Maternity Test 2 Chapter 19 Application

A nursing instructor is teaching about causes of infertility and identifies a need for further instruction when a student states which of the following? "Diet does not play a role in infertility." "Exercise can influence infertility." "A genetic abnormality may cause infertility." "An absence of ovulation may cause infertility."

"Diet does not play a role in infertility."

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 will monitor my peak expiratory flow rate regularly to help me predict when an asthma attack is coming on." "I need to begin taking allergy shots like my friend to prevent me from having an allergic reaction this spring." "I need to be aware of my triggers and avoid them as much as possible." "It is fine for me to use my albuterol inhaler if I begin to feel tight."

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

The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse's teaching was successful? "Pregnancy affects insulin production, so I'll need to make adjustments in my diet." "I'll basically follow the same diet that I was following before I became pregnant." "I'll adjust my diet and insulin based on the results of my urine tests for glucose." "Because I need extra protein, I'll have to increase my intake of milk and meat."

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

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? "Your primary care provider will order safe doses of your medication." "They won't cause any major defects." "It's OK to not use them if you would feel more comfortable." "I'll let your primary care provider know how you feel about it."

"Your primary care provider will order safe doses of your medication."

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? 120 mg/dL 85 mg/dL 136 mg/dL 45 mg/dL

85 mg/dL

The nurse is caring for a diabetic, postpartum client who has developed an infection.The nurse is aware that infections in diabetic clients tend to be more severe and can quickly lead to complications. Which complication should the nurse assess this client for? Respiratory acidosis Anemia Respiratory alkalosis Ketoacidosis

Ketoacidosis

The nurse is caring for a client with a high-risk pregnancy. Which circumstance(s) may have caused the pregnancy to be labeled as high-risk? Select all that apply. multiple gestation pregnancy three-vessel umbilical cord daily exercises by mother maternal high blood pressure genetic defect of fetus HIV-positive mother

HIV-positive mother multiple gestation pregnancy genetic defect of fetus maternal high blood pressure

A nursing instructor is teaching students about caring for a pregnant patient with a pre-existing disease. Which of the following does the instructor suggest has added to an increased incidence of pregnant women with a pre-existing disease? More women waiting until after age 30 years to get pregnant Women seeking out earlier prenatal care Better tests to diagnose diseases Better assessment skills by physicians

More women waiting until after age 30 years to get pregnant

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? Dried apples Orange juice Fortified grains Dried beans

Orange juice

A pregnant client with diabetes in the hospital reports waking up with shakiness and diaphoresis. Which action should the nurse prioritize after discovering the client's fasting blood sugar is 60 mg/dl (3.33 mmol/L)? Withhold her insulin, and notify the health care provider. Stay with her, and ask another nurse to bring her insulin. Provide the client some milk to drink. Recheck her blood sugar for accuracy.

Provide the client some milk to drink.

The client is 32 weeks pregnant and has been referred for biophysical profile (BPP) after a nonreassuring nonstress test (NST). Which statement made by the client indicates that the nurse's explanation of the procedure was effective? The BPP is a blood test to detect placental problems. The BPP is a screening for neural tube defects. The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume. The BPP is a diagnostic procedure whereby a needle is inserted into the amniotic sac to obtain fluid.

The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.

A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is most important in the first 48 hours postpartum? ensuring that the client consumes a high fiber diet inspecting the extremities for edema limiting sodium intake assessing for cardiac decompensation

assessing for cardiac decompensation

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

avoidance of infection

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? left lateral recumbent right lateral recumbent on her back prone

left lateral recumbent

In women with cardiac failure, the maternal blood pressure becomes insufficient to provide an adequate supply of blood to the placenta. The infant will likely experience some undesired effects, including which of the following? high birth weight hypoglycemia low birth weight hyperglycemia

low birth weight

A couple who is in for fertility testing ask the nurse what tests are commonly performed to assess fertility. The nurse replies that there are only three primary tests that are used. What are these tests? pelvic sonogram, ovulation monitoring, and semen analysis serologic test for syphilis, semen analysis, and tubal patency assessment semen analysis, ovulation monitoring, and tubal patency assessment semen analysis, urinalysis, and ovulation monitoring

semen analysis, ovulation monitoring, and tubal patency assessment

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

type 1 diabetes

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." "I will call the health care provider if my stool is black and tarry." "I should take my iron with milk." "I should avoid drinking orange juice."

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

A 32-year-old woman with epilepsy mentions to the nurse during a routine well-visit that she would like to have children and asks the nurse for advice. Which response is most appropriate from the nurse? "Do you want to talk to a counselor who can help you weigh the pros and cons of having your own child rather than adopting?" "You should talk to the doctor about that; the medications you're on can damage the fetus." "I'll let the doctor know so you can discuss your medications. In the meantime, I'll give you a list of folate-rich foods you can add to your diet." "That's great. I've got a 4-year-old and a 2-year-old myself."

"I'll let the doctor know so you can discuss your medications. In the meantime, I'll give you a list of folate-rich foods you can add to your diet."

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? "I may need an amniocentesis during the third trimester to see if my baby's lungs are ready to be born." "If my blood sugars are elevated, my baby's lungs will mature faster, which is good." "My baby may be very large and I may need a cesarean section to have him." "Beginning at 28 weeks' gestation, I will start counting with my baby's movements every day."

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

When evaluating fetal well-being, what is the maximum score on a biophysical profile?

10

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 needs to be careful of and cautious about accidents and illnesses during her pregnancy." "A pregnant woman with a chronic condition can put herself at risk." "A pregnant woman with a chronic illness can put the fetus at risk." "A pregnant woman does not have to worry about contracting new illnesses during pregnancy."

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

Which of the following statements regarding weight and pregnancy is correct? An underweight woman should increase her caloric intake by 500 to 1000 calories a day. Women who are underweight coming into pregnancy should gain the same amount of weight as women with a normal BMI. Dieting during pregnancy to reduce weight is recommended only for morbidly obese women. Obesity usually occurs from hypothyroidism.

An underweight woman should increase her caloric intake by 500 to 1000 calories a day.

A patient with asthma who is 32 weeks' pregnant is concerned that the health care provider has reduced the doses of asthma maintenance medications. How should the nurse respond to this patient's concern? Asthma medication may reduce labor contractions and should be reduced. Asthma improves during pregnancy so higher doses are not needed. Asthma medication is ineffective during pregnancy and should be stopped. Asthma medication is teratogenic and should not be taken.

Asthma medication may reduce labor contractions and should be reduced.

A patient with type 2 diabetes mellitus is planning to become pregnant within the next several months. What should the nurse instruct the patient to support the 2020 National Health Goals of reducing the complications of pregnancy from diabetes? Reduce the use of insulin for blood glucose coverage. Avoid episodes of hyperglycemia. Limit the intake of carbohydrates and fats in the diet. Reduce the current exercise regimen by half.

Avoid episodes of hyperglycemia.

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? Bed rest and bathroom privileges only until birth. Increase fluids and take more vitamins. Discuss induction of labor with the health care provider. Decrease activity and rest more often.

Decrease activity and rest more often.

A pregnant patient asks why an α-fetoprotein serum level has been ordered. What should the nurse explain to the patient about this test? It screens for placenta function. It may reveal chromosomal abnormalities. It tests the ability of the patient's heart to accommodate the pregnancy. It measures the fetal liver function.

It may reveal chromosomal abnormalities.

Which response is most appropriate for a client with diabetes who wants to breast-feed but is concerned about the effects of breastfeeding on her health? Diabetic clients who breast-feed have a hard time controlling their insulin needs Diabetic clients may breast-feed; insulin requirements may decrease from breast-feeding Diabetic clients shouldn't breast-feed because of potential complications Diabetic clients shouldn't breast-feed; insulin requirements are doubled

Diabetic clients may breast-feed; insulin requirements may decrease from breast-feeding

A nurse is assessing a client in her seventh month of pregnancy who has an artificial valve prosthesis. The client is taking an oral anticoagulant to prevent the formation of clots at the valve site. Which of the following nursing interventions is most appropriate in this situation? Urge the client to discontinue the anticoagulant to prevent pregnancy complications Put the client on bed rest Observe the client for signs of petechiae and premature separation of the placenta Instruct the client to avoid wearing constrictive knee-high stockings

Observe the client for signs of petechiae and premature separation of the placenta

The nurse is caring for a pregnant client admitted for abdominal trauma following an assault. The nurse will monitor the client for which potential complications? Select all that apply. Spontaneous abortion (miscarriage) Placental abruption (abruptio placentae) Preterm labor Uterine rupture Gestational hypertension

Spontaneous abortion (miscarriage) Placental abruption (abruptio placentae) Preterm labor Uterine rupture

Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client with chronic hypertension: week 16 - 130/86 mm Hg; week 20 - 138/88 mm Hg; week 24 - 136/82 mm Hg; and week 28 - 138/88 mm Hg. The nurse interprets these findings as indicating which classification of her blood pressure? Stage 2 Elevated Stage 1 Hypertensive crisis

Stage 1

A pregnant woman with a history of mitral valve stenosis is to be prescribed medication as treatment. Which medication class would the nurse expect the client to be prescribed? inotropic angiotensin receptor blockers vasodilator anticoagulant

anticoagulant

A nurse is caring for a pregnant client. The initial interview reveals that the client is accustomed to drinking coffee at regular intervals. For which increased risk should the nurse make the client aware? anemia scurvy heart disease rickets

anemia

When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which schedule would be most appropriate? bi-monthly visits until 28 weeks, then weekly visits bi-monthly visits until 36 weeks, then weekly visits monthly visits until 32 weeks, then bi-monthly visits monthly visits until 20 weeks, then bi-monthly visits

bi-monthly visits until 28 weeks, then weekly visits

A pregnant client with type I diabetes asks the nurse about how to best control her blood sugar while she is pregnant. The best reply would be for the woman to: exercise for 1 to 2 hours each day to keep the blood glucose down. limit weight gain to 15 pounds during the pregnancy. begin oral hyperglycemic medications along with the insulin she is currently taking. check her blood sugars frequently and adjust insulin accordingly.

check her blood sugars frequently and adjust insulin accordingly.

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 increased urinary output, tachycardia, and dry cough shortness of breath, bradycardia, and hypertension regular heart rate and hypertension

dyspnea, crackles, and irregular weak pulse

A woman with type 2 diabetes is considering becoming pregnant and asks the nurse whether she will be able to continue taking her current oral hypoglycemics. The nurse's response will point out which factor? are usually suggested primarily for women who develop gestational diabetes. have been shown to be effective and safe in recent short term studies. can be used as long as they control serum glucose levels. can be taken until the degeneration of the placenta occurs.

have been shown to be effective and safe in recent short term studies.

A client at 36 weeks' gestation who is 2 years post bariatric surgery would be expected to have a weight gain that is: the same as other pregnant clients at that gestational age determined by the client's BMI and gestational age. less than other pregnant clients at the same gestational age. more than other pregnant clients at the same gestational age.

less than other pregnant clients at the same gestational age

While providing care to a pregnant woman at the clinic, the nurse suspects that the client may be a victim of intimate partner violence. Which findings would lead the nurse to suspect this? Select all that apply. relaxed appearance during pelvic examinations not keeping up with scheduled treatments up and down weight gain frequent questions about how she and the baby are doing irregular adherence to scheduled prenatal visits

not keeping up with scheduled treatments up and down weight gain irregular adherence to scheduled prenatal visits

A nurse is interviewing a couple at a preconception counseling session. The couple is of Greek heritage and are concerned about the possibility of their children being born with a genetic disorder. Based on the nurse's understanding of genetic disorders, the nurse would identify this couple as being at risk for which condition? Tay-Sachs disease sickle cell anemia α-thalassemia β-thalassemia

β-thalassemia

The nurse is assessing a mother who just delivered a 7 lb (3136 g) baby via cesarean delivery. Which assessment finding should the nurse prioritize if the mother has a history of controlled atrial fibrillation? Urinary retention Jugular distention Abdominal cramps Nausea and vomiting

Jugular distention