OB Ch. 16 Questions

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 pregnant woman does not have to worry about contracting new illnesses during pregnancy."

A pregnant client is diagnosed with syphilis. Which response would demonstrate respect for the client and therapeutic communication?

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

A mother is talking to the nurse and is concerned about managing her asthma while she is pregnant. Which response to the nurse's teaching indicates that the woman needs further instruction?

"I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring."

A pregnant woman is diagnosed with iron-deficiency anemia and is prescribed an iron supplement. After teaching her about the prescribed iron supplement, which statement indicates successful teaching?

"I need to drink plenty of fluids to prevent constipation."

A pregnant client with a history of asthma since childhood presents for a prenatal visit. What statement by the client would the nurse prioritize?

"I sometimes get a bit wheezy."

A nurse is talking to a newly pregnant woman who had a mitral valve replacement in the past. Which statement by the client reveals an understanding about the preexisting condition?

"I understand that my fetus and I both are at risk for complications."

A pregnant client with iron-deficiency anemia is prescribed an Iron supplement. After teaching the woman about using the supplement, the nurse determines that more teaching is needed based on which client statement?

"I will take the iron with milk instead of orange or grapefruit juice."

The nurse is caring for a pregnant client with asthma that is well managed with long- and short-acting bronchodilators. Which statements) does the nurse associate with the client's condition? Select all that apply.

-Adequate analgesia decreases the woman's risk for exacerbation during labor. -The woman should receive her regularly scheduled bronchodilators during labor. -Adequate hydration decreases the woman's risk for exacerbation during labor.

The nurse is teaching a client with gestational diabetes about complications that can occur either following birth or during the birth for the infant. Which statement by the mother indicates that further teaching is needed by the nurse?

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

The nurse is teaching a pregnant client with type 2 diabetes about diet during pregnancy. Which client statement indicates that the nurse's teaching was successful?

"Pregnancy affects insulin production, so I will need to make adjustments in my diet."

The nurse is caring for a pregnant client in the first trimester with a preexisting condition of rheumatic heart disease. The client reports mild shortness of breath with strenuous activity. When teaching the client, which statement(s) will the nurse include? Select all that apply.

-"be sure to drink an adequate amount of fluids." -"be sure to receive an influenza vaccine." -"perform moderate exercises as tolerated."

A woman arrives at the prenatal clinic and is accompanied by her partner. Which behaviors would be suggestive of intimate partner violence (IPV)? Select all that apply.

-The partner is overly protective of the pregnant client. -Poor weight gain during the pregnancy and low birth weight infant -The partner answers questions for the pregnant client.

A pregnant woman with gestational diabetes is prescribed 10 units of an intermediate-acting insulin and 5 units of a short-acting insulin each day. The total dose is to be divided into two injections, a morning and an evening dose. To provide the most effective control of the woman's blood glucose levels, the nurse anticipates that the client is likely to be prescribed how many total units for the morning dose?

10

Which condition is the most common cause of anemia in pregnancy?

iron-deficiency anemia

A pregnant client with type 1 diabetes is in labor. The client's blood glucose levels are being monitored every hour and she has a prescription for an infusion of regular insulin as needed based on the client's blood glucose levels. Her levels are as follows: • 1300: 105 mg/dL (5.83 mmol/L) • 1400: 100 mg/dL (5.55 mmol/L) • 1500: 120 mg/dL (6.66 mmol/L) • 1600: 106 mg(al (5.88 mmol/L) Based on the recorded blood glucose levels, at which time would the nurse likely administer the regular insulin infusion?

1500

At which age range are women most vulnerable for intimate partner violence?

16 to 24 years

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 3-hour glucose tolerance test for follow-up

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?

obtaining enough rest

Which initial interview technique would be least effective in gathering information from a suspected abuse victim?

Ask the client to strip down and show you where she has been hurt.

The maternal health nurse is caring for a pregnant client with pre-existing heart disease. Which concept will the nurse identify as a priority?

Balancing weight gain

A 38-year-old client comes into the office for prenatal care, stating that she is about 12 weeks pregnant with her first child. What action will the nurse take, considering the client's age and potential sensitivity to being labeled an "older" primipara?

Be nonjudgmental in your history gathering and offer her pregnancy resources to read and explore.

The maternal health nurse cares for a homeless pregnant woman who presented to the emergency room in precipitous labor. The woman has not had prenatal care. Upon delivery, her infant weighs 4.6 kg and notes the infant appears to be jittery. Which nursing action will the nurse perform first?

Check the infant's blood glucose level.

A pregnant client with a history of heart disease has been admitted to a health care center reporting breathlessness. The client also reports shortness of breath and easy fatigue when doing ordinary activity. The client's condition is markedly compromised. The nurse would document the client's condition using the New York Heart Association (NYHA) classification system as which class?

Class III

A pregnant woman with diabetes at 10 weeks' gestation has a glycosylated hemoglobin (HbA1 c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome?

Congenital anomalies

The maternal health nurse is caring for a pregnant client with a history of epilepsy. The client's antiepileptic drug (AED) levels have been in the non-therapeutic range the last two times the labs were drawn. Which factor does the nurse associate with this finding?

Drug metabolism changes during pregnancy

Which change in insulin is most likely to occur in a woman during pregnancy?

Less effective than normal

A pregnant woman diagnosed with diabetes should be instructed to perform which action?

Notify the primary care provider if unable to eat because of nausea and vomiting.

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?

Sickle cell anemia is recessively inherited.

A 15-year-old adolescent arrives at the office with a report of flu symptoms, including nausea and vomiting and recent weight loss. A pregnancy test is done and is positive. The client begins crying and tells the nurse her mother will be furious with her. What can the nurse do to assist this adolescent at this point?

Support her by respecting her right to privacy and confidentiality.

A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection?

Toxoplasmosis

A 29-year-old client has gestational diabetes. The nurse is teaching her about managing her glucose levels. Which therapy would be most appropriate for this client?

diet

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?

dyspnea, crackles, and irregular weak pulse

During a prenatal examination the nurse observes bruises on the client's arms and a black eye. When asked about the bruises, the client states, "It was an accident. My spouse just had a bad day at work, and I was late getting dinner prepared. But my spouse is being so kind now; my spouse brought me flowers yesterday. My spouse is looking for a new job, so it will not happen again." This client is in which phase of the cycle of violence?

honeymoon phase

A nurse is assisting a client in active labor whose diabetes has been poorly controlled. Which assessment of the neonate should be prioritized after its birth?

macrosomia

The maternal health nurse is caring for a group of high-risk pregnant clients. Which client condition will the nurse identify as being the highest risk for pregnancy?

pulmonary hypertension

Which factor would contribute to a high-risk pregnancy?

type 1 diabetes