Chapter 20 OB test 2

Nursing care of the pregnant woman often involves the management of medications. When assessing the client history, the nurse should verify that the client is not taking any prescribed medications of which category? a. B b. C c. D d. X

d. X

complications of gestational diabetes

macrosomia, hypoglycemia, birth trauma, preeclampsia, c-section birth

Medical treatment of HIV/AIDS during pregnancy

-administer retrovir at 14 weeks of gestation, throughout pregnancy, and before the onset of labor or cesarean birth - administer retrovir to infant at delivery and for 6 weeks following birth

A nurse is admitting a client who is in labor and has HIV. Which of the following interventions should the nurse identify as contraindicated for this client? (Select all that apply) A. Episiotomy B. Oxytocin infusion C. Forceps D. Cesarean birth E. Internal fetal monitoring

A, C, E

A woman at 26 weeks' gestation is undergoing screening for diabetes with a 1-hour oral glucose challenge test. On the client's return visit, the nurse anticipates the need to schedule a 3-hour glucose challenge test based on which result of the previous test? A) 130 mg/dL B) 146 mg/dL C) 100 mg/dL D) 114 mg/dL

B) 146 mg/dL For a 1-hour glucose challenge test, a 75-g oral glucose load is given, without regard to the timing or content of the last meal. Blood glucose is measured 1 hour later; a level above 140 mg/dL is abnormal. If the result is abnormal, a 3-hour glucose tolerance test is done.

A pregnant woman with diabetes is having her glycosylated hemoglobin level evaluated. The nurse determines that the woman's glucose is under control and continues the woman's plan of care based on which result? A) 8.5% B) 8.0% C) 6.5% D) 7.5%

C) 6.5% A glycosylated hemoglobin level of less than 7% indicates good control; a value of more than 8% indicates poor control and warrants intervention. A glycosylated hemoglobin level of more than 8.0% indicates poor blood glucose control and the need for intervention, necessitating a revision in the woman's plan of care.

Leading cause of hearing loss and intellectual disability in U.S.

CMV

Diabetes testing done at first prenatal visit vs. 24-28weeks

First prenatal visit: *Fasting: <126mg/dL *HbA1C: <7% *Random: 200 mg/dL 24-28 Weeks: *Fasting: <92 mg/dL *75 g OGTT-1 hr: <180mg/dL *75 g OGTT-2hr: <153mg/dL

This infection is screened at 35-37 weeks gestation and treated with Penicillin G during labor

Group B streptococcal infection (GBS)

In preparing for a class for a group of new parents, the nurse should include that smoking can increase the risk of which of the following complications? (Select all that apply.) a. Abruptio placenta b. Premature rupture of membranes c. Spontaneous abortion d. High birth weight e. Maternal hypertension

a. Abruptio placenta c. Spontaneous abortion e. Maternal hypertension

After conducting a class on possible congenital infections with a group of student nurses, the instructor recognizes the class was successful when the class identifies which of the following as the most common congenital viral infection? a. CMV b. RSV c. HIV d. HPV

a. CMV

A woman with cardiac disease has come to the office for prenatal counseling. According to the functional classification system developed by the Criteria Committee of the New York Heart Association, which category of women should avoid pregnancy? a. Class IV b. Class III c. Class I d. Class II

a. class IV

Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client: week 16 : 124/86; week 20 : 138/90; week 24 : 140/92; and week 28 : 142/94. Which of the following would be the correct classification of her blood pressure? a. Mild hypertensive b. Prehypertensive c. Severe hypertensive d. Normotensive

a. mild hypertensive

A pregnant client has tested positive for hepatitis B virus. When discussing the situation with the client, the nurse explains that her infant should be vaccinated with an initial HBV vaccine dose at which of the following? a. Within 12 hours of birth b. Within 36 hours of birth c. Within 24 hours of birth d. Within 48 hours of birth

a. within 12 hours of birth

screening for diabetes should be done

at 1st prenatal visit and screening at 24-28 weeks

Part of the assessment of the first prenatal visit includes screening for rubella antibodies. The nurse explains which of the following titer results shows evidence of immunity against rubella? a. 1:10 b. 1:6 c. 1:8 d. 1:4

c. 1:8

A pregnant woman is determined to be at high risk for gestational diabetes. At which time would the nurse schedule a rescreening for the client? a. 20 to 24 weeks b. 16 to 20 weeks c. 24 to 28 weeks d. 28 to 32 weeks

c. 24-38 weeks

A nurse is caring for a pregnant client who is HIV-positive. What is a priority issue that the nurse should discuss with the client? a. The client's relationship with the spouse b. The amount of physical contact that should occur with the infant c. The client's plan for future pregnancies d. The need for the client to avoid breastfeeding

d. The need for the client to avoid breastfeeding

When discussing the various risks to the mother and infant, the nurse should include that which of the following is the leading cause of mental retardation in the United States? a. Genetic anomalies b. Pregnancy Category X medications c. Maternal drug addiction d. Fetal alcohol spectrum disorder

d. Fetal alcohol spectrum disorder

A pregnant woman with chronic hypertension presents challenges in controlling the hypertension and preventing additional complications. Which hypertensive medication is prescribed due to its safety record during pregnancy? a. Labetalol b. Atenolol c. Nifedipine d. Methyldopa

d. Methyldopa

Increased risk to fetus when mother has diabetes

spontaneous abortion, infections, hydramnios (too much amniotic fluid), ketoacidosis, hypoglycemia, hyperglycemia