Chapter 12 EAQ
Spontaneous termination of a pregnancy is considered to be an abortion if: a. The pregnancy is less than 20 weeks. b. The fetus weighs less than 1000 g c. The products of conception are passed intact. d. No evidence exists of intrauterine infection
a. The pregnancy is less than 20 weeks.
which is a possible cause of miscarriage during early pregnancy a) premature dilation of cervix b) chromosomal abnormalaites c) endocrine imbalance d) hypothyroidism e) antiphospholipid antibodies
b) chromosomal abnormalaites c) endocrine imbalance d) hypothyroidism e) antiphospholipid antibodies
which finding in a urine specimen of a pregnant patient indicates the patient has proteinuria a) value of > 0.5 protein in a dipstick testing b) protein concentration that is >300 mg /24 hours c) protein concentration at 10 mg/dl in random urine specimen d) concentration of > 1g protein in a 24 hour urine collection
b) protein concentration that is >300 mg /24 hours
Women with hyperemesis gravidarum: a. Are a majority, because 80% of all pregnant women suffer from it at some time. b. Have vomiting severe and persistent enough to cause weight loss, dehydration, and electrolyte imbalance. c. Need intravenous (IV) fluid and nutrition for most of their pregnancy. d. Often inspire similar, milder symptoms in their male partners and mother
b. Have vomiting severe and persistent enough to cause weight loss, dehydration, and electrolyte imbalance.
Magnesium sulfate is given to women with preeclampsia and eclampsia to: a. Improve patellar reflexes and increase respiratory efficiency. b. Shorten the duration of labor. c. Prevent and treat convulsions. d.Prevent a boggy uterus and lessen lochial flow
c. Prevent and treat convulsions.
A woman with preeclampsia has a seizure. The nurses primary duty during the seizure is to: a. Insert an oral airway. b. Suction the mouth to prevent aspiration. c. Administer oxygen by mask. d. Stay with the client and call for help.
d. Stay with the client and call for help.
A placenta previa in which the placental edge just reaches the internal os is more commonly known as: a. Total b. Partial c. Complete d. marginal
d. marginal
Which medication is the antidote for magnesium toxicity in a pregnant patient with preeclampsia a) calcium gluconate b) nifedipine c) hydralazine d) labetalol hydrochloride
a) calcium gluconate
which hypertensive disorder can occur during pregnancy (SATA a) chronic hypertension b) preeclampsia-eclampsia c) gestational trophoblastic disease d) gestational hypertension e) hyperemesis gravidarum
a) chronic hypertension b) preeclampsia-eclampsia d) gestational hypertension
which condition during pregnancy can result in preeclampsia in the patient (SATA) a) genetic abnormalities b) dietary deficiencies c) abnormal trophoblast invasion d) cardiovascular changes e) maternal hypotension
a) genetic abnormalities b) dietary deficiencies c) abnormal trophoblast invasion d) cardiovascular changes
a woman diagnosed with marginal placenta previa gave birth vaginally 15 minutes ago. Which condition is she at greatest risk for a) hemorrhage b) infection c) urinary retention d) thrombophlebitis
a) hemorrhage
Which clinical finding in the patient indicates that the disease has progressed to HELLP syndrome (SATA) a) hepatic dysfunction b) elevated liver enzymes c) vaginal bleeding d) low platelet count e) chronic hypertension
a) hepatic dysfunction b) elevated liver enzymes d) low platelet count
which condition is seen in a pregnant patient if uterine artery doppler measurements in the second trimester of pregnancy are abnormal a) preeclampsia b) HELLP syndrome c) molar pregnancy d) gestational hypertension
a) preeclampsia
Which assessment finding might indicate the presence of a hypertensive disorder in a pregnant patient (SATA) a) proteinuria b) epigastric pain c) placenta previa d) presence of edema e) blood pressure 160/100
a) proteinuria b) epigastric pain d) presence of edema e) blood pressure 160/100
which clinical screening tool does the nurse evaluate to identify ectopic pregnancy in a patient (SATA) a) quantitative hCG levels b) transvaginal ultrasound c) progesterone level d) thyroid test reports e) kleihauer-betke test
a) quantitative hCG levels b) transvaginal ultrasound c) progesterone level
In caring for the woman with disseminated intravascular coagulation (DIC), what order should the nurse anticipate? a. Administration of blood b. Preparation of the client for invasive hemodynamic monitoring c. Restriction of intravascular fluids d. Administration of steroids
a. Administration of blood
The priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to: a. Assess fetal heart rate (FHR) and maternal vital signs b. Perform a venipuncture for hemoglobin and hematocrit levels c. Place clean disposable pads to collect any drainage d. Monitor uterine contractions
a. Assess fetal heart rate (FHR) and maternal vital signs
Which order should the nurse expect for a patient admitted with a threatened abortion? a. Bed rest b. Ritodrine IV c. NPO d. Narcotic analgesia every 3 hours, pr
a. Bed rest
In caring for an immediate postpartum client, you note petechiae and oozing from her IV site. You would monitor her closely for the clotting disorder: a. Disseminated intravascular coagulation (DIC) b. Amniotic fluid embolism (AFE) c. Hemorrhage d. HELLP syndrome
a. Disseminated intravascular coagulation (DIC)
The nurse caring for pregnant women must be aware that the most common medical complication of pregnancy is: a. Hypertension b. Hyperemesis gravidarum c. Hemorrhagic complications. d. Infections
a. Hypertension
In planning care for women with preeclampsia, nurses should be aware that: a. Induction of labor is likely, as near term as possible. b. If at home, the woman should be confined to her bed, even with mild preeclampsia. c. A special diet low in protein and salt should be initiate d. Vaginal birth is still an option, even in severe case
a. Induction of labor is likely, as near term as possible.
A client who has undergone a dilation and curettage for early pregnancy loss is likely to be discharged the same day. The nurse must ensure that vital signs are stable, bleeding has been controlled, and the woman has adequately recovered from the administration of anesthesia. To promote an optimal recovery, discharge teaching should include (Select all that apply) a. Iron supplementation. b. Resumption of intercourse at 6 weeks following the procedure. c. Referral to a support group if necessary. d. Expectation of heavy bleeding for at least 2 weeks. e. Emphasizing the need for rest
a. Iron supplementation. c. Referral to a support group if necessary. e. Emphasizing the need for rest
What nursing diagnosis would be the most appropriate for a woman experiencing severe preeclampsia? a. Risk for injury to the fetus related to uteroplacental insufficiency b. Risk for eclampsia c. Risk for deficient fluid volume related to increased sodium retention secondary to administration of MgSO 4 d. Risk for increased cardiac output related to use of antihypertensive dru
a. Risk for injury to the fetus related to uteroplacental insufficiency
Your patient is being induced because of her worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active despite several hours of oxytocin administration. She asks the nurse, Why is it taking so long? The most appropriate response by the nurse would be: a. The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor. b. I dont know why it is taking so long. c. The length of labor varies for different women. d.Your baby is just being stubborn
a. The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor.
The nurse caring for a woman hospitalized for hyperemesis gravidarum should expect that initial treatment to involve: a. Corticosteroids to reduce inflammation. b. IV therapy to correct fluid and electrolyte imbalances. c. An antiemetic, such as pyridoxine, to control nausea and vomiting. d. Enteral nutrition to correct nutritional deficits.
b. IV therapy to correct fluid and electrolyte imbalances.
An abortion in which the fetus dies but is retained within the uterus is called a a. Inevitable abortion b. Missed abortion c. Incomplete abortion d. Threatened abortion
b. Missed abortion
What laboratory marker is indicative of disseminated intravascular coagulation (DIC)? a. Bleeding time of 10 minutes b. Presence of fibrin split product c. Thrombocytopenia d. Hyperfibrinogenemia
b. Presence of fibrin split product
Which maternal condition always necessitates delivery by cesarean section? a. Partial abruptio placentae b. Total placenta previ c. Ectopic pregnancy d. Eclampsia
b. Total placenta previ
A 26-year-old pregnant woman, gravida 2, para 1-0-0-1 is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what would be an expected diagnostic procedure a. Amniocentesis for fetal lung maturity b. Ultrasound for placental location c. Contraction stress test (CST) d. Internal fetal monitoring
b. Ultrasound for placental location
A patient with pregnancy-induced hypertension is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs are an indication of: a. Anxiety due to hospitalization. b. Worsening disease and impending convulsion. c. Effects of magnesium sulfate. d. Gastrointestinal upset
b. Worsening disease and impending convulsion.
The most prevalent clinical manifestation of placenta abruption as opposed to placenta previa is a. bleeding b. intense abdominal pain c. uterine activity d. cramping
b. intense abdominal pain
laboring woman with no known risk factors suddenly experiences spontaneous rupture of membranes (ROM). The fluid consists of bright red blood. Her contractions are consistent with her current stage of labor. There is no change in uterine resting tone. The fetal heart rate begins to decline rapidly after the ROM. The nurse should suspect the possibility of a. placenta previa b. vasa previa c. Severe abruptio placentae. d. Disseminated intravascular coagulation (DIC
b. vasa previa
which maternal risk is associated with placenta previa a) preeclampsia b) placental abruption c) surgery related trauma d) gestational hypertension
c) surgery related trauma
What finding on a prenatal visit at 10 weeks could suggest a hydatidiform mole? a. Complaint of frequent mild nausea b. Blood pressure of 120/80 mm Hg c. Fundal height measurement of 18 cm d. History of bright red spotting for 1 day, weeks ago
c. Fundal height measurement of 18 cm
The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the Pitocin infusion, the nurse reviews the womans latest laboratory test findings, which reveal a platelet count of 90,000, an elevated aspartate transaminase (AST) level, and a falling hematocrit. The nurse notifies the physician because the laboratory results are indicative of: a. Eclampsia. b. Disseminated intravascular coagulation (DIC). c. HELLP syndrome. d. Idiopathic thrombocytopenia.
c. HELLP syndrome.
Nurses should be aware that HELLP syndrome: a. Is a mild form of preeclampsia b. Can be diagnosed by a nurse alert to its symptoms. c. Is characterized by hemolysis, elevated liver enzymes, and low platelets. d. is associated with preterm labor but not perinatal mortality
c. Is characterized by hemolysis, elevated liver enzymes, and low platelets.
A woman presents to the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion a. incomplete b. inevitable c. threatened d. septic
c. threatened
which medication may be administered to a patient if there is excessive bleeding after dilation curettage a) Nifedipine b) Methyldopa c) Hydralazine d) Ergonovine
d) Ergonovine
which statement by the nursing student about the management of cervical insufficiency (premature dilation of the cervix) in a pregnancy patient indicates effective learning a) progesterone supplementation is the only effective treatment b) an abdominal cerclage is performed at the first week of gestation c) surgical treatment is ineffective in patients with an extremely short cervix d) a prophylactic cerclage is used to constrict the internal os of the cervix
d) a prophylactic cerclage is used to constrict the internal os of the cervix
what is a priority nursing action when a pregnant patient with severe gestational hypertension is admitted to the health care facility a) administer IV and oral fluids b) provide diversionary activites during bed rest c) prepare the patient for cesearn delivery d) administer the prescribed magnesium sulfate
d) administer the prescribed magnesium sulfate
which fetal risk is associated with an ectopic pregnancy a) miscarriage b) fetal anemia c) preterm birth d) fetal deformity
d) fetal deformity
32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Nursing care is based on knowledge that a) bed rest and analgesics are the recommended treatment b) she will be unable to conceive in the future c) A D&C will be performed to remove the products of conception d) hemorrhage is the major concern
d) hemorrhage is the major concern
a patient reports excessive vomiting in the first trimester of the pregnancy which has resulted in nutritional deficiency, weight loss, and ketonuria. Which disorder of pregnancy does this patient have a) preeclampsia b) hyperthyroid disorder c) gestational hypertension d) hyperemesis gravidarum
d) hyperemesis gravidarum
which condition of pregnancy is typically characterized by painless bight red vaginal bleeding in the second or third semester a) eclampsia b) preeclampsia c) pyelonephritis d) placenta previa
d) placenta previa
Nurses should be aware that chronic hypertension: a. Is defined as hypertension that begins during pregnancy and lasts for the duration of pregnancy. b. Is considered severe when the systolic blood pressure (BP) is greater than 140 mm Hg or the diastolic BP is greater than 90 mm Hg. c. Is general hypertension plus proteinuria. d. Can occur independently of or simultaneously with gestational hypertension
d. Can occur independently of or simultaneously with gestational hypertension
As related to the care of the patient with miscarriage, nurses should be aware that: a. It is a natural pregnancy loss before labor begins. b. It occurs in fewer than 5% of all clinically recognized pregnancies. c. It often can be attributed to careless maternal behavior such as poor nutrition or excessive exercise. d. If it occurs before the twelfth week of pregnancy, it may manifest only as moderate discomfort and blood loss
d. If it occurs before the twelfth week of pregnancy, it may manifest only as moderate discomfort and blood loss
Approximately 10% to 15% of all clinically recognized pregnancies end in miscarriage. Which is the most common cause of spontaneous abortion? a. Chromosomal abnormalities b. Infections c. Endocrine imbalance d. Immunologic factors
d. Immunologic factors
A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset of: a. Eclamptic seizure b. Rupture of the uterus. c. Placenta previa d. Placental abruption
d. Placental abruption