Week 10 BSN 346 Substance Misuse in Pregnancy

Question 10 of 18 A patient who is positive for human immunodeficiency virus (HIV) is about to be discharged from the hospital with her new infant. Which patient statement indicates that further patient teaching is required? "I'm glad I'll still be able to breastfeed my baby." "It's still possible that I gave my baby HIV, even though I took all my medication." "I will go to the pharmacy right now to fill my antiretroviral drug." "Even though I don't feel sick, I should plan on bottle-feeding my baby."

"I'm glad I'll still be able to breastfeed my baby." The patient's statement that she will be able to breastfeed her baby is incorrect, so further teaching is required. Breast milk is a route of HIV virus transmission and should be avoided completely.

Question 2 of 7 A patient is prescribed lamotrigine for bipolar depression. Which patient teaching statement made by the nurse is accurate regarding lamotrigine and pregnancy? "Serum levels should be monitored in the second and third trimesters." "This medication is a high alert and not recommended for use in pregnancy." "The dose should be decreased between 24 to 48 hours prior to delivery." "Lamotrigine causes known effects in newborns, including floppy baby syndrome, hypothyroid, poor feeding, and developmental delays."

"Serum levels should be monitored in the second and third trimesters." The statement "Serum levels should be monitored in the second and third trimesters" is accurate regarding lamotrigine due to increased renal clearance.

Question 2 of 4 The nurse notes +2 patellar reflexes during magnesium sulfate administration. Which information would the nurse report to the health care provider regarding the infusion? "The magnesium sulfate infusion should be discontinued." "The magnesium sulfate infusion is likely not toxic at this time." "The magnesium sulfate infusion will need to be increased to reach therapeutic levels." "I will administer calcium gluconate."

"The magnesium sulfate infusion is likely not toxic at this time." +2 reflexes indicate a therapeutic level of magnesium sulfate.

Question 9 of 9 Which statements by the nurse are the most appropriate to make to a patient who has recently had a miscarriage? Select all that apply. "When it is meant to happen, it will happen." "The fetus likely had a congenital anomaly that was incompatible with life." "Don't worry; nature has a way of taking care of mistakes. It is for the best." "This is often a consequence of unavoidable factors, and it is important to realize this is not your fault." "I am very sorry for your loss. Having a miscarriage must be so emotionally painful. How are you feeling?" NOT SURE

"This is often a consequence of unavoidable factors, and it is important to realize this is not your fault." The nurse can help the patient by emphasizing that most spontaneous abortions are caused by unavoidable factors or abnormalities. "I am very sorry for your loss. Having a miscarriage must be so emotionally painful. How are you feeling?" Acknowledging the patient's pregnancy loss and associated emotional pain is part of supportive nursing care.

Question 2 of 7 Which statement by the health care provider is an example of coercive behavior? "Your child will be taken away if you continue to use marijuana in your pregnancy." "Your child may be born with multiple birth defects and learning disorders if you continue to use alcohol while pregnant." "The staff at the hospital will discuss all possible options for pain management in labor if you have too much pain." "Using alcohol and cocaine while pregnant is not a healthy behavior for you or your baby."

"Your child will be taken away if you continue to use marijuana in your pregnancy." Stating that the patient's child will be taken away is a threatening statement that suggests legal retaliation for maternal behaviors.

Mental Health Disorders During Pregnancy: Question 1 of 7 Which statement by the nurse is an appropriate response when the pregnant patient asks about the safety of psychiatric medication during pregnancy? "The medications used to treat mental illness will cause birth defects, so you should discontinue your antidepressants." "Your mental wellness is an important part of pregnancy wellness, and continuing your medication is sometimes necessary." "All psychiatric medications have been proven to cross the placenta and cause birth defects in babies." "Your obstetrician should have enough information to prescribe your antipsychotics without consulting with your psychiatrist."

"Your mental wellness is an important part of pregnancy wellness, and continuing your medication is sometimes necessary." Many patients are encouraged to continue their medications throughout pregnancy under the guidance of a health care provider.

Question 12 of 12 Which interventions are most appropriate when caring for a patient admitted for preeclampsia on magnesium sulfate therapy? Select all that apply. Encourage increased PO fluid intake. Monitor strict intake and output. Place protective padding on the bed's side rails. Assist patient with ambulating to the bathroom instead of using a bedpan. Ensure that calcium gluconate is immediately available.

. Monitor strict intake and output. Place protective padding on the bed's side rails. Ensure that calcium gluconate is immediately available.

Question 1 of 7 How many ounces of alcohol are considered safe in the first trimester of pregnancy? 18 to 22 12 to 16 0 4 to 8

0 No amount of alcohol is considered safe at any point in pregnancy.

Hypertensive Disorders of Pregnancy: Question 1 of 3 The nurse understands that the definition of preeclampsia includes diagnostic criteria of a blood pressure of ______mm Hg on two or more occasions at least 4 hours apart.

140/90 Preeclampsia is new onset hypertension (140/90 on two or more occasions at least 4 hours apart) usually diagnosed after 20 weeks' gestation that usually, but not always includes the presence of proteinuria

Question 2 of 12 Which woman has an increased risk for developing preeclampsia? A 25-year-old woman with liver disease A 26-year-old woman with a body mass index (BMI) of 32 A 34-year-old woman who has breast cancer A 30-year-old woman with a family history of diabetes

A 26-year-old woman with a body mass index (BMI) of 32 Overweight patients have an increased risk for developing preeclampsia.

Question 1 of 12 Which finding would the nurse recognize as indicating progression of preeclampsia to eclampsia? Proteinuria Weight gain in the absence of edema Pitting edema in the absence of weight gain A generalized seizure not attributed to other causes

A generalized seizure not attributed to other causes Generalized seizure is the defining sign of eclampsia.

Question 4 of 6 An Rh-negative woman needs an amniocentesis. The nurse understands which statement to be true based upon the information provided? The amniocentesis will determine if the mother needs a blood transfusion. A shot of Rho(D) immune globulin will be required for this procedure. A Coombs test should be performed immediately after the procedure. The fetus is likely Rh-positive, so delivery should be expedited.

A shot of Rho(D) immune globulin will be required for this procedure. As a result of the potential for maternal fetal hemorrhage, Rho(D) immune globulin should be given after an amniocentesis when a woman is Rh-negative.

Question 3 of 6 Which methods can all women use to reduce risk in the preconception period? Select all that apply. Increasing saturated fats in their diet Abstaining from alcohol Taking a folic acid supplement Learning about inherited conditions that can affect pregnancy Achieving a healthy weight Waiting to update vaccines until after pregnancy to prevent exposure to teratogens

Abstaining from alcohol Taking a folic acid supplement Learning about inherited conditions that can affect pregnancy Achieving a healthy weight

Question 9 of 18 A woman tests positive for group B streptococcus (GBS) at 36 weeks gestation before a vaginal birth. Which interventions would the nurse include in the plan of care? Select all that apply. Retest for GBS upon admission to labor and delivery. Instruct the patient to use condoms until the infection clears. Administer antibiotics during labor until delivery as prescribed. Monitor the neonate for signs and symptoms of respiratory distress. Inspect the perineum carefully for lesions upon admission for labor and delivery.

Administer antibiotics during labor until delivery as prescribed. Antibiotics are administered in labor to help prevent transmission to the neonate during delivery. Monitor the neonate for signs and symptoms of respiratory distress. Signs of respiratory distress accompany neonatal GBS infection.

Question 7 of 7 Which action should the nurse take when a pregnant patient with bulimia nervosa presents to the office with tachycardia and orthostatic hypotension? Alert the health care provider and consider hospitalization. Nothing; these are expected abnormal findings. Advise the patient to rest and retake the vital signs in 10 minutes. Encourage vitamin B12 and calcium supplementation.

Alert the health care provider and consider hospitalization. Tachycardia and orthostatic hypotension are indicative of severe malnutrition and dehydration requiring hospitalization.

Question 3 of 18 When cardiovascular disease is severe during pregnancy, which health care providers may be a part of the interdisciplinary care team? Select all that apply. Anesthesiologists Nurses Dermatologists Neonatologists Obstetricians Maternal-fetal medicine specialists

Anesthesiologists Nurses Neonatologists Obstetricians Maternal-fetal medicine specialists

Question 11 of 12 The nurse assesses the blood pressure of a pregnant patient with preeclampsia and notes that is elevated. Which antihypertensive classification would be avoided for this patient? Calcium channel blockers Angiotensin-converting enzyme (ACE) inhibitors Vasodilators Beta blockers

Angiotensin-converting enzyme (ACE) inhibitors ACE inhibitors may cause renal damage to a developing fetus, and they are not used in pregnancy.

Question 2 of 18 Which antihypertensive classifications are contraindicated in pregnancy? Select all that apply. Beta blockers Angiotensin-converting enzyme (ACE) inhibitors Calcium channel blockers Vasodilators Angiotensin receptor blockers (ARBs)

Angiotensin-converting enzyme (ACE) inhibitors Angiotensin receptor blockers (ARBs)

Question 12 of 18 Which considerations would the nurse recognize for a pregnant patient with human immunodeficiency virus (HIV)? Select all that apply. A second test toward the end of the third trimester is not recommended. Vaginal delivery is always contraindicated. Antiretroviral therapy for the mother and neonate helps reduce transmission at birth. Testing all pregnant women for HIV at the beginning of pregnancy is a best practice. Breastfeeding should be avoided. An elective cesarean birth at 38 weeks helps prevent transmission to the neonate.

Antiretroviral therapy for the mother and neonate helps reduce transmission at birth. The risk for transmission decreases from 30% to less than 2% with antiretroviral therapy. Testing all pregnant women for HIV at the beginning of pregnancy is a best practice. All women, regardless of history, should be tested for HIV in the beginning of pregnancy. Breastfeeding should be avoided. Breastfeeding is contraindicated with maternal HIV infection. An elective cesarean birth at 38 weeks helps prevent transmission to the neonate. Elective cesarean birth has been shown to reduce the rate of neonatal HIV

Question 7 of 18 A patient reports a fishy, greenish, malodorous vaginal discharge after intercourse. The nurse understands these findings to be classic symptoms of which condition? Genital warts (condyloma) Chlamydia Bacterial vaginosis (Gardnerella) Vaginal yeast infections (Candidiasis)

Bacterial vaginosis (Gardnerella) The number one complaint for women with bacterial vaginosis is a fishy, greenish, thin discharge that is worse after intercourse.

Question 13 of 18 Which description is true of congenital cytomegalovirus (CMV)? Can lead to severe maternal anemia Can lead to neonatal hearing loss Often causes severe flulike symptoms in the mother Causes weeping skin lesions on the neonate

Can lead to neonatal hearing loss CMV is a leading cause of neonatal hearing loss.

Question 8 of 12 The nurse is completing a medication reconciliation for a pregnant patient with chronic hypertension. Which medication would cause the nurse to alert the health care provider? Captopril (angiotensin-converting enzyme [ACE] inhibitor) 25 mg bid Labetalol (beta blocker) 200 mg tid Nifedipine (calcium channel blocker) 30 mg daily Oral (PO) hydralazine (vasodilator) 25 mg tid

Captopril (angiotensin-converting enzyme [ACE] inhibitor) 25 mg bid ACE inhibitors are contraindicated in pregnancy.

Concurrent Conditions of Pregnancy: Question 1 of 18 The nurse understands that which concurrent condition during pregnancy is the leading cause of maternal mortality in the United States today? Cytomegalovirus (CMV) Human immunodeficiency virus (HIV) Cardiovascular disease Anemia secondary to blood loss

Cardiovascular disease Cardiovascular disease is now the leading cause of maternal mortality in the United States today.

Question 6 of 18 Which characteristics are associated with sickle cell anemia? Select all that apply. Causes frequent hospitalization throughout the life span Characterized by distorted and decreased erythrocytes Can lead to preterm birth Causes severe pain Commonly leads to fetal neural tube defects May be cured with diet and supplementation

Causes frequent hospitalization throughout the life span Crises may cause frequent hospitalization from childhood and beyond. Characterized by distorted and decreased erythrocytes Erythrocytes appear sickled under microscopy. Can lead to preterm birth Pregnant women with sickle cell anemia are at increased risk for preterm birth. Causes severe pain Sickle cell patients have extreme pain when experiencing a flare-up.

Question 3 of 4 Which signs/symptoms if exhibited by this patient would indicate that the disease process is advancing? Select all that apply. Clonus Epigastric pain Decreased generalized edema 15 mL/hour urine output +4 patellar reflexes

Clonus Clonus may indicate impending seizure and worsening disease process. Epigastric pain Complaints of epigastric pain indicate worsening preeclampsia and the development of HELLP syndrome. 15 mL/hour urine output Less than 30 mL/hour of urine output is oliguria and is a sign of worsening preeclampsia. +4 patellar reflexes +4 reflexes may indicate impending seizure and worsening disease process. Seizure Seizure onset would indicate development of eclampsia.

Question 5 of 9 Which type of placenta previa would the nurse recognize as being most dangerous? Concealed previa Marginal previa Complete previa Partial previa

Complete previa A complete previa is the most dangerous, as the placenta completely covers the cervical os, increasing the risk for injury and bleeding.

Question 1 of 9 Which cause of spontaneous abortion is the most common? Infectiont Congenital anomalies Vaginal bleeding Anomalies of the maternal reproductive tract

Congenital anomalies Severe congenital abnormalities that are incompatible with life are the most common causes of spontaneous abortions.

Question 3 of 9 Which signs would the nurse recognize as indicative of missed abortion? Select all that apply. Vaginal bleeding Products of conception partially expelled Decrease in uterine size Absent fetal heart rate Subsiding nausea Absence of breast tenderness

Decrease in uterine size As the fetus degenerates, the fundal height decreases. Absent fetal heart rate With missed abortion, there is no fetal heart tone. Subsiding nausea Signs of pregnancy begin to disappear after fetal death. Absence of breast tenderness Breast tenderness, an early sign of pregnancy, disappears after fetal death.

Question 3 of 3 Which change is associated with preeclampsia? Decreased renal perfusion Large-for-gestational-age fetus Increased colloid oncotic pressure Increased liver circulation

Decreased renal perfusion Vasospasm leads to decreased renal perfusion.

Question 4 of 7 A patient with bipolar depression and bulimia nervosa who is homeless enters care at 30 weeks' gestation. Which health care providers should be a part of the interdisciplinary team when developing a plan of care for this patient? Select all that apply. Dentist Obstetrician Nurse Psychiatrist Social worker Legal aid

Dentist Obstetrician Nurse Psychiatrist Social worker Legal aid

Question 9 of 12 Which instructions would the nurse include when educating the family of a patient admitted for preeclampsia? Select all that apply. Dim the lights. Limit activity. Increase fluid intake. Turn off the television. Limit the number of visitors. Decrease protein intake.

Dim the lights. Limit activity. Turn off the television. Limit the number of visitors.

Question 5 of 12 The nurse admitting a patient for preeclampsia notes that the patient's platelet count is 95,000. Which additional laboratory result would support the diagnosis of HELLP syndrome? Elevated AST/ALT Low hemoglobin Increased glomerular filtration rate (GFR) Decreased serum lactate (LD)

Elevated AST/ALT Elevated liver enzymes AST/ALT are suggestive of the development of HELLP syndrome.

Question 18 of 18 The nurse understands that which physiologic changes in the thyroid are considered abnormal in pregnancy? Select all that apply. Fatigue, edema, and muscle aches may be the result of thyroid activity in pregnancy. The thyroid gland enlarges and becomes palpable. Thyroid-stimulating hormone (TSH) decreases in the first trimester. Free thyroxine (T4) levels increase. Increased free thyroxine (T4) levels lead to weight loss and goiter.

Fatigue, edema, and muscle aches may be the result of thyroid activity in pregnancy. Fatigue, edema, and muscle aches may indicate hypothyroidism and are not normal. The thyroid gland enlarges and becomes palpable. The thyroid gland enlarging and becoming palpable is not an expected finding in pregnancy. Increased free thyroxine (T4) levels lead to weight loss and goiter. Weight loss and goiter would be abnormal and indicative of hyperthyroidism.

Question 6 of 6 Which assessments may be performed using ultrasonography? Select all that apply. Fetal anatomy Fetal Rh status Gestational age Chromosomal disorders Fetal heart activity Amniotic fluid index

Fetal anatomy Gestational age Chromosomal disorders Fetal heart activity Amniotic fluid index

Question 5 of 6 Which method would the nurse recognize as a low-tech assessment of fetal well-being? Fetal aneuploidy screening Fetal kick counts Ultrasonography Biophysical profile assessment

Fetal kick counts Fetal kick counts are an inexpensive, noninvasive method of fetal assessment.

Question 4 of 18 Which supplement would the nurse recommend to prevent fetal neural tube defects as a result of pernicious anemia? Folic acid Calcium carbonate Magnesium hydroxide Red raspberry leaf tea

Folic acid Folic acid supplementation has been shown to decrease the incidence of neural tube defects when initiated at least 1 month before conception and continued throughout the pregnancy.

Assessment of High-Risk Pregnancy: Question 1 of 6 The nurse is responsible for intake history at an obstetrics and gynecology (OB/GYN) office. Which medical conditions would the nurse recognize as high-risk conditions that could have adverse outcomes on a pregnancy? Select all that apply. Hemophilia Type 1 diabetes mellitus Human immunodeficiency virus (HIV) Chronic hypertension Xeroderma

Hemophilia Hemophilia is a coagulopathy that increases a woman's risk in pregnancy. Type 1 diabetes mellitus Type 1 diabetes mellitus is a medical condition that exists before pregnancy and can have serious adverse health outcomes for the pregnant mother and fetus. Human immunodeficiency virus (HIV) HIV is a medical diagnosis that can have adverse outcomes on a pregnancy. Chronic hypertension Chronic hypertension can cause adverse outcomes for a mother and fetus during pregnancy.

Question 14 of 18 Which viral infection can result in neonatal brain complications? Herpes infection Rubella infection Varicella-zoster infection Cytomegalovirus infection

Herpes infection A herpes infection can cause neonatal encephalitis

Question 7 of 7 The laboring patient becomes verbally abusive when denied a cigarette to relax. Which response by the nurse is most appropriate? "I know this is scary and may be causing some anxiety, but I'll help you the best way that I can." "I'm sorry, but smoking isn't allowed inside the hospital." "I'm sorry, but smoking is bad for you and the baby." "Please don't talk to me like that—I'm here to help you."

I know this is scary and may be causing some anxiety, but I'll help you the best way that I can." The nurse is providing nonjudgmental therapeutic communication with the patient

Question 3 of 7 Which adverse maternal effect can be caused when a patient experiences anxiety disorders in pregnancy? Increased incidence of first trimester bleeding Increased risk for cord prolapse in labor Increased risk for maternal mortality Increased risk for forceps delivery

Increased risk for forceps delivery Women with anxiety disorders have an increased risk for operative delivery (forceps/vacuum/episiotomy).

Question 11 of 18 Which action would the nurse take if a pregnant patient opts out of prenatal human immunodeficiency virus (HIV) testing? Report the mother to child protective services. Inform the mother that the baby will likely be screened for HIV after birth. Collect the sample anyway. Request that the patient's sexual partners come in for screening.

Inform the mother that the baby will likely be screened for HIV after birth. It is recommended that the neonate be screened after birth even if the mother has opted out of prenatal testing.

Question 3 of 12 A patient asks the nurse to describe which factors are included in HELLP syndrome. Which factors would the nurse include in response? Select all that apply. Low platelets Hemolysis Low leukocytes Elevated erythrocytes Elevated liver enzymes

Low platelets Hemolysis Elevated liver enzymes

Question 7 of 12 After administration of oral (PO) labetalol for a patient with gestational hypertension, the nurse notes a blood pressure (BP) of 178/96 mm Hg. The patient also reports headache and blurry vision. Which order from the patient's health care provider would the nurse anticipate? Up ad lib Lisinopril Salt-free diet Magnesium sulfate

Magnesium sulfate Headache, blurred vision, and a BP of 178/96 mm Hg are indicative of preeclampsia. Magnesium sulfate would be administered to prevent seizures.

Question 17 of 18 Which major concern regarding epilepsy in pregnancy would the nurse recognize? Many antiseizure medications are known teratogens. There is an increased risk for miscarriage and preeclampsia. A woman who has been seizure-free for many years may have a severe exacerbation in pregnancy. Epilepsy in pregnancy may lead to Graves disease.

Many antiseizure medications are known teratogens. Women who are pregnant and have epilepsy may require specialized medication management to prevent adverse fetal effects while managing their condition.

Question 8 of 18 A pregnant woman presents with clumpy, white vaginal discharge, vulvar pruritus, and burning. Which treatment would the nurse expect for this patient? Clindamycin Miconazole Metronidazole Imiquimod

Miconazole Clumpy, white vaginal discharge with vulvar pruritus and burning is associated with candidiasis and should be treated with the appropriate antifungal, such as miconazole.

Question 16 of 18 Which nursing intervention would be included in the care of a woman with lupus during her first trimester of pregnancy? Monitor for liver function. Monitor for increased joint pain and fatigue. Provide patient education on remission of lupus. Administer subcutaneous heparin for thrombosis prevention.

Monitor for liver function. Renal function, not liver function, often worsens with lupus.

Question 8 of 9 A patient presents with bleeding caused by placenta previa in late pregnancy. Which physical assessments are the most important for the nurse to perform? Select all that apply. Monitor urinary output. Monitor vaginal bleeding. Assess vital signs for the patient. Monitor fetal heart rate and contraction patterns. Perform digital vaginal examination for dilation. Measure fundal height.

Monitor urinary output. Monitor vaginal bleeding. Assess vital signs for the patient. Monitor fetal heart rate and contraction patterns.

Question 6 of 7 Which action would the nurse take after calculating a score of five on the Edinburgh Postpartum Depression scale for a pregnant patient with a history of depression? Initiate a referral to psychiatry. Nothing; this is a normal score. Advise the patient to discontinue her selective serotonin reuptake inhibitor. Rescore the patient before she leaves the office.

Nothing; this is a normal score. A score of less than eight is not suggestive of current depressive symptoms or exacerbation.

Question 4 of 7 A pregnant woman is yawning excessively, is diaphoretic, and is experiencing nausea, vomiting, diaphoresis, and diarrhea. The nurse suspects that the woman may be withdrawing from which substance? Opioids Alcohol Cocaine Marijuana

Opioids Symptoms of opioid withdrawal include yawning, diaphoresis, rhinorrhea, restlessness, tearing of the eyes, nausea, vomiting, and abdominal cramps.

Question 2 of 6 Which pregnancy-related condition is related to both maternal and fetal influences? Amniotic banding Polyhydramnios Nuchal cord Preeclampsia

Polyhydramnios Polyhydramnios can happen without a known cause. However, maternal diabetes can also lead to polyhydramnios. Because the fetus creates amniotic fluid, the condition is considered both maternal and fetal.

Question 4 of 12 When assessing the neonate born to a mother with preeclampsia, the nurse knows that low birth weight may be attributed to which factor? Maternal diabetes Limited maternal diet Maternal hypotension Poor placental perfusion

Poor placental perfusion Decreased blood flow to the placenta leads to decreased nutrients to the fetus and can impair fetal growth.

Question 1 of 4 Which hypertensive disorder would the nurse suspect this patient has based upon the information provided? Gestational hypertension Chronic hypertension Preeclampsia Eclampsia

Preeclampsia Preeclampsia is new onset hypertension, usually diagnosed after 20 weeks gestation, that typically, but not always, includes the presence of proteinuria. This patient has severe hypertension, a headache, and proteinuria with no previous history of elevated blood pressure.

Question 4 of 9 The nurse notes recurrent late decelerations that do not respond to intrauterine resuscitation on the fetal monitor attached to a patient with a concealed placental abruption. Which order would the nurse anticipate? Administer pain medication as prescribed. Prepare for emergency cesarean birth. Turn the patient to the left lateral position. Palpate the fundal tone.

Prepare for emergency cesarean birth. This fetus is demonstrating signs of hypoxia leading to hypoxemia, likely as a result of an advancing abruption. Delivery should be expedited to prevent maternal/fetal morbidity and mortality.

Question 2 of 9 Which sign would lead the nurse to suspect ectopic pregnancy in a patient with a missed period? Severe, localized abdominal pain in the left lower abdominal quadrant Vaginal bleeding after intercourse Nausea and vomiting Painless, bright-red vaginal bleeding

Severe, localized abdominal pain in the left lower abdominal quadrant Localized and severe pain in the lower abdominal quadrants may indicate ectopic pregnancy in the proximal end of the fallopian tube.

Question 5 of 18 Which type of anemia is an inherited anemia? Sickle cell anemia Aplastic anemia Iron deficiency anemia Pernicious anemia

Sickle cell anemia Sickle cell anemia is an autosomal recessive disorder.

Question 10 of 12 When assessing a patient with preeclampsia on magnesium sulfate for seizure prophylaxis, the nurse notes the patient demonstrates hyperreflexia (+4). How does the nurse interpret this patient cue? The nurse should administer a 500-mL bolus of lactated Ringer's solution. The nurse should interpret this as normal and continue the therapy as prescribed. The nurse should request a prescription for calcium gluconate immediately. The nurse should question the health care provider regarding the current dose of magnesium sulfate.

The nurse should question the health care provider regarding the current dose of magnesium sulfate. Hyperreflexia and neurologic instability are signs of worsening preeclampsia. This patient's magnesium sulfate is likely subtherapeutic, and the health care provider should prescribe the rate to be increased to prevent seizure.

Question 15 of 18 Which statements are true regarding rubella in pregnancy? Select all that apply. Women develop a "slapped-cheek rash." Titers less than 1:8 demonstrate immunity. The virus can cross the placental barrier. Most women of childbearing age in the United States have received this vaccine already. If a woman is not immune, she can be offered the vaccine during pregnancy.

The virus can cross the placental barrier. Crossing of the placental barrier is a serious concern with rubella infection. Most women of childbearing age in the United States have received this vaccine already. The measles-mumps-rubella (MMR) vaccine contains the rubella vaccine.

Question 7 of 9 A patient in early pregnancy presents with heavy bleeding and blood clots. Her hemoglobin and hematocrit are low. Based upon the information given, which order would the nurse anticipate? Prepare for emergency cesarean birth. Administer 650 mg acetaminophen for pain stat. Transfuse 1 unit packed red blood cells stat. Massage the fundus.

Transfuse 1 unit packed red blood cells stat. When hemoglobin and hematocrit are low as a result of hemorrhage, blood transfusion is necessary to replace blood lost.

Question 3 of 7 Which signs would the nurse assess in a newborn exposed to tobacco while in utero? Select all that apply. Flat nasal bridge Tremors Signs of prematurity Open spinal cord defect Colic/fussy behavior A lower-than-expected weight

Tremors Signs of prematurity Colic/fussy behavior A lower-than-expected weight

Question 5 of 7 Which signs and symptoms would a patient with pica demonstrate? Select all that apply. Uncontrollable urge to eat toothpaste Increased levels of blood toxins Intestinal parasites Epistaxis Diplopia Large-for-gestational-age babies

Uncontrollable urge to eat toothpaste Increased levels of blood toxins Intestinal parasites

Question 6 of 9 Which classic findings would the nurse identify in a patient with placental abruption (abruptio placentae)? Select all that apply. Absent vaginal bleeding Uterine irritability with low-intensity contractions Severe abdominal cramping Painless vaginal bleeding Boardlike abdomen

Uterine irritability with low-intensity contractions Severe abdominal cramping Boardlike abdomen

Question 6 of 7 Which complications of pregnancy are associated with substance misuse? Select all that apply. Vaginal bleeding Gestational diabetes Preterm labor Intrauterine growth restriction (IUGR) Umbilical cord prolapse Congenital anomalies

Vaginal bleeding Preterm labor Intrauterine growth restriction (IUGR) Congenital anomalies

Question 5 of 7 Which methods of screening for substance abuse in a pregnant woman are considered acceptable? Select all that apply. Verbally screening only at the first prenatal visit Collecting a urine sample and sending without consent Verbally using a validated screening tool Asking the pregnant woman's significant other Obtaining patient consent and collecting laboratory samples

Verbally using a validated screening tool Using a validated tool improves screening accuracy. Obtaining patient consent and collecting laboratory samples Obtaining laboratory samples helps the nurse determine which substances a patient may have used recently and determine care for the neonate and mother. It is always important to obtain consent for toxicology by following hospital protocol.

Question 6 of 12 A patient with preeclampsia has an emergency delivery at 32 weeks gestation. Which findings would the nurse anticipate in this premature neonate? Select all that apply. Yellow skin Weight of 2000 g Axillary temperature of 97.7°F Heart rate of 120 beats/min Poor respiratory effort

Yellow skin Weight of 2000 g Poor respiratory effort