Prep U CH 19
When evaluating fetal well-being, what is the maximum score on a biophysical profile?
10
The nurse is assessing a pregnant client who has a history of heart disease. The nurse will prioritize assessments focusing on the heart during which time frame?
28 to 32 weeks' gestation
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.
A pregnant client in her 20th week of gestation, having systemic lupus erythematosus (SLE), is admitted to the healthcare unit for management of the exacerbation of SLE. Which of the following would be most appropriate to treat the client's condition?
Corticosteroids
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?
semen analysis, ovulation monitoring, and tubal patency assessment
The nurse is caring for a pregnant client who is in her 30th week of gestation and has congenital heart disease. Which finding should the nurse recognize as a symptom of cardiac decompensation with this client?
swelling of the face
Which factor would contribute to a high-risk pregnancy?
type 1 diabetes
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?
Ketoacidosis
A nurse is conducting a program for pregnant women with gestational diabetes about reducing complications. The nurse determines that the teaching was successful when the group identifies which factor as being most important in helping to reduce complications associated with pregnancy and diabetes?
degree of blood glucose control achieved during the pregnancy
Your patient is very conscious of the weight she gained during her pregnancy. She has decided to breastfeed her baby and asks you how many calories a day extra she should be eating so that she and her baby are healthy. She states she does not want to gain any extra weight from over-eating. What would be your best response?
"You should be eating an extra 200 kcal over what you were eating while you were pregnant."
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 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?
β-thalassemia
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 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?
"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."
A nurse is caring for a 45-year-old pregnant client with a cardiac disorder who has been instructed by her primary care provider to follow class I functional activity recommendations. The nurse correctly instructs the client to follow which limitations?
"You do not need to limit your physical activity unless you experience any problems such as fatigue, chest pain, or shortness of breath."
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?
Prednisone is considered safe in the doses prescribed by her care provider.
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:
check her blood sugars frequently and adjust insulin accordingly.
What problem does the nurse address in the plan of care for a pregnant client post-bariatric surgery?
poor absorption of fat-soluble vitamins
A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make?
"Be sure that your lupus is stable or in remission for 6 months before getting pregnant."
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."
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?
"If my blood sugars are elevated, my baby's lungs will mature faster, which is good."
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."
A pregnant woman who has been taking penicillin prophylactically because she had rheumatic fever tells the nurse that she wants to stop taking it now that she is pregnant. Which of the following is the best response by the nurse?
"You should continue taking this drug, because penicillin is not known to be a fetal teratogen."
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."
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?
85 mg/dL
Charlene McCoy, who has several children already, reports for a first prenatal visit. She seems preoccupied and withdrawn, and she makes consistently negative remarks about the pregnancy. Reviewing her records, you note that she is receiving a serotonin reuptake inhibitor. What should you do?
Alert the RN or primary care provider
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.
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?
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?
Decrease activity and rest more often.
Which change best describes the insulin needs of a client with type 1 diabetes mellitus who has just delivered an infant vaginally without complications?
Decreased
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 may breast-feed; insulin requirements may decrease from breast-feeding
A pregnant client with deep vein thrombosis has been diagnosed as having systemic lupus erythematosus (SLE). The nurse would monitor the client closely for the development of which complication?
Fetal malnutrition
The nurse is planning to instruct a patient who is 12 weeks pregnant on interventions to stop smoking. What should the nurse include in these instructions? Select all that apply.
Follow a smoking cessation plan. Ask a friend to help with smoking cessation actions. Ask the physician if a smoking cessation medication can be used.
The nurse is caring for a toddler diagnosed with iron deficiency anemia and prescribed an iron supplement. What would the nurse include in the educational plan for the parents? Select all that apply.
Give the iron supplement with a liquid or food high in vitamin C (such as orange juice/oranges) Iron supplements may cause dark stools, so monitor for this as an expected finding
A nurse is giving a talk to a local group about the benefits of genetic counseling and identifies diseases known as autosomal-dominant disorders. Which of the following diseases should the nurse include? (Select all that apply.)
Huntington's disease Marfan syndrome Breast cancer syndrome Breast/ovarian cancer syndrome
The nurse is educating a client with type 1 diabetes about the complications associated with diabetes and pregnancy. Which problems would the nurse include in her teaching? Select all that apply.
Increased risk of spontaneous abortion Polyhydramnios Hypertension
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 may reveal chromosomal abnormalities.
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
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?
Observe the client for signs of petechiae and premature separation of the placenta
A pregnant client has developed iron-deficiency anemia and has been prescribed 200 mg of elemental iron per day. The nurse should encourage the client to take this medication with which substance?
Orange Juice
A woman with known cardiac disease is in labor. In what position would the nurse place the client?
Semi-recumbent with a pillow under one hip
During the initial obstetrical clinic visit, the nurse shares with a client that several blood studies will be drawn. What screening is performed for black women because of the ethnically inherited nature of the disease?
Sickle cell trait or disease
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) Uterine rupture Preterm labor
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 an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.
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
A nurse is conducting a class for a group of couples about subfertility. When describing the causes of subfertility, which cause would the nurse include as being most common?
anovulation
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?
anticoagulant
A woman's obstetrician prescribes vitamin K supplements for a client who is on antiepileptic medications beginning at 36 weeks' gestation. The mother asks the nurse why she is taking this medication. The nurse's best response would be:
antiepileptic therapy can lead to vitamin K-deficient hemorrhage of the newborn.
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?
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 highestnursing priority?
avoidance of infection
The nurse is presenting a class at a local community health center on violence during pregnancy. Which possible complication would the nurse include?
chorioamnionitis
After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse determines that the teaching was successful when the woman identifies which foods as being good sources of iron in her diet? Select all that apply.
dried fruits peanut butter meats
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
A pregnant client has a history of asthma. After reviewing the possible medications that may be prescribed during her pregnancy to control her asthma, the nurse determines additional teaching is needed when the client identifies which drug as being used?
misoprostol
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
