Maternity Test 2 Chapter 20 Application

The nurse is comforting and listening to a young couple who just suffered a spontaneous abortion (miscarriage). When asked why this happened, which reason should the nurse share as a common cause? Maternal smoking Chromosomal abnormality Lack of prenatal care The age of the mother

Chromosomal abnormality

A client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal? Decrease blood pressure Reverse edema Prevent maternal seizures Decrease protein in urine

Prevent maternal seizures

A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth? The mother's age Prophylactic ART to infant at birth Amniocentesis results at 34 weeks The viral load

The viral load

A pregnant woman with diabetes at 10 weeks' gestation has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome? congenital anomalies incompetent cervix placental abruption (abruptio placentae) placenta previa

congenital anomalies

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? elevated lipoproteins liver enzyme elevation low platelet count hemolysis

elevated lipoproteins

The nurse is appraising the medical record of a pregnant client who is resting in a darkened room and receiving betamethasone and magnesium sulfate. The nurse recognizes the client is being treated for which condition? postterm pregnancy gestational diabetes severe preeclampsia gestational hypertension

severe preeclampsia

When assessing a pregnant client for possible gestational hypertension, which factors would lead the nurse to suspect that the client is at increased risk? Select all that apply. High socioeconomic status Preexisting hypertension History of antiphospholipid syndrome Primiparas, particularly obese clients Age group within 18-35 years

Preexisting hypertension History of antiphospholipid syndrome Primiparas, particularly obese clients

The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 12 breaths/min, BP 148/110 mm Hg. What other priority physical assessments by the nurse should be implemented to assess for potential toxicity? Magnesium sulfate level Reflexes Lung sounds Oxygen saturation

Reflexes

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: ectopic pregnancy. hydatidiform mole. hydramnios. placenta accrete.

hydatidiform mole.

A patient having an examination to check the placement of an intrauterine device (IUD) is diagnosed as being pregnant. For which action should the nurse prepare the patient at this time? Potential for a spontaneous abortion Surgery to abort the fetus Removal of the IUD Nothing since the IUD can remain in place

Removal of the IUD

The nurse is caring for a multigravid who experienced a placental abruption 4 hours ago. For which potential situation will the nurse prioritize assessment? Blood incompatibilities Maternal blood loss Uterine atony Hypertensive crisis

Uterine atony

A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which statement by the nurse would be most appropriate? "Wait until after the infant is born, and then something can be done." "Antibodies cross the placenta and provide immunity to the newborn." "Antiretroviral medications are available to help reduce the risk of transmission." "You'll probably have a cesarean birth to prevent exposing your newborn."

"Antiretroviral medications are available to help reduce the risk of transmission."

The nurse is assessing a new client who is being admitted with gestational hypertension. Which nursing diagnosis should the nurse prioritize for this client? Imbalanced nutrition related to decreased sodium levels Deficient fluid volume related to vasospasm of arteries Risk for injury related to fetal distress Decreased reflexes due to medication administration

Deficient fluid volume related to vasospasm of arteries

A client with a high-risk pregnancy has been prescribed inpatient bed rest. When assessing the client each morning, which risk factor of is common with this treatment plan? Diarrhea Muscle rigidity Depression Weight loss

Depression

A patient in her late twenties visits the clinic to begin the process of in vitro fertilization (IVF). Her husband in his late fifties asks if there are any tests to check for any irregularities. What tests should the nurse discuss with this couple? CVS PPD Examination of egg and sperm amniocentesis

Examination of egg and sperm

TORCH is an acronym for maternal infections associated with congenital malformations and disorders. Which of the following disorders does the H represent? Herpes simplex virus Hepatitis B virus Human immunodeficiency virus Hemophilia

Herpes simplex virus

The nurse is identifying nursing diagnoses for a client with gestational hypertension. Which diagnosis would be the most appropriate for this client? Risk for injury related to fetal distress Ineffective tissue perfusion related to vasoconstriction of blood vessels Ineffective tissue perfusion related to poor heart contraction Imbalanced nutrition related to decreased sodium levels

Ineffective tissue perfusion related to vasoconstriction of blood vessels

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? Plan for immediate induction of labor. Institute and maintain seizure precautions. Admit the client to the middle of ICU where she can be constantly monitored. Institute NPO status.

Institute and maintain seizure precautions.

A client at 37 weeks' gestation presents to the emergency department with a BP 150/108 mm Hg, 1+ pedal edema, 1+ proteinuria, and normal deep tendon reflexes. Which assessment should the nurse prioritize as the client is administered magnesium sulfate IV? Ability to sleep Urine protein Respiratory rate Hemoglobin

Respiratory rate

A pregnant patient with a history of premature cervical dilatation undergoes cervical cerclage. Which outcome indicates that this procedure has been successful? The client has reduced shortness of breath and abdominal pain during the pregnancy. The client's membranes spontaneously rupture at week 30 of gestation. The client delivers a full-term fetus at 39 weeks' gestation. The client experiences minimal vaginal bleeding throughout the pregnancy.

The client delivers a full-term fetus at 39 weeks' gestation.

The obstetric nurse is caring for a pregnant client who has been diagnosed with hydatidiform mole. What assessment should the nurse prioritize? Blood pressure Pain Vaginal bleeding Severe nausea and vomiting

Vaginal bleeding

A woman who is Rh negative asks the nurse how many children she will be able to have before Rh incompatibility causes them to die in utero. The nurse's best response would be that: no more than three children is recommended. she will have to ask her primary care provider. as long as she receives Rho(D) immune globulin, there is no limit. only her next child will be affected.

as long as she receives Rho(D) immune globulin, there is no limit.

A woman who is 8 months' pregnant comes to the clinic with urinary frequency and pain on urination. The client is diagnosed with a urinary tract infection (UTI). Which medication would the nurse anticipate the physician will prescribe? tetracycline bactrim amoxicillin septra

amoxicillin

A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition? gonorrhea cytomegalovirus chlamydia toxoplasmosis

cytomegalovirus

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? diminished reflexes elevated liver enzymes serum magnesium level of 6.5 mEq/L seizures

diminished reflexes

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? infection central nervous system (CNS) involvement cord compression fetal distress related to hypoxia

fetal distress related to hypoxia

A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion. The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first trimester abortions? uterine fibroids cervical insufficiency fetal genetic abnormalities maternal disease

fetal genetic abnormalities

A woman with gestational hypertension develops eclampsia and experiences a seizure. Which intervention would the nurse identify as the priority? fluid replacement birth of the fetus oxygenation control of hypertension

oxygenation

A nurse is reviewing a client's history and physical examination findings. Which information would the nurse identify as contributing to the client's risk for an ectopic pregnancy? heavy, irregular menses ovarian cyst 2 years ago use of oral contraceptives for 5 years recurrent pelvic infections

recurrent pelvic infections

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? premature birth spontaneous abortion (miscarriage) preterm labor hypertension

spontaneous abortion (miscarriage)

A patient with diabetes is in the first trimester of pregnancy and is currently having difficulty keeping blood glucose levels within normal limits. The patient explains that she has been "eating for two" so the baby is healthy. How should the nurse respond to the patient? "Elevated blood glucose levels in the first trimester have been linked to congenital anomalies." "Elevated blood glucose levels hasten the development of the fetus in utero." "Elevated blood glucose levels ensure the baby has mature lungs at birth." "Elevated blood glucose levels cause low birth weights in infants."

"Elevated blood glucose levels in the first trimester have been linked to congenital anomalies."

A client in her first trimester arrives at the emergency room with reports of severe cramping and vaginal spotting. On examination, the health care provider informs her that no fetal heart sounds are evident and orders a dilatation and curettage. The client looks frightened and confused and states that she does not believe in abortion. Which statement by the nurse is best? "Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications." "You have experienced an incomplete miscarriage and must have the placenta and any other tissues cleaned out." "The choice is up to you but the health care provider is recommending an abortion." "I know that it is sad but the pregnancy must be terminated to save your life."

"Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications."

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? halts the progression of the abortion alleviates strong uterine cramping ensures passage of all the products of conception suppresses the immune response to prevent isoimmunization

ensures passage of all the products of conception

Which medication will the nurse anticipate the health care provider will prescribe as treatment for an unruptured ectopic pregnancy? oxytocin methotrexate promethazine ondansetron

methotrexate

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? strong abdominal cramping no passage of fetal tissue slight vaginal bleeding closed cervical os

strong abdominal cramping

A woman with hyperemesis gravidarum asks the nurse about suggestions to minimize nausea and vomiting. Which suggestion would be most appropriate for the nurse to make? "Make sure that anything around your waist is quite snug." "Drink fluids in between meals rather than with meals." "Lie down for about an hour after you eat." "Try to eat three large meals a day with less snacking."

"Drink fluids in between meals rather than with meals."

A pregnant women calls the clinic to report a small amount of painless vaginal bleeding. What response by the nurse is best? "Please come in now for an evaluation by your health care provider." "Bleeding during pregnancy happens for many reasons, some serious and some harmless." "Lie on your left side and drink lots of water and monitor the bleeding." "If the bleeding lasts more than 24 hours, call us for an appointment."

"Please come in now for an evaluation by your health care provider."

The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client? Monitor the fetal heart rate (FHR). Monitor the client's vital signs and bleeding. Monitor the client's beta-hCG level. Monitor the mass with transvaginal ultrasound.

Monitor the client's vital signs and bleeding.

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding? disseminated intravascular coagulation (DIC) elevated platelet count hyperglycemia elevated liver enzymes

elevated liver enzymes

A pregnant patient with intermittent preterm contractions at 30 weeks has been on weekly home care assessments for 1 month without health care visits to the doctor or any activities outside the home. The nurse has established adequate fetal growth and is aware that contractions have been occurring roughly two times a day. The patient makes little effort to look at the nurse or discuss her plans for the upcoming delivery. The nurse makes which diagnosis of the current needs of this patient? Inadequate dietary intake related to activity restriction At risk for venous thromboembolism because of restricted activity At risk for depression because of extended activity restriction, as evidenced by affect Threatened preterm delivery related to contractions, as evidenced by reports by the patient of contractions before 38 weeks' gestation

At risk for depression because of extended activity restriction, as evidenced by affect