NUAS240T - Chapter 20 - Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations

a. Sickle cell anemia is recessively inherited.

A woman who has sickle cell anemia asks the nurse if her infant will develop sickle cell disease. The nurse would base the answer on which information? a. Sickle cell anemia is recessively inherited. b. Sickle cell anemia is not inherited; it occurs following a malaria infection. c. Sickle cell anemia is dominantly inherited. d. Sickle cell anemia has more than one polygenic inheritance pattern.

d. Semi-recumbent with a pillow under one hip

A woman with known cardiac disease is in labor. In what position would the nurse place the client? a. Supine b. High-Fowler's with a pillow at the back c. Trendelenburg d. Semi-recumbent with a pillow under one hip

d. left lateral recumbent

A nurse informs a pregnant woman with cardiac disease that she will need two rest periods each day and a full night's sleep. The nurse further instructs the client that which position for this rest is best? a. on her back b. right lateral recumbent c. prone d. left lateral recumbent

b. baked turkey, brown rice, and strawberries

A nurse is caring for a pregnant client with gestational diabetes. Which meal should the nurse recommend for this client? a. steak, baked potato with butter, and ice cream b. baked turkey, brown rice, and strawberries c. pizza, corn, and orange slices d. baked chicken, green beans, and chocolate cake

b. Orange juice

The nurse is preparing to teach a pregnant client with iron deficiency anemia about the various iron-rich foods to include in her diet. Which food should the nurse point out will help increase the absorption of her iron supplement? a. Dried apples b. Orange juice c. Fortified grains d. Dried beans

b. "If my blood sugars are elevated, my baby's lungs will mature faster, which is good."

The nurse is teaching a client with gestational diabetes about complications that can occur either following birth or at delivery for her baby. Which statement by the mother indicates that further teaching is needed by the nurse? a. "My baby may be very large and I may need a cesarean section to have him." b. "If my blood sugars are elevated, my baby's lungs will mature faster, which is good." c. "I may need an amniocentesis during the third trimester to see if my baby's lungs are ready to be born." d. "Beginning at 28 weeks' gestation, I will start counting with my baby's movements every day."

d. physiological anemia

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. respiratory acidosis b. mastitis c. metabolic alkalosis d. physiological anemia

d. Increased risk of development of type 2 diabetes

An infant is born to a mother with gestational diabetes. Which long-term maternal complication is associated with this diagnosis? a. Development of long-term hypertension b. Heart disease c. Weight gain that is not lost after the pregnancy d. Increased risk of development of type 2 diabetes

b. A 3-hour glucose tolerance test for follow-up

At 24 weeks' gestation, a client's 1-hour glucose tolerance test is elevated. The nurse explains that, based on this finding, the client will need to take which action? a. Daily fingersticks for a fasting blood glucose level b. A 3-hour glucose tolerance test for follow-up c. Daily insulin injections for gestational diabetes d. Monthly hemoglobin A1C levels to rule out diabetes

C. because it works to minimize withdrawal symptoms and blocks the effects of illicit opiate drugs. Maintenance therapy is associated with reduced rates of preterm births, longer gestation, and increased birth weights.

Maintenance on methadone or buprenorphine is the most common medical treatment for which of the following drug addictions? a. Alcohol b. Nicotine c. Opiates d. Marijuana

a. Maintain adequate hydration.

What important instruction should the nurse give a pregnant client with tuberculosis? a. Maintain adequate hydration. b. Wear light, cotton clothes. c. Avoid red meat. d. Avoid direct sunlight.

b. stressing the positive benefits of a healthy lifestyle

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 regular walks and exercise d. stressing the avoidance of dairy products

b. restricted sodium intake

A client is diagnosed with peripartum cardiomyopathy (PPCM). Which therapy would the nurse expect to administer to the client? a. ginger therapy b. restricted sodium intake c. methadone therapy d. monoamine oxidase inhibitors

c. "The antibodies may be those transferred across the placenta; the baby may not develop AIDS."

A woman's baby is HIV positive at birth. She asks the nurse if this means the baby will develop AIDS. Which statement would be the nurse's best answer? a. "HIV antibodies do not cross the placenta; this means the baby will develop AIDS." b. "She already has AIDS. That's what being HIV positive means." c. "The antibodies may be those transferred across the placenta; the baby may not develop AIDS." d. "HIV is transmitted at birth; having a cesarean birth prevented transmission."

B. Levels of the hormone hPL (insulin antagonist) progressively rise throughout pregnancy, and additional insulin is needed to overcome its resistance. Having a carbohydrate craving is not associated with gestational diabetes.

Which of the following would the nurse include when teaching a pregnant woman about the pathophysiologic mechanisms associated with gestational diabetes? a. Pregnancy fosters the development of carbohydrate cravings. b. There is progressive resistance to the effects of insulin. c. Hypoinsulinemia develops early in the first trimester. d. Glucose levels decrease to accommodate fetal growth.

D. because excessive adipose tissue increases cardiac workload, coupled with increased circulatory demands of obesity increases risk for vasoconstriction leading to hypertension.

Women who are obese have a greater risk of developing which of the following during pregnancy? a. Type 1 diabetes b. Hypotension c. Low birth weight infant d. Gestational hypertension

C. Alcohol ingested by the woman during pregnancy is teratogenic to the fetus, and the newborn can be born with fetal alcohol spectrum disorder.

Women who drink alcohol during pregnancy: a. Often produce more alcohol dehydrogenase b. Usually become intoxicated faster than before c. Can give birth to an infant with fetal alcohol spectrum disorder d. Gain fewer pounds throughout the gestation

a. "I am sure it is frightening to you to be diagnosed with a disease that can affect your baby."

A pregnant client is diagnosed with syphilis. Which interviewing question would demonstrate respect for the client and therapeutic communication? a. "I am sure it is frightening to you to be diagnosed with a disease that can affect your baby." b. "Why didn't you use protection when having intercourse with your partner?": c. "You should have thought about what diseases you could be exposed to. At least you are HIV negative." d. "I noticed that you seem fidgety. Is there something wrong besides your STI?"

c. I.V. fluids

A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize? a. diuretic drugs b. antibiotics c. I.V. fluids d. antihypertensive drugs

c. dyspnea, crackles, and irregular weak pulse

The nurse is assessing a pregnant client with a known history of congestive heart failure who is in her third trimester. Which assessment findings should the nurse prioritize? a. shortness of breath, bradycardia, and hypertension b. regular heart rate and hypertension c. dyspnea, crackles, and irregular weak pulse d. increased urinary output, tachycardia, and dry cough

d. Eat a sustaining-carbohydrate snack.

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 take which action? a. Add a bolus of long-acting insulin. b. Eat a high-carbohydrate snack. c. Inject a bolus of insulin. d. Eat a sustaining-carbohydrate snack.

b. Avoid outdoor activities such as gardening. c. Avoid cleaning the cat's litter box. e. Eat meat cooked to 160° F (71° C).

The nurse is caring for a pregnant client who indicates that she is fond of meat, works with children, and has a pet cat. Which instructions should the nurse give this client to prevent toxoplasmosis? (Select all that apply.) a. Keep the cat outdoors at all times. b. Avoid outdoor activities such as gardening. c. Avoid cleaning the cat's litter box. d. Avoid contact with children when they have a cold. e. Eat meat cooked to 160° F (71° C).

c. Maintain a daily blood glucose log

The nurse is preparing information for a client who has just been diagnosed with gestational diabetes. Which instruction should the nurse prioritize in this information? a. Plan daily menus with dietitian b. Report any signs of possible urinary tract infection c. Maintain a daily blood glucose log d. Long term therapy goals

a. citrus juice.

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. citrus juice. b. coffee. c. tea. d. fiber-rich foods.

D. A pregnant woman with asthma who is having an acute exacerbation will be poorly oxygenated, and thus perfusion to the placenta is compromised. Immediate treatment is needed for her well-being as well as that of the fetus.

When providing prenatal education to a pregnant woman with asthma, which of the following would be important for the nurse to do? a. Explain that she should avoid steroids during her pregnancy. b. Demonstrate how to assess her blood glucose levels. c. Teach correct administration of subcutaneous bronchodilators. d. Ensure she seeks treatment for any acute exacerbation.

B. Extreme nausea and vomiting as part of hyperemesis gravidarum would cause fluid and electrolyte imbalances and would alter blood glucose levels tremendously.

Which of the following conditions would most likely cause a pregnant woman with type 1 diabetes the greatest difficulty during her pregnancy? a. Placenta previa b. Hyperemesis gravidarum c. Abruptio placentae d. Rh incompatibility

b. avoidance of infection

A nurse is client teaching with a 30-year-old gravida 1 who has sickle cell anemia. Providing education on which topic is the highest nursing priority? a. constipation prevention b. avoidance of infection c. consumption of a low-fat diet d. administration of immunoglobulins

b. cytomegalovirus

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? a. chlamydia b. cytomegalovirus c. gonorrhea d. toxoplasmosis

B. The highest percentage of HIV transmission results from sexual activity, followed by intravenous drug use.

When explaining to a pregnant woman about HIV infection and transmission, which of the following would the nurse include? a. It primarily occurs when there is a large viral load in the blood. b. HIV is most commonly transmitted via sexual contact. c. It affects the majority of infants of mothers with HIV infection. d. Nurses are most frequently affected due to needlesticks.

a. mild hypertensive

Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client with chronic hypertension: week 16 - 124/86 mm Hg; week 20 - 138/90 mm Hg; week 24 - 140/92 mm Hg; and week 28 - 142/94 mm Hg. The nurse interprets these findings as indicating which classification of her blood pressure? a. mild hypertensive b. normotensive c. prehypertensive d. severe hypertensive

a. hypertension b. previous large for gestational age (LGA) infant d. obesity

A pregnant client has been diagnosed with gestational diabetes. Which are risk factors for developing gestational diabetes? (Select all that apply.) a. hypertension b. previous large for gestational age (LGA) infant c. maternal age less than 18 years d. obesity e. genitourinary tract abnormalities

d. "You should wait until after you give birth to obtain the cat for your daughter."

A pregnant single mom living alone tells the nurse she is considering getting a cat for her 2-year-old daughter. Which is the best response by the nurse? a. "If you don't think caring for a cat is too much work, that would be great." b. "The exposure to the cat litter may cause you to need a C-section." c. "This will cut down on the jealousy for your two-year-old when the baby comes." d. "You should wait until after you give birth to obtain the cat for your daughter."

c. "Pregnancy taxes the circulatory system of every woman."

A pregnant woman who has had cardiovascular disease for the last 3 years asks the nurse why this disorder makes her pregnancy an "at-risk" pregnancy. What is the nurse's best response? a. "The fact that you are receiving prenatal care will help." b. "Our facility has a lot of experience in dealing with this." c. "Pregnancy taxes the circulatory system of every woman." d. "Don't worry. You have an excellent primary care provider."

b. 8.5%

A pregnant woman with diabetes is having a glycosylated hemoglobin (HbA1C) level drawn. Which result would require the nurse to revise the client's plan of care? a. 7% b. 8.5% c. 6.0% d. 5.5%

c. 6%

A pregnant woman with type 2 diabetes is scheduled for a laboratory test of glycosylated hemoglobin (HbA1C). What does the nurse tell the client is a normal level for this test? a. 14% b. 12% c. 6% d. 8%

b. "I sometimes get a bit wheezy."

A pregnant client with a history of asthma since childhood presents for a prenatal visit. What statement by the client would the nurse prioritize? a. "I have trouble getting comfortable in bed." b. "I sometimes get a bit wheezy." c. "Certain substances make me sneeze." d. "I sometimes get a feeling of euphoria."

a. Both parents have to carry the trait.

A pregnant woman with sickle cell anemia is very concerned her infant will also develop the disease and questions the nurse about that possibility. Which is the best response from the nurse? a. Both parents have to carry the trait. b. The infant inherits the disease from the father. c. If the mother goes into a crisis while pregnant, the baby will develop sickle cell anemia. d. There is a good chance the infant will inherit the disease from the mother.

d. Prednisone is considered safe in the doses prescribed by her care provider.

A woman is pregnant and has asthma. Her primary care provider has told her to continue taking prednisone during pregnancy, but she is concerned the drug may be teratogenic. What advice would be best to give her regarding this? a. She should omit the drug during pregnancy. b. Prednisone is a teratogenic drug, but she may need it to control her asthma symptoms. c. She should half her dose during the first 3 months of pregnancy. d. Prednisone is considered safe in the doses prescribed by her care provider.

d. obtaining enough rest

A woman with an artificial mitral valve develops heart failure at the 20th week of pregnancy. Which measure would the nurse stress with her during the remainder of the pregnancy? a. maintaining a high fluid intake b. beginning a low-impact aerobics program c. discontinuing her prepregnancy anticoagulant d. obtaining enough rest

d. Decrease activity and rest more often.

A woman with cardiac disease at 32 weeks' gestation reports she has been having spells of light-headedness and dizziness every few days. Which instruction should the nurse prioritize? a. Discuss induction of labor with the primary care provider. b. Bed rest and bathroom privileges only until birth. c. Increase fluids and take more vitamins. d. Decrease activity and rest more often.