CHP 19/20

B

A 25-year-old client at 22 weeks' gestation is noted to have proteinuria and dependent edema on her routine prenatal visit. Which additional assessment should the nurse prioritize and alert the RN or health care provider? A) Initial BP 120/80mm Hg; current BP 130/88 mm Hg B) Initial BP 100/70 mm Hg; current BP 140/90 mm Hg C) Initial BP 140/85 mm Hg; current BP 130/80 mm Hg D) Initial BP 110/60 mm Hg; current BP 112/86 mm Hg

B

A 28-year-old client with a history of endometriosis presents to the emergency department with severe abdominal pain and nausea and vomiting. The client also reports her periods are irregular with the last one being 2 months ago. The nurse prepares to assess for which possible cause for this client's complaints? A) Healthy pregnancy B) Ectopic pregnancy C) Molar pregnancy D) Placenta previa

C

A 40-year-old woman comes to the clinic reporting having missed her period for two months. A pregnancy test is positive. What is she and her fetus at increased risk for? A) type 2 diabetes mellitus B) type 1 diabetes mellitus C) placental abnormalities D) postterm birth

C

A nurse has been assigned to assess a pregnant client for abruptio placenta. For which classic manifestation of this condition should the nurse assess? A) painless bright red vaginal bleeding B) increased fetal movement C) "knife-like" abdominal pain with vaginal bleeding D) generalized vasospasm

B

A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does the observation of meconium indicate? A) cord compression B) fetal distress related to hypoxia C) infection D)central nervous system (CNS) involvement

C

A nursing instructor is teaching students about anemia during pregnancy. Which type of anemia does the instructor teach students is most prevalent during pregnancy? A) sickle-cell anemia B) pernicious anemia C) iron-deficiency anemia D) folic acid anemia

A

A young mother has tested positive for HIV. When discussing the situation with the client, the nurse should advise the mother that she should avoid which activity? A) breastfeeding B) future pregnancies C) cesarean birth B) handling the infant with open sores

B

Between her regularly scheduled visits, a woman in her first trimester of pregnancy who is taking iron supplements for anemia calls the nurse at her obstetrician's office reporting constipation. She reports that she has never had this problem before and asks for some advice about how to get relief. What is the best advice the nurse can give her? A) Stop taking iron supplements for a few days, exercise more, drink more fluids, eat high-fiber, low-iron foods until the constipation is relieved, then resume the iron supplement. B) Continue taking iron supplements but increase fluids and high-fiber foods; exercise more. C) Increase the iron supplements, fluid intake, and consumption of high-fiber foods; exercise more. D) Take the iron supplement every other day, increase fluid intake and consumption of high-fiber foods; exercise more.

C

The nurse encourages a woman with gestational diabetes to maintain an active exercise period during pregnancy. Prior to this exercise period, the nurse would advise her to do which action? A) Inject a bolus of insulin. B) Eat a high-carbohydrate snack. C) Eat a sustaining-carbohydrate snack. D) Add a bolus of long-acting insulin.

B

The nurse is assessing a woman with Class III heart disease who is in for a prenatal visit. What would be the first recognizable sign that this client is in heart failure? A) Audible wheezes B) Persistent rales in the bases of the lungs C) Elevated blood pressure D) Low blood pressure

A,B,C

The nurse is doing meal planning with a pregnant woman with iron-deficiency anemia. What dietary recommendations would the nurse make to enhance the woman's intake of iron? Select all that apply. A) Drink orange juice with the iron supplement. B) Increase intake of dried beans and green leafy vegetables. C) Cook food in an iron skillet, if possible. D) Limit intake of dried fruits, eating only fresh fruit. E) Since fortified cereals are a poor source of iron, eat eggs or pancakes for breakfast.

A

What important instruction should the nurse give a pregnant client with tuberculosis? A) Maintain adequate hydration. B) Avoid direct sunlight. C) Avoid red meat. D) Wear light, cotton clothes.

A

When assessing a pregnant woman with vaginal bleeding, the nurse would suspect a threatened abortion based on which finding? A) slight vaginal bleeding B) cervical dilation C) strong abdominal cramping D) passage of fetal tissue

D

Which factor would contribute to a high-risk pregnancy? A) blood type O positive B) first pregnancy at age 33 C) history of allergy to honey bee pollen D) type 1 diabetes

C

A 44-year-old client has lost several pregnancies over the last 10 years. For the past 3 months, she has had fatigue, nausea, and vomiting. She visits the clinic and takes a pregnancy test; the results are positive. Physical examination confirms a uterus enlarged to 13 weeks' gestation; fetal heart tones are heard. Ultrasound reveals that the client is experiencing some bleeding. Considering the client's prenatal history and age, what does the nurse recognize as the greatest risk for the client at this time? A) premature birth B) hypertension C) pregnancy loss D) preterm labor

A

A client with asthma is confused by her primary care provider continuing her medication while she is pregnant, since she read online the medications can cause birth defects. What is the nurse's best response? A) "Your primary care provider will order safe doses of your medication." B) "It's OK to not use them if you would feel more comfortable." C) "They won't cause any major defects." D) "I'll let your primary care provider know how you feel about it."

C

A nursing instructor is teaching students about preexisting illnesses and how they can complicate a pregnancy. The instructor recognizes a need for further education when one of the students makes which statement? A) "A pregnant woman with a chronic condition can put herself at risk." B) "A pregnant woman with a chronic illness can put the fetus at risk." C) "A pregnant woman does not have to worry about contracting new illnesses during pregnancy." D) "A pregnant woman needs to be careful of and cautious about accidents and illnesses during her pregnancy."

A

A pregnant patient is diagnosed with placenta previa. Which action should the nurse implement immediately for this patient? A) Assess fetal heart sounds with an external monitor. B) Help the patient remain ambulatory to reduce bleeding. C) Assess uterine contractions by an internal pressure gauge. D) Prepare for a vaginal examination to assess the extent of bleeding.

A

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

D

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) 100 mg/dL B) 114 mg/dL C) 130 mg/dL D) 146 mg/dL

A

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) elevated liver enzymes C) seizures D) serum magnesium level of 6.5 mEq/L

A

A client has come to the office for a prenatal visit during her 22nd week of gestation. On examination, it is noted that her blood pressure has increased to 138/90 mm Hg. Her urine is negative for proteinuria. The nurse recognizes which factor as the potential cause? A) gestational hypertension B) chronic hypertension C) HELLP D) preeclampsia

C

A client in her fifth month of pregnancy is having a routine clinic visit. The nurse should assess the client for which common second trimester condition? A) mastitis B) metabolic alkalosis C) physiological anemia D) respiratory acidosis

D

The nurse is required to assess a pregnant client who is reporting vaginal bleeding. Which nursing action is the priority? A) monitoring uterine contractility B) assessing signs of shock C) determining the amount of funneling D) assessing the amount and color of the bleeding

B

A client is 33 weeks pregnant and has had diabetes since age 21. When checking her fasting blood glucose level, which value would indicate the client's disease is controlled? A) 45 mg/dl B) 85 mg/dl C) 120 mg/dl D) 136 mg/dl

A

A woman in labor suddenly reports sharp fundal pain accompanied by slight dark red vaginal bleeding. The nurse should prepare to assist with which situation? A) Premature separation of the placenta B) Preterm labor that was undiagnosed C) Placenta previa obstructing the cervix D) Possible fetal death or injury

C

A woman is admitted with a diagnosis of ectopic pregnancy. For which procedure should the nurse prepare? A) bed rest for the next 4 weeks B) intravenous administration of a tocolytic C) immediate surgery D) internal uterine monitoring

D

A woman is being admitted to the obstetric unit for severe preeclampsia. When assigning room placement, which area would be most appropriate? A) Beside the supply room B) Near the staff elevator C) Across from the nurse's station D) At the end of the hallway