Maternity Exam 3 Review Questions

The charge nurse on a labor and delivery unit has numerous admissions of laboring clients and must transfer one of the clients to the postpartum/gynecological unit, where the nurse-to-client ratio will be 1:4. Which antepartum client would be the most appropriate one to transfer? a. The 36-year-old, gravida I, para 0 client who is at 24 weeks' gestation and is being monitored for preterm labor b. The 26-year-old, gravida I, para 0 client who is at 10 weeks' gestation and is experiencing vaginal bleeding c. The 40-year-old, gravida III, para 0 client who is at 38 weeks' gestation and is complaining of decreased fetal movement d. The 29-year-old, gravida I, para 0 client who is at 42 weeks' gestation and had a biophysical profile score of 5 earlier today

B

The nurse is aware that, in the second half of pregnancy, women who are Type I diabetics require: a.Decreased caloric intake b.Increased dosage of insulin c.Administration of pancreatic enzymes d.Administration of estrogenic hormones

B

The nurse is caring for a client whose labor is being augmented with oxytocin. He or she recognizes that the oxytocin should be discontinued immediately if there is evidence of: a. Uterine contractions occurring every 8 to 10 minutes. b. A fetal heart rate (FHR) of 180 with absence of variability. c. The client's needing to void. d. Rupture of the client's amniotic membranes.

B

The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes interventions focusing on which of the following because of the woman's increased risk? A) Oligohydramnios B) Preeclampsia C) Post-term labor D) Chorioamnionitis

B

The nurse is explaining to a nursing student what conditions occur in the body to cause the development of gestational diabetes in a pregnant mother. Which statement by the nurse is the most accurate pertaining to what causes gestational diabetes? a. "A decreased level of glucose in the blood cannot get into the cells because there is a decreased level of insulin. This condition in the body causes GDM." b. "An excessive level of glucose in the blood cannot get into the cells because there is not enough insulin to carry the high amount of glucose present. This condition in the body causes GDM." c. "A decreased level of glucose in the blood cannot get into the cells because there is an excessive level of insulin. This condition in the body causes GDM."

B

The nurse is performing an initial assessment on a client who has just been told that a pregnancy test is positive. Which assessment finding indicates that the client is at risk for preterm labor? a. The client is a 35-year-old primigravida b. The client has a history of cardiac disease c. The client's hemoglobin level is 13.5 g/dL d. The client is a 20-year-old primigravida of average weight and height

B

With regard to dysfunctional labor, nurses should be aware that: a. Women who are underweight are more at risk. b. Women experiencing precipitous labor are about the only "dysfunctionals" not to be exhausted. c. Hypertonic uterine dysfunction is more common than hypotonic dysfunction. d. Abnormal labor patterns are most common in older women.

B

The nurse is caring for a client with a diagnosis of placenta previa. The nurse collects data knowing that which are characteristic of placenta previa? (Select all that apply) a. A tender and rigid uterus b. Painless, bright red vaginal bleeding c. Location in the lower uterine segment d. Greenish discoloration of the amniotic fluid e. Vaginal bleeding accompanied by abdominal pain

B C

Complications and risks associated with cesarean births include (Select all that apply): a. Placental abruption. b. Wound dehiscence. c. Hemorrhage. d. Urinary tract infections. e. Fetal injuries.

B C D E

The nurse reviews the assessment history for a client with a suspected ectopic pregnancy. Which assessment findings predispose the client to an ectopic pregnancy? (Select all that apply) a. Use of diaphragm b. Use of fertility medications c. History of Chlamydia d. Use of an intrauterine device e. History of pelvic inflammatory disease (PID)

B C D E

A OB-GYN nurse practitioner is educating her pregnant patient, who has been recently diagnosed with GDM, about the various signs of hyperglycemia. Which of the following are all signs of hyperglycemia that the nurse would discuss with her patient? (select all that apply) a. cool, clammy skin b. hot, flushed skin c. polyuria or increased urine output d. decreased urine output e. polydipsia f. weight gain g. sudden weight loss

B C E G

The nurse is assessing a woman in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which findings should the nurse expect to note if abruptio placentae is present? (Select all that apply) a. Soft uterus b. Abdominal pain c. Nontender uterus d. Firm uterus by palpation e. Painless vaginal bleeding

B D

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions. What clinical cues would alert the nurse that the woman is experiencing uterine hyperstimulation (Select all that apply)? a. Uterine contractions lasting <90 seconds and occurring >2 minutes in frequency b. Uterine contractions lasting >90 seconds and occurring <2 minutes in frequency c. Uterine tone <20 mm Hgd. Uterine tone >20 mm Hge. Increased uterine activity accompanied by a nonreassuring fetal heart rate (FHR) and pattern

B D E

A pregnant client with Gestational Diabetes Mellitus at 36 weeks gestation is at risk for premature labor. The doctor informs her that he may have to conduct which of the following procedures to ensure that the baby is fit to be delivered? a. a biophysical profile to determine L/S ratio and maturation of lung tissue prior to labor b. a contraction stress test to determine L/S ratio and maturation of lung tissue prior to labor c. an aminocentesis to determine L/S ratio and maturation of lung tissue prior to labor

C

A prenatal client at 16 weeks' gestation presents to the clinic with unexplained, bright red bleeding; cramping; and backache for the past 2 days. A pelvic exam reveals a closed cervix. What type of abortion does this indicate? a. Imminent b. Missed c. Threatened d. Incomplete

C

A prenatal nurse is assessing a client at 34 weeks' gestation who complains of vaginal irritation and thin, vaginal discharge that is "a funny color." What should be the nurse's initial action? a. Prepare for a nonstress test. b. Obtain vaginal cultures for STIs. c. Test the fluid with nitrazine paper. d. Test the urine for bacteria.

C

A primigravida at 40 weeks of gestation is having uterine contractions every 1.5 to 2 minutes and says that they are very painful. Her cervix is dilated 2 cm and has not changed in 3 hours. The woman is crying and wants an epidural. What is the likely status of this woman's labor? a. She is exhibiting hypotonic uterine dysfunction. b. She is experiencing a normal latent stage. c. She is exhibiting hypertonic uterine dysfunction. d. She is experiencing pelvic dystocia.

C

Later in pregnancy, which placental hormone causes insulin resistance of the tissues? a. progesterone b. estrogen c. human placental lactogen (hPL)

C

The nurse is preparing to care for a client who is being admitted to the hospital with a possible diagnosis of ectopic pregnancy. The nurse develops a plan of care for the client and determines that which nursing action is the priority? a. Checking for edema b. Monitoring daily weight c. Monitoring the apical pulse d. Monitoring the temperature

C

A prenatal client with severe abdominal pain is admitted to the maternity unit. The nurse is monitoring the client closely because concealed bleeding is suspected. Which assessment findings indicate the presence of concealed bleeding? (Select all that apply) a. Back pain b. Heavy vaginal bleeding c. Increase in fundal height d. Hard, boardlike abdomen e. Persistent abdominal pain f. Early deceleration on the fetal heart monitor

C D E

A client arrives at the health care clinic and tells the nurse that her last menstrual period was 9 weeks ago. The client tells the nurse that a home pregnancy test was positive but that she began to have mild cramps and is now having moderate vaginal bleeding. On physical examination of the client, it is noted that she has a dilated cervix. Which statement, if made by the client, indicates that the client is interpreting the situation correctly? a. "I will need to remain on bed rest for 2 weeks." b. "I will need to take a full course of antibiotic treatment." c. "I will need to take tocolytic medication to halt the labor process." d. "I will need to prepare myself and my family for the loss of this pregnancy."

D

A 25-year-old woman arrives on the maternity unit on February 2. She states that her estimated date of delivery (EDD) is March 22. She is verbalizing complaints of dull lower back pain, pelvic heaviness, and diarrhea for the past few days. On admission for observation, the client's blood pressure is 128/80 mm Hg, pulse is 100 beats/minute, respirations are 16 breaths per minute, and temperature is 99° F. The nurse plans care based on which interpretation? a. The woman requires further evaluation for preterm labor. b. The woman is suffering from an intestinal bacterial infection. c. The woman is exhibiting signs and symptoms of gestational hypertension. d. The woman needs instruction on pelvic tilts to decrease her lower back pain.

A

A client at 30 weeks' gestation is admitted to the maternity unit with vaginal bleeding. What should be the nurse's initial action? a. Assess blood pressure and pulse. b. Count and weigh peripads. c. Observe for pallor, clammy skin, and perspiration. d. Start an intravenous infusion drip.

A

After a spontaneous abortion the nurse should observe the client for: a.Hemorrhage and infection b.Dehydration and hemorrhage c.Subinvolution and dehydration d.Signs of PIH

A

Before the physician performs an external version, the nurse should expect an order for a: a. Tocolytic drug. b. Contraction stress test (CST). c. Local anesthetic. d. Foley catheter

A

Clients with gestational diabetes are usually managed by which of the following therapies? a. diet b. long acting insulin c. oral hypoglycemic drugs d. oral hypoglycemic drugs/insulin

A

Immediately after the forceps-assisted birth of an infant, the nurse should: a. Assess the infant for signs of trauma. b. Give the infant prophylactic antibiotics. c. Apply a cold pack to the infant's scalp. d. Measure the circumference of the infant's head.

A

In evaluating the effectiveness of oxytocin induction, the nurse would expect: a. Contractions lasting 40 to 90 seconds, 2 to 3 minutes apart. b. The intensity of contractions to be at least 110 to 130 mm Hg. c. Labor to progress at least 2 cm/hr dilation. d. At least 30 mU/min of oxytocin will be needed to achieve cervical dilation.

A

In the 12th week of gestation a client completely expels the products of conception. Because the client is Rh negative, the nurse must: a.Administer RhoGAM within 72 hours b.Make certain she receives RhoGAM on her first clinic visit c.Not give RhoGAM, since it is not used with the birth of a stillborn d.Make certain the client does not receive RhoGAM, since the gestation was only 12 weeks

A

The exact cause of preterm labor is unknown and believed to be multifactorial. Infection is thought to be a major factor in many preterm labors. Select the type of infection that has not been linked to preterm births. a. Viral b. Periodontal c. Cervical d. Urinary tract

A

The nurse notes a new mother has type B negative blood. Her baby's blood type is AB positive. The nurse is aware that the mother's plan of care should include: a.Obtaining an order for RhoGAM b.Observing for ABO incompatibility c.Determining the father's blood type d.Immediate typing and crossmatching of her blood

A

When obtaining the nursing history from a client with a diagnosis of ruptured tubal pregnancy, the nurse should expect the client to indicate that her symptoms of pain in the lower abdomen and vaginal bleeding started: a.About the sixth week of pregnancy b.At the beginning of the last semester c.Midway through the second trimester d.Immediately after implantation occurred

A

A 17 y.o. primigravida with severe PIH has been receiving mag sulfate IV for 3 hours. The latest assessment reveals DTR of +1, BP 150/100 mmHg, pulse 92 bpm, respiratory rate 10bpm and urine output 20ml/hr. Which of the following actions would be most appropriate? a. Continue monitoring per standards of care b. Stop the mag sulfate infusion c. Increase infusion by 5gtt/min d. Decrease infusion by 5gtt/min

B

A nurse in the ED is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states she missed one menstrual cycle and cannot be pregnant because she has an IUD. The nurse should suspect which of the following? A. Missed abortion B. Ectopic pregnancy C. Severe preeclampsia D. Hydatidiform mole

B

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication? A) Urinary output of 20 mL per hour B) Respiratory rate of 10 breaths/minute C) Deep tendons reflexes 2+ D) Difficulty in arousing

C

The nurse realizes that the abdominal pain associated with abruptio placentae initially may be caused by: a.Hemorrhagic shock b.Inflammatory reactions c.Concealed hemorrhage d.Blood in the uterine muscle

C

The priority nursing care associated with an oxytocin (Pitocin) infusion is: a. Measuring urinary output. b. Increasing infusion rate every 30 minutes. c. Monitoring uterine response. d. Evaluating cervical dilation.

C

When a client in labor is being infused with Pitocin, it is the nurse's responsibility to: a.Flush the IV tubing if the flow slows b.Monitor fetal heart tones q2hours c.Shut off the infusion in the presence of hypertonic contractions d.Obtain a physician's order to slow the IV in the presence of hypertonic contractions

C

With a hypertonic labor pattern the client will experience: a.Labor to slow or stop completely b.Mild to moderate pain with contractions c.Pain that is out of proportion to the intensity of contractions d.Uterine relaxation between contractions

C

A birth hazard associated with breech delivery may be: a.Abruptio placentae b.Cephalohematoma c.Pathologic jaundice d.Compression of cord

D

A woman is 34 weeks' gestation and on oral Terbutaline (Brethine) for tocolysis. The nurse might expect the client to complain of: a.Stronger contractions b.Decreased fetal movement c.Minimal vaginal bleeding d.Extreme restlessness

D

Nurses should be aware that the induction of labor: a. Can be achieved by external and internal version techniques. b. Is also known as a trial of labor (TOL). c. Is almost always done for medical reasons. d. Is rated for viability by a Bishop score.

D

Which is the priority nursing action for the client with an ectopic pregnancy? a. Assessing urine for proteinuria b. Checking the electrolyte values c. Monitoring for signs of infection d. Monitoring the pulse and blood pressure

D

A client presents to the primary healthcare provider's office with complaints of right-sided abdominal pain, dizziness, and vaginal bleeding. A pelvic exam determines the client to be at 10 weeks' gestation with adnexal tenderness. What diagnosis should the nurse suspect? a. Threatened abortion b. Appendicitis c. Cholelithiasis d. Ectopic pregnancy

D

A nurse is assessing a client who is at 34 weeks gestation and has a mild placental abruption. Which finding should the nurse expect? a. increased platelet count b. fetal distress c. decreased urinary output d. dark red vaginal bleeding

D

A nurse is assessing a pregnant woman with gestational hypertension. Which of the following would lead the nurse to suspect that the client has developed severe preeclampsia? A) Urine protein 300 mg/24 hours B) Blood pressure 150/96 mm Hg C) Mild facial edema D) Hyperreflexia

D

A nurse is caring for a client who has a diagnosis of ruptured ectopic pregnancy. Which of the following findings is seen with this condition? A. No alteration in menses B. Transvaginal ultrasound indicating a fetus in the uterus C. Serum progesterone greater than the expected reference range D. Report of severe shoulder pain

D

A prenatal client with vaginal bleeding is being admitted to the labor unit. The labor room nurse is performing the admission assessment and would suspect a diagnosis of placenta previa if which finding is noted? a. Back pain b. Abdominal pain c. Painful vaginal bleeding d. Painless vaginal bleeding

D

Which patient status is an acceptable indication for serial oxytocin induction of labor? a. Past 42 weeks' gestation b. Multiple fetuses c. Polyhydramnios d. History of long labors

A

With regard to the process of augmentation of labor, the nurse should be aware that it: a. Is part of the active management of labor that is instituted when the labor process is unsatisfactory. b. Relies on more invasive methods when oxytocin and amniotomy have failed. c. Is a modern management term to cover up the negative connotations of forceps-assisted birth. d. Uses vacuum cups.

A

Induction of labor is considered an acceptable obstetric procedure if it is in the best interest to deliver the fetus. The charge nurse on the labor and delivery unit is often asked to schedule patients for this procedure and therefore must be cognizant of the specific conditions appropriate for labor induction. These include (Select all that apply): a. Rupture of membranes at or near term. b. Convenience of the woman or her physician. c. Chorioamnionitis (inflammation of the amniotic sac). d. Post-term pregnancy. e. Fetal death.

A C D E

A nurse is caring for a client who is pregnant and reviewing signs of complications the client should promptly report to the provider. Which of the following complications should the nurse include in the teaching? A. Vaginal bleeding B. Swelling of the ankles C. Heartburn after eating D. Lightheadedness when lying on back

A

A nurse is providing care for a client who is at 32 weeks of gestation and who has a placenta previa. The nurse notes that the client is actively bleeding. Which of the following types of medications should the nurse anticipate the provider will prescribe? A. Betamethasone B. Indomethacin C. Nifedipine D. Methylergonovine

A

After reviewing a client's history, which factor would the nurse identify as placing her at risk for gestational hypertension? A) Mother had gestational hypertension during pregnancy B) Client has a twin sister. C) Sister-in-law had gestational hypertension. D) This is the client's second pregnancy.

A

The nurse is conducting an intake interview for a new prenatal client. A review of her records and self-reported history reveals she is a G6P1132 and the current pregnancy was diagnosed as a twin gestation in the emergency department the week before. What significant risk should be taken into account in the care of this client? a. Cervical insufficiency b. Postterm pregnancy c. Placenta previa d. Placental abruption

A

Which of the following is true of asthma management in pregnancy? a. The medication regimen should be modified to reduce danger to the fetus. b. It usually improves in pregnancy, so the mother can stop her medications. c. Treatment approaches are the same as those for nonpregnant women. d. Medications can be reduced because of the increased oxygen-carrying capacity of fetal hemoglobin.

A

Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia? A) Calcium gluconate B) Potassium chloride C) Ferrous sulfate D) Calcium carbonate

A

A nurse is educating her pregnant patient with gestational diabetes about the various birth complications that are caused by GDM. Which of the following are birth complications that the nurse would discuss with this patient? (select all that apply) a. birth injuries due to a large baby b. hyperglycemia in newborn after delivery c. hypoglycemia in a newborn after delivery d. respiatory difficulties caused by an inhibition of L/S development e. olgiohydaminos f. polyhydraminos g. preeclampsia due to vascular damage and vascular damage to the newborn due to the glucose h. retinopathy i. intellectual disorders j. miscarriage or stillbirth

A C D G F H J

A nurse suspects that a pregnant client may be experiencing abruption placenta based on assessment of which of the following? (Select all that apply.) A) Dark red vaginal bleeding B) Insidious onset C) Absence of pain D) Rigid uterus E) Absent fetal heart tones

A D E

The nurse is caring for a client who is not in labor but has been diagnosed with ruptured membranes at 30 weeks' gestation. For what intervention should the nurse prepare? a. Induction of labor b. Administration of magnesium sulfate c. Digital vaginal examination d. Amnioinfusion

B

A client at 33 weeks gestation and leaking amniotic fluid is placed on an EFM. The monitor indicates uterine irritability and contractions occurring every 4-6 min. The doctor orders terbutaline. Which of the following teaching statements is appropriate for this client? a. This medicine will make you breathe better b. You may feel a fluttering or tight sensation in your chest c. This will dry your mouth and make you thirsty d. You'll need to replace potassium lost by this drug

B

A maternal indication for the use of vacuum extraction is: a. A wide pelvic outlet. b. Maternal exhaustion. c. A history of rapid deliveries. d. Failure to progress past 0 station.

B

A 35-week-gestation pregnant woman is transferred to the maternity unit from the emergency department, where she was treated for minor injuries sustained in a motor vehicle crash. The maternal nurse's priority will be to assess for which complication? a. Placenta previa b. Polyhydramnios c. Abruptio placentae d. Gestational hypertension

C

A nurse is discussing potential health issues that may affect the fetus of a new mother with gestational diabetes mellitus. Which of the following statements by the nurse is the most accurate pertaining to health issues that affect the fetus with a diabetic mother? a. "Your baby may have birth defects of the heart. This is caused by high levels of glycogen in your body, which is actually a teratogen." b. "Your baby may have birth defects of the heart and brain This is caused by high levels of glycogen in your body, which is actually a teratogen." c. "Your baby may have birth defects of the heart, brain, neural tube, and extremities. This is caused by high levels of glycogen in your body, which is actually a teratogen."

C

A nurse is teaching a group of prenatal clients about hazards in the workplace during pregnancy. The nurse correctly teaches that pregnant women who have jobs requiring long periods of standing have higher incidences of: a. Prolapsed cord. b. Placenta previa. c. Preterm birth. d. Abruptio placentae.

C

A nurse is teaching a pregnant woman with preterm premature rupture of membranes who is about to be discharged home about caring for herself. Which statement by the woman indicates a need for additional teaching? A) "I need to keep a close eye on how active my baby is each day." B) "I need to call my doctor if my temperature increases." C) "It's okay for my husband and me to have sexual intercourse." D) "I can shower but I shouldn't take a tub bath."

C

Preconception goals for a mother's blood glucose levels include: a. a fasting glucose of greater than 95 mg/dL and 2 hours after eating (postprandial) a blood glucose level of greater than 120 mg/dL b. a fasting glucose of less than 95 mg/dL and 3 hours after eating (postprandial) a blood glucose level of less than 120 mg/dL c. a fasting glucose of less than 95 mg/dL and 2 hours after eating (postprandial) a blood glucose level of less than 120 mg/dL

C

The clinic nurse is performing a prenatal assessment on a pregnant client. The nurse should plan to implement teaching related to the risk of abruptio placentae if which information is obtained on assessment? a. The client is 28 years of age. b. This is the second pregnancy. c. The client has a history of hypertension. d. The client performs moderate exercise on a regular daily schedule.

C

The least common cause of long, difficult, or abnormal labor (dystocia) is: a. Midplane contracture of the pelvis. b. Compromised bearing-down efforts as a result of pain medication. c. Disproportion of the pelvis. d. Low-lying placenta.

C

The nurse has completed the initial assessment on four prenatal clients. Which client is at greatest risk for a spontaneous preterm birth? a. A 26-year-old client with a history of diabetes b. A 17-year-old client with a hyperthyroid disorder c. A 19-year-old client with twins d. A 40-year-old client with anemia

C

With regard to the care management of preterm labor, nurses should be aware that: a. Because all women must be considered at risk for preterm labor and prediction is so hit-and-miss, teaching pregnant women the symptoms probably causes more harm through false alarms. b. Braxton Hicks contractions often signal the onset of preterm labor. c. Because preterm labor is likely to be the start of an extended labor, a woman with symptoms can wait several hours before contacting the primary caregiver. d. The diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.

D

The nurse is performing an assessment on a client diagnosed with placenta previa. Which of these assessment findings would the nurse expect to note? Select all that apply. a. Uterine rigidity b. Uterine tenderness c. Severe abdominal pain d. Bright red vaginal bleeding e. Soft, relaxed, nontender uterus f. Fundal height may be greater than expected for gestational age.

D E F

Nurses should know some basic definitions concerning preterm birth, preterm labor, and low birth weight. For instance: a. The terms preterm birth and low birth weight can be used interchangeably. b. Preterm labor is defined as cervical changes and uterine contractions occurring between 20 and 37 weeks of pregnancy. c. Low birth weight is anything below 3.7 pounds. d. In the United States early in this century, preterm birth accounted for 18% to 20% of all births.

B

A pregnant woman's amniotic membranes rupture. Prolapsed umbilical cord is suspected. What intervention would be the top priority? a. Placing the woman in the knee-chest position b. Covering the cord in sterile gauze soaked in saline c. Preparing the woman for a cesarean birth d. Starting oxygen by face mask

A

A woman in preterm labor at 30 weeks of gestation receives two 12-mg doses of betamethasone intramuscularly. The purpose of this pharmacologic treatment is to: a. Stimulate fetal surfactant production. b. Reduce maternal and fetal tachycardia associated with ritodrine administration. c. Suppress uterine contractions. d. Maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy.

A

An ultrasound is performed on a client with suspected abruptio placentae, and the results indicate that a placental abruption is present. Which intervention should the nurse prepare the client for? a. Delivery of the fetus b. Strict monitoring of intake and output c. Complete bed rest for the remainder of the pregnancy d. The need for weekly monitoring of coagulation studies until the time of delivery

A

A nurse is providing care for a client who is diagnosed with a marginal abruptio placentae. The nurse is aware that which of the following findings are risk factors for developing the condition? (Select all that apply) A. Fetal position B. Blunt abdominal trauma C. Cocaine use D. Maternal age E. Cigarette smoking

B C E

A nurse is educating her diabetic pregnant client about what fetal hyperinsulinism is. Which of the following statements by the nurse about fetal hyperinsulinism is true? a. "Fetal hyperinsulinism results before organ development, which causes excess insulin production." b. "Fetal hyperinsulinism results after organ development, which causes excess insulin production." c. "Fetal hyperinsulinism results after birth, when there is mature organ development, which causes excess insulin production."

B

A nurse is educating her pregnant client who has Type 1 DM about the use of antidiabetic drugs during pregnancy. Which of the following responses by the nurse is the most accurate pertaining to antidiabetic drug use during pregnancy? a. "It is acceptable to use oral antidiabetic drugs, such as glyburide or metformin, because they do not cross the placenta. They also do not cause any additional stress to the pancreas." b. "It is not acceptable to use oral antidiabetic drugs, such as glyburide or metformin, because they do cross the placenta. They also cause additional stress to the pancreas." c. "It is acceptable to use oral antidiabetic drugs, such as glyburide or metformin, because they do not cross the placenta. However, they do cause additional stress to the pancreas."

B

A nursing student is reviewing an article about preterm premature rupture of membranes. Which of the following would the student expect to find as factor placing a woman at high risk for this condition? (Select all that apply.) A) High body mass index B) Urinary tract infection C) Low socioeconomic status D) Single gestations E) Smoking

B C E

A nurse is reviewing discharge teaching with a client who has premature rupture of membranes at 26 weeks gestation. Which of the following instructions should the nurse include in the teaching? A. Use a condom with sexual intercourse B. Avoid bubble bath solution when taking a tub bath C. Wipe from the back to front when performing perineal hygiene D. Keep a daily record of fetal kick counts

D

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. What finding indicates that preterm labor is occurring? a. Estriol is not found in maternal saliva. b. Irregular, mild uterine contractions are occurring every 12 to 15 minutes. c. Fetal fibronectin is present in vaginal secretions. d. The cervix is effacing and dilated to 2 cm.

D

For a woman at 42 weeks of gestation, which finding would require further assessment by the nurse? a. Fetal heart rate of 116 beats/min b. Cervix dilated 2 cm and 50% effaced c. Score of 8 on the biophysical profile d. One fetal movement noted in 1 hour of assessment by the mother

D

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, what finding would alert the nurse to possible side effects? a. Urine output of 160 mL in 4 hours b. Deep tendon reflexes 2+ and no clonus c. Respiratory rate of 16 breaths/min d. Serum magnesium level of 10 mg/dL

D

The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of ectopic pregnancy? a. Painless vaginal bleeding b. Abdominal cramping c. Throbbing pain in the upper quadrant d. Sudden, stabbing pain in the lower quadrant

D

A woman hospitalized with severe preeclampsia is being treated with hydralazine to control blood pressure. Which of the following would the lead the nurse to suspect that the client is having an adverse effect associated with this drug? A) Gastrointestinal bleeding B) Blurred vision C) Tachycardia D) Sweating

C

After reviewing the client's maternal history of magnesium sulfate during labor, which condition would the nurse anticipate as a potential problem in the neonate? a. hypoglycemia b. jitteriness c. resp depression d. tachycardia

C

A woman with placenta previa is being treated with expectant management. The woman and fetus are stable. The nurse is assessing the woman for possible discharge home. Which statement by the woman would suggest to the nurse that home care might be inappropriate? A) "My mother lives next door and can drive me here if necessary." B) "I have a toddler and preschooler at home who need my attention." C) "I know to call my health care provider right away if I start to bleed again." D) "I realize the importance of following the instructions for my care."

B

During admission, a client in early active labor acts somewhat euphoric. During assessment and the admission interview, she admits to the nurse that before coming to the hospital, she smoked crack cocaine. In addition to constant monitoring of fetal heart rate, you should monitor for symptoms of which of the following? A. Placenta previa B. Abruptio placenta C. Ruptured uterus D. Maternal hypotension

B

In planning for an expected cesarean birth for a woman who has given birth by cesarean previously and who has a fetus in the transverse presentation, which information would the nurse include? a. "Because this is a repeat procedure, you are at the lowest risk for complications." b. "Even though this is your second cesarean birth, you may wish to review the preoperative and postoperative procedures." c. "Because this is your second cesarean birth, you will recover faster." d. "You will not need preoperative teaching because this is your second cesarean birth."

B

The maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the health care provider's prescriptions and should question which prescription? a. Prepare the client for an ultrasound. b. Obtain equipment for a manual pelvic examination. c. Prepare to draw a hemoglobin and hematocrit blood sample. d. Obtain equipment for external electronic fetal heart rate monitoring.

B

The nurse is reviewing the laboratory test results of a pregnant client. Which one of the following findings would alert the nurse to the development of HELLP syndrome? A) Hyperglycemia B) Elevated platelet count C) Leukocytosis D) Elevated liver enzymes

B

The nurse providing care to a woman in labor should understand that cesarean birth: a. Is declining in frequency in the twenty-first century in the United States. b. Is more likely to be performed for poor women in public hospitals who do not receive the nurse counseling as do wealthier clients. c. Is performed primarily for the benefit of the fetus. d. Can be either elected or refused by women as their absolute legal right.

C

Which of the following complications can be potentially life threatening and can occur in a client receiving a tocolytic agent? a. diabetic ketoacidosis b. hyperemesis gravidarum c. pulmonary edema d. sickle cell anemia

C

The nurse is reviewing the record of a pregnant client seen in the health care clinic for the first prenatal visit. Which data, if noted on the client's record, would alert the nurse that the client is at risk for a spontaneous abortion? a. Age of 35 years b. History of syphilis c. History of genital herpes d. History of diabetes mellitus

B

The nurse providing care for a woman with preterm labor who is receiving terbutaline would include which intervention to identify side effects of the drug? a. Assessing deep tendon reflexes (DTRs) b. Assessing for chest discomfort and palpitations c. Assessing for bradycardia d. Assessing for hypoglycemia

B

The onset of which type of diabetes is diagnosed during pregnancy for carbohydrate intolerance: a. Type 2 diabetes b. gestational diabetes mellitus c. Type 1 diabetes

B

A pregnant patient who is at 26 weeks gestation explains to her nurse that she has been eating small meals and skipping breakfast because of morning sickness. The patient also informs the nurse that she has been going to the YMCA to swim everyday for 3 hours straight because she read it is healthy for the baby. The nurse checks the patient's blood glucose levels because the patient has been complaining of dizziness and headaches. The patient's blood glucose levels were 120 mg/dL. The nurse knows all this subjective data and objective data indicate the patient is MOST likely: a. hyperglycemic b. hypoglycemic c. anorexia

B

A pregnant woman at 29 weeks of gestation has been diagnosed with preterm labor. Her labor is being controlled with tocolytic medications. She asks when she would be able to go home. Which response by the nurse is most accurate? a. "After the baby is born." b. "When we can stabilize your preterm labor and arrange home health visits." c. "Whenever the doctor says that it is okay." d. "It depends on what kind of insurance coverage you have."

B

A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. Which level would the nurse identify as therapeutic? A) 3.3 mEq/L B) 6.1 mEq/L C) 8.4 mEq/L D) 10.8 mEq/L

B

A woman with gestational hypertension experiences a seizure. Which of the following would be the priority? A) Fluid replacement B) Oxygenation C) Control of hypertension D) Delivery of the fetus

B

The nurse is assessing a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which assessment finding should the nurse expect to note if this condition is present? a. Soft abdomen b. Uterine tenderness c. Absence of abdominal pain d. Painless, bright red vaginal bleeding

B

When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which of the following 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

B

A client at 42 weeks is 3cm dilated, 30% effaced, with membranes intact and the fetus at +2 station. FHR is at 140-150 bpm. After 2 hours, the nurse notes on the EFM that, for the past 10 min, the FHR ranged from 160-190bpm. The client states that her baby has been extremely active. Contractions are strong, occurring every 3-4 min. and lasting 40-60 sec. Which of the following findings would indicate fetal hypoxia? a. Abnormally long contractions b. Abnormally strong uterine intensity c. Excessively frequent contractions with rapid fetal movement d. Excessive fetal activity and fetal tachycardia

D

The clinic nurse has provided home care instructions to a client with a history of cardiac disease who has just been told that she is pregnant. Which statement, if made by the client, indicates a need for further instructions? a. "It is best that I rest lying on my side to promote blood return to the heart." b. "I need to avoid excessive weight gain to prevent increased demands on my heart." c. "I need to try to avoid stressful situations because stress increases the workload on the heart." d. "During the pregnancy, I need to avoid contact with other individuals as much as possible to prevent infection.

D

The nurse is assessing a prenatal client diagnosed with possible placenta previa. What signs and symptoms should the nurse expect this client to demonstrate? a. Dark red vaginal bleeding b. Severe abdominal pain c. Absence of fetal heart sounds d. Bright red vaginal bleeding

D

The nurse is caring for a third-trimester prenatal client admitted with bright red, painless vaginal bleeding. What nursing intervention is not recommended? a. Intravenous fluids with lactated Ringer's b. Assessment of the fetal heart rate with continuous monitoring c. Application of a pulse oximeter d. Vaginal exams

D

The nurse practicing in a labor setting knows that the woman most at risk for uterine rupture is: a. A gravida 3 who has had two low-segment transverse cesarean births. b. A gravida 2 who had a low-segment vertical incision for delivery of a 10-pound infant. c. A gravida 5 who had two vaginal births and two cesarean births. d. A gravida 4 who has had all cesarean births.

D

Which of the following factors would contribute to a high risk pregnancy? a. Blood type O positive b. first pregnancy at age 33y.o. c. Hx of allergy to honey bee pollen d. Hx of insulin dependent DM

D