautions. c. Institute NPO status. d. Admit the client to the middle of ICU where she can be constantly monitored.

b. Institute and maintain seizure precautions.

A client at 33 weeks' gestation comes to the emergency department with vaginal bleeding. Assessment reveals the following: Onset of slight vaginal bleeding at 29 weeks with spontaneous cessation Recent onset of bright red vaginal bleeding, more than with previous episode No uterine contractions at present Fetal heart rate within normal range Uterus soft and nontender Based on the assessment findings, which condition would the nurse likely suspect? a. Polyhydramnios b. Placenta previa c. Placental abruption d. Ruptured ectopic pregnancy

b. Placenta previa

A nurse is conducting a presentation for a group of pregnant women about conditions that can occur during pregnancy and that place the woman at high-risk. When discussing blood incompatibilities, which measure would the nurse explain as most effective in preventing isoimmunization during pregnancy? a. cerclage b. Rho(D) immune globulin administration to Rh-negative women c. blood typing of mothers with type A or B blood d. amniocentesis

b. Rho(D) immune globulin administration to Rh-negative women

A nurse is providing care to a pregnant client hospitalized with preeclampsia. The nurse immediately notifies the health care provider that the client has developed eclampsia based on which finding? a. Hyperreflexia b. Seizure activity c. Blood pressure greater than 160/100 mm Hg d. Proteinuria

b. Seizure activity

A pregnant 36-year-old woman has presented to the emergency department with vaginal bleeding. While reviewing the client's history, the nurse suspects placenta previa when which risk factors are found in her record? Select all that apply. a. hypotension b. advancing maternal age c. infertility treatment d. previous induced surgical abortion e. smoking

b. advancing maternal age c. infertility treatment d. previous induced surgical abortion e. smoking

A home health care nurse is visiting a pregnant client with preeclampsia who is being managed at home. The nurse is reviewing the situations for which the client should contact the nurse. The nurse determines that the client demonstrates understanding when identifying which situation(s) as needing to be reported? Select all that apply. a. Increased urination b. Sinus headache c. Blurred vision d. Excessive heartburn e. Dizziness

c. Blurred vision d. Excessive heartburn e. Dizziness

A pregnant client at 14 weeks' gestation calls the clinic. When talking with the nurse, the client reports continued, frequent nausea and vomiting. She states, "This has been happening since I got pregnant and now I cannot keep anything down." Which intervention would be the priority for this client? a. Initiating intravenous access for fluids b. Administering an antiemetic c. Stopping all intake of food and drink d. Obtaining serum electrolyte levels

c. Stopping all intake of food and drink

A pregnant client at 24 weeks' gestation arrives in the office and reports that her feet and legs swelling. During a client evaluation, the nurse notes that she can elicit a 4-mm skin depression that disappears in 10 to 15 seconds. The client is considered at risk for preeclampsia. What additional assessment would be beneficial for the nurse to complete? a. Complete blood count b. Fundal height c. Weight gain d. Urine culture

c. Weight gain

A nurse is teaching a group of pregnant woman about bleeding that can occur early in pregnancy. The nurse determines that additional teaching is needed when the group identifies which condition as a common cause? a. GTD b. ectopic pregnancy c. placenta previa d. spontaneous abortion

c. placenta previa

Which measure would the nurse include in the plan of care for a woman with prelabor rupture of membranes if her fetus's lungs are mature? a. observation for signs of infection b. administration of corticosteroids c. reduction in physical activity level d. labor induction

d. labor induction

Some women experience a rupture of their membranes before going into true labor. A nurse recognizes that a woman who presents with premature prelabor rupture of membranes (PPROM) has completed how many weeks of gestation? a. less than 39 weeks b. less than 38 weeks c. less than 40 weeks d. less than 37 weeks

d. less than 37 weeks

A woman at 12 weeks' gestation comes to the clinic with vaginal bleeding. When assessing the woman further, the nurse would suspect a threatened abortion based on which finding? a. high beta human chorionic gonadotropin (hCG) level b. passage of fetal tissue c. cervical dilation d. slight vaginal bleeding

d. slight vaginal bleeding