Chapter 20 OB

A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome? A) congenital anomalies B) incompetent cervix C) placenta previa D) abruptio placentae

A

When teaching a class of pregnant women about the effects of substance abuse during pregnancy, the nurse would most likely include which effect? A) low-birthweight infants B) excessive weight gain C) higher pain tolerance D) longer gestational periods

A

A nurse is conducting a review class for a group of perinatal nurses working at the local clinic. The clinic sees a high population of women who are HIV positive. After discussing the recommendations for antiretroviral therapy with the group, the nurse determines that the teaching was successful when the group identifies which rationale as the underlying principle for the therapy? A) reduction in viral loads in the blood B) treatment of opportunistic infections C) adjunct therapy to radiation and chemotherapy D) can cure acute HIV/AIDS infections

A

A nurse is preparing a teaching program for a group of pregnant women about preventing infections during pregnancy. When describing measures for preventing cytomegalovirus infection, which measure would the nurse most likely include? A) frequent handwashing B) immunization C) prenatal screening D) antibody titer screening

A

A pregnant client whose diabetes has been poorly controlled throughout her pregnancy is in labor. The nurse would assess the neonate closely at birth for which condition? A) macrosomia B) hyperglycemia C) low birthweight D) hypobilirubinemia

A

A pregnant woman tests positive for HBV. What would the nurse expect to administer? A) HBV immune globulin B) HBV vaccine C) acylcovir D) valacyclovir

A

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

A

After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse determines that the teaching was successful when the woman identifies which food as being good sources of iron in her diet? Select all that apply. A) dried fruits B) peanut butter C) meats D) milk E) white bread

A, B, C

A nurse has been invited to speak at a local high school about adolescent pregnancy. When developing the presentation, the nurse would incorporate information related to which aspect? Select all that apply. A) peer pressure to become sexually active B) rise in teen birth rates over the years. C) latinas as having the highest teen birth rate D) loss of self-esteem as a major impact E) majority of teen pregnancies in the 15- to 17-year-old age group

A, C, D

A 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 preventative? A) washing raw fruits and vegetables before eating them B) cooking all meat to an internal temperature of 140° F C) wearing gardening gloves when working in the soil D) avoiding contact with a cat's litter box

B

A nurse is conducting a class for pregnant women with diabetes. Which factor would the nurse emphasize as being most important in helping to reduce the maternal/fetal/neonatal complications associated with pregnancy and diabetes? A) stability of the woman's emotional and psychological status B) degree of glycemic control achieved during the pregnancy C) evaluation of retinopathy by an ophthalmologist D) blood urea nitrogen level (BUN) within normal limits

B

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? A) stability of the woman's emotional and psychological status B) degree of blood glucose control achieved during the pregnancy C) reduction in retinopathy risk by frequent ophthalmologic evaluations D) control of blood urea nitrogen (BUN) levels for optimal kidney function

B

A nurse is conducting an in-service presentation to a group of perinatal nurses about sexually transmitted infections and their effect on pregnancy. The nurse determines that the teaching was successful when the group identifies which infection as being responsible for ophthalmia neonatorum? A) syphilis B) gonorrhea C) chlamydia D) HPV

B

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? A) "It's probably not a good idea for you to get pregnant since you have lupus." B) "Be sure that your lupus is stable or in remission for 6 months before getting pregnant." C) "Your lupus will not have any effect on your pregnancy whatsoever." D) "If you get pregnant, we'll have to add quite a few medications to your normal treatment plan.

B

The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion? A) wide, large eyes B) thin upper lip C) protruding jaw D) elongated nose

B

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

B

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. A) low whimpering cry B) hypertonicity C) lethargy D) excessive sneezing E) overly vigorous sucking F) tremors

B, D, F

A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world? A) rubella B) hepatitis B C) cytomegalovirus D) parvovirus B19

C

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 theteaching was successful? A) "The majority of women who become pregnant over age 35 experience complications." B) "Women over the age of 35 who become pregnant require a specialized type of assessment." C) "Women over age 35 and are pregnant have an increased risk for spontaneous abortions." D) "Women over age 35 are more likely to have substance abuse problems."

C

After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicates successful teaching? A) "I should take my iron with milk." B) "I should avoid drinking orange juice." C) "I need to eat foods high in fiber." D) "I'll call the primary care provider if my stool is black and tarry."

C

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? A) "I'll basically follow the same diet that I was following before I became pregnant." B) "Because I need extra protein, I'll have to increase my intake of milk and meat." C) "Pregnancy affects insulin production, so I'll need to make adjustments in my diet." D) "I'll adjust my diet and insulin based on the results of my urine tests for glucose."

C

A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which statement by the nurse would be most appropriate? A) "You'll probably have a cesarean birth to prevent exposing your newborn." B) "Antibodies cross the placenta and provide immunity to the newborn." C) "Wait until after the infant is born, and then something can be done." D) "Antiretroviral medications are available to help reduce the risk of transmission."

D

A nurse is counseling a pregnant woman with rheumatoid arthritis about medications that can be used during pregnancy. Which drug would the nurse emphasize as being contraindicated at this time? A) hydroxychloroquine B) nonsteroidal anti-inflammatory drugs C) glucocorticoid D) methotrexate

D

A nurse is providing care to several pregnant women at different weeks of gestation. The nurse would expect to screen for group B streptococcus infection in the client who is at: A) 16 weeks' gestation. B) 28 weeks' gestation. C) 32 weeks' gestation. D) 36 weeks' gestation.

D

A nurse is providing prenatal care to a pregnancy client. At which time would the nurse expect to screen the client for group B streptococcus infection? A) 16 weeks' gestation B) 28 week' gestation C) 32 weeks' gestation D) 36 weeks' gestation

D

A pregnant woman asks the nurse, "I'm a big coffee drinker. Will the caffeine in my coffee hurt my baby?" Which response by the nurse would be most appropriate? A) "The caffeine in coffee has been linked to birth defects." B) "Caffeine has been shown to cause growth restriction in the fetus." C) "Caffeine is a stimulant and needs to be avoided completely." D) "If you keep your intake to less than 300 mg/day, you should be okay."

D

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? A) budesonide B) albuterol C) salmeterol D) oral prednisone

D

A woman with diabetes is considering becoming pregnant. She asks the nurse whether she will be able to take oral hypoglycemics when she is pregnant. The nurse's response is based on the understanding that oral hypoglycemics: A) can be used as long as they control serum glucose levels. B) can be taken until the degeneration of the placenta occurs. C) are usually suggested primarily for women who develop gestational diabetes. D) show promising results, but more studies are needed to confirm their degree of safety.

D

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? A) marijuana B) alcohol C) heroin D) cocaine

D

When assessing a pregnant woman with heart disease throughout the antepartal period, the nurse would be especially alert for signs and symptoms of cardiac decompensation at which time? A) 16 to 20 weeks' gestation B) 20 to 24 weeks' gestation C) 24 to 28 weeks' gestation D) 28 to 32 weeks' gestation

D