Chapter 20

A woman with diabetes is in labor. To promote optimal outcomes for the mother and neonate, the nurse monitors the client's blood glucose level closely ensuring that it is maintained below which level? 110 mg/dL 150 mg/dL 130 mg/dL 120 mg/dL

110 mg/dL

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 120 mg/dl 45 mg/dl 136 mg/dl

85 mg/dl

A pregnant woman with gestational diabetes comes to the clinic for a fasting blood glucose level. When reviewing the results, the nurse determines that the woman is achieving good glucose control based on which result? 110 mg/dL 88 mg/dL 100 mg/dL 120 mg/dL

88 mg/dL

A nurse is admitting a pregnant woman with sickle cell anemia to the emergency department. Which findings would lead the nurse to suspect the client is in crisis? Select all that apply. pallor increased skin turgor fever fatigue joint pain

fever joint pain fatigue

A nurse is conducting a class on gestational diabetes for a group of pregnant women who are at risk for the condition. The nurse determines that additional teaching is needed when the class identifies which complication as affecting the neonate? hypoglycemia hyperglycemia macrosomia birth trauma

hyperglycemia

A pregnant woman at 36 weeks' gestation comes to the care center for a follow-up visit. The woman is to be screened for group B streptococcus (GBS) infection. When describing this screening to the woman, the nurse would explain that a specimen will be taken from which area(s)? Select all that apply. vagina nasal cavity rectum throat conjunctiva

vagina rectum

After teaching a group of nurses working at the women's health clinic about the impact of pregnancy on the older woman, which statement by the group indicates that the teaching was successful? "Women over age 35 are more likely to have a substance use disorder." "The majority of women who become pregnant over age 35 experience complications." "Women over age 35 and are pregnant have an increased risk for spontaneous abortions." "Women over the age of 35 who become pregnant require a specialized type of assessment."

"Women over age 35 and are pregnant have an increased risk for spontaneous abortions."

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? "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." "I may need an amniocentesis during the third trimester to see if my baby's lungs are ready to be born." "My baby may be very large and I may need a cesarean section to have him."

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

A nurse is conducting a presentation for a group of pregnant women about measures to prevent toxoplasmosis. The nurse determines that additional teaching is needed when the group identifies which measure as preventive? washing raw fruits and vegetables before eating them wearing gardening gloves when working in the soil cooking all meat to an internal temperature of 125° F (52° C) avoiding contact with a cat's litter box

cooking all meat to an internal temperature of 125° F (52° C)

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? low birthweight hyperglycemia hypobilirubinemia macrosomia

macrosomia

A pregnant woman with diabetes is having a glycosylated hemoglobin (HgbA1C) level drawn. Which result would require the nurse to revise the client's plan of care? 5.5% 8.5% 7% 6.0%

8.5%

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? 8% 14% 6% 12%

6%

What criteria would the ob/gyn base a decision on to begin insulin therapy for a mother with gestational diabetes? Client cannot keep fasting blood sugar lower than 90 mg/dl. A 2-hour postprandial glucose level cannot be kept below 120 mg/dl. Urine is 2+ for glucose and serum blood glucose is 120. Weight gain is over 30 pounds (13.6 kg) and blood sugars are fluctuating between 95 and 130 throughout the day.

A 2-hour postprandial glucose level cannot be kept below 120 mg/dl.

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 Daily insulin injections for gestational diabetes Daily fingersticks for a fasting blood glucose level Monthly hemoglobin A1C levels to rule out diabetes

A 3-hour glucose tolerance test for follow-up

A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize? IV fluids antihypertensive drugs diuretic drugs antibiotics

IV fluids

A 17-year-old primigravida with type 1 diabetes is at 37 weeks' gestation comes to the clinic for an evaluation. The nurse notes her blood sugar has been poorly controlled and the health care provider is suspecting the fetus has macrosomia. The nurse predicts which step will be completed next? Allowing her to continue without plans for delivery. Preparing for amniocentesis and fetal lung maturity assessment Scheduling a cesarean delivery at 39 weeks. Scheduling the woman for induction of labor today.

Preparing for amniocentesis and fetal lung maturity assessment

A nurse is caring for a pregnant client with asthma. Which intervention would the nurse perform first? assessing oxygen saturation monitoring temperature frequently assessing for feeling nauseated monitoring frequency of headache

assessing oxygen saturation

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance? heroin cocaine marijuana alcohol

cocaine

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? chlamydia cytomegalovirus toxoplasmosis gonorrhea

cytomegalovirus

A woman at 38 weeks' gestation with a history of heroin use disorder has given birth to a newborn several hours ago. Upon assessment, the nurse determines that the newborn is experiencing withdrawal based on which findings? Select all that apply. flaccid extremities high-pitched shrill cry almost constant sneezing nasal stuffiness poor sucking reflex

high-pitched shrill cry almost constant sneezing nasal stuffiness poor sucking reflex

Which condition is the most common cause of anemia in pregnancy? sickle cell anemia beta thalassemia alpha thalassemia iron-deficiency anemia

iron-deficiency anemia

A pregnant woman with chronic hypertension comes to the clinic for evaluation. The last several blood pressure readings have been gradually increasing. On today's visit her blood pressure is 166/100 mm Hg. The health care provider prescribes an antihypertensive agent. The nurse anticipates which agent as likely to be prescribed? hydroxychloroquine labetalol ipratropium albuterol

labetalol

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? albuterol misoprostol salmeterol ipratropium

misoprostol

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

obesity previous large for gestational age (LGA) infant hypertension

A woman with no previous history of heart disease begins to have symptoms of myocardial failure a few weeks before the birth of her first child. Findings include shortness of breath, chest pain, and edema, with her heart also showing enlargement. The nurse suspects which condition? mitral stenosis pulmonary valve stenosis peripartum cardiomyopathy left-sided heart failure

peripartum cardiomyopathy

A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant? prednisone ipratropium salmeterol albuterol

prednisone

During a routine prenatal checkup, the nurse interviews a pregnant client to identify possible risk factors for developing gestational diabetes. Which factor(s) will the nurse identify as increasing the woman's risk? Select all that apply. previous history of spontaneous abortion (miscarriage) African heritage maternal obesity with body mass index more than 35 younger maternal age at pregnancy previous birth of small-for-gestational-age neonate

previous history of spontaneous abortion (miscarriage) African heritage maternal obesity with body mass index more than 35

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

restricted sodium intake

What is the role of the nurse during the preconception counseling of a pregnant client with chronic hypertension? stressing the increased use of Vitamin D supplements stressing regular walks and exercise stressing the positive benefits of a healthy lifestyle stressing the avoidance of dairy products

stressing the positive benefits of a healthy lifestyle

A nurse is performing an assessment on a new client. The woman estimates that she is approximately 16 weeks pregnant. While assessing her, the nurse asks her about apparent scratch marks on her hands, and she tells the nurse that she has three cats at home. What screening would be prescribed for this woman? toxoplasmosis cytomegalovirus herpes simplex virus hepatitis C

toxoplasmosis

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 cytomegalovirus herpes simplex virus parvovirus B19

toxoplasmosis

A G4P3 client with a history of controlled asthma is upset her initial prenatal appointment is taking too long, making her late for another appointment. What is the nurse's best response when the client insists she knows how to handle her asthma and needs to leave? Remind her to continue taking asthma medications, to monitor peak flow daily, and to monitor the baby's kicks in the second and third trimesters. Note in the chart that the woman was not counseled about her asthma. Acknowledge her need to leave but ask her to demonstrate the use of inhaler and peak flow meter before she goes; remind her to take regular medications. Schedule an appointment for her to return to discuss her asthma management.

Acknowledge her need to leave but ask her to demonstrate the use of inhaler and peak flow meter before she goes; remind her to take regular medications.

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. Avoid cleaning the cat's litter box. Avoid outdoor activities such as gardening. Eat meat cooked to 160° F (71° C). Avoid contact with children when they have a cold. Keep the cat outdoors at all times.

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

A woman at 26 weeks' gestation is undergoing screening for diabetes with a 1-hour oral glucose challenge test. On the client's return visit, the nurse anticipates the need to schedule a 3-hour glucose challenge test based on which result of the previous test? 100 mg/dL 146 mg/dL 130 mg/dL 114 mg/dL

B) 146 mg/dL

A nurse is conducting a teaching program for pregnant woman who are older than age 35. The nurse explains that although most women in their age group have healthy pregnancies and healthy newborns, they are at increased risk for possible complications. Which complications would the nurse include? Select all that apply. postpartum hemorrhage preeclampsia abruptio placentae type 1 diabetes preterm labor

Everything except type 1 diabetes and abruptio placentae

A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which signs would the nurse assess? Select all that apply. lethargy low whimpering cry excessive sneezing overly vigorous sucking hypertonicity tremors

Hypertonicity Excessive sneezing tremors

A nurse is providing education to a woman at 28 weeks' gestation who has tested positive for gestational diabetes mellitus (GDM). What would be important for the nurse to include in the client teaching? She is at increased risk for type 2 diabetes mellitus after her baby is born. Her baby is at increased risk for neonatal diabetes mellitus. Her baby is at increased risk for type 1 diabetes mellitus. She is at increased risk for type 1 diabetes mellitus after her baby is born.

She is at increased risk for type 2 diabetes mellitus after her baby is born.