OB ch. 20

A, B, D, E

A woman at 38 weeks' gestation with a history of heroin abuse has given birth to a newborn several hours ago. The nurse assesses the newborn and determines that he is experiencing withdrawal based on which findings? Select all that apply. a. high-pitched shrill cry b. almost constant sneezing c. flaccid extremities d. nasal stuffiness e. poor sucking reflex

D

A woman develops gestational diabetes. Which assessment should she make daily? a. Test her urine for protein with a chemical reagent strip. b. Measure her abdominal diameter with a tape measure. c. Measure her uterine height by hand-span distance. d. Measure serum for glucose level by a finger prick.

C

A nurse is assisting a client in active labor whose diabetes has been poorly controlled. Which assessment of the neonate should be prioritize after its birth? a. hyperglycemia b. low birthweight c. macrosomia d. hypobilirubinemia

A, B, C, D

A nurse is caring for a client with cardiovascular disease who has just given birth. What nursing interventions should the nurse perform when caring for this client? Select all that apply. a. Assess for shortness of breath. b. Assess for a moist cough. c. Assess for edema and note any pitting. d. Auscultate heart sounds for abnormalities. e. Monitor the client's hemoglobin and hematocrit.

D

A nurse is caring for a pregnant client who is human immunodeficiency virus (HIV) positive. What is a priority issue that the nurse should discuss with the client? a. the client's relationship with the spouse b. the amount of physical contact that should occur with the infant c. the client's plan for future pregnancies d. the need for the client to avoid breastfeeding

B

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

C

A nurse is caring for a pregnant client with gestational diabetes. Which meal should the nurse recommend for this client? a. baked chicken, green beans, and chocolate cake b. pizza, corn, and orange slices c. baked turkey, brown rice, and strawberries d. steak, baked potato with butter, and ice cream

B

A nurse is caring for a pregnant woman in her third trimester. The woman is HIV positive and voices concerns about passing the infection on to her baby. What is the nurse's best response? a. "There is nothing you can do. You will just have to wait and see if your baby is born HIV positive." b. "If you are taking antiretroviral medications and you don't breastfeed your baby, you greatly reduce the risk of perinatal transmission of the disease." c. "Do you have other children? Your baby has a one-in-four chance of having HIV at birth, so if you have three other children who are not HIV positive, then this one will be HIV positive." d. "Perinatal transmission of the virus is a real fear. Would you like to talk to a social worker?"

A

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? a. hyperglycemia b. macrosomia c. hypoglycemia d. birth trauma

A, B, C, D, E

A nurse is conducting a class on the effects of nicotine during pregnancy. Which complications will the nurse include in the teaching? Select all that apply. a. Spontaneous abortion b. Placenta previa c. Preterm labor and birth d. Tubal ectopic pregnancy e. Spontaneous rupture of membranes

A

A pregnant client with diabetes in the hospital reports waking up with shakiness and diaphoresis. Which action should the nurse prioritize after discovering the client's fasting blood sugar is 60 mg/dL? a. Provide the client some milk to drink. b. Recheck her blood sugar for accuracy. c. Withhold her insulin, and notify the health care provider. d. Stay with her, and ask another nurse to bring her insulin.

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."

A

A pregnant woman who is HIV-positive comes to the labor and birth unit in labor. When developing the plan of care for this client, which intervention would be most important for the nurse to include? a. adhering to standard precautions b. educating her about family planning c. preparing the woman for cesarean birth d. helping her choose a newborn feeding method

C

A woman with a positive history of genital herpes is in active labor. Assessment reveals vesicles in the perineum area, membranes are ruptured, dilated 5 cm, and effaced 70%. The nurse should prepare the client for which type of birth? a. Spontaneous vaginal b. Vacuum-assisted c. Cesarean d. Forceps-assisted

B, D

During a routine prenatal check up, the nurse interviews a pregnant client to identify possible risk factors for developing gestational diabetes. Which factor would the nurse identify as increasing the woman's risk? Select all that apply. a. younger maternal age at pregnancy b. previous history of spontaneous abortion c. previous birth of small for gestational age baby d. maternal obesity with body mass index more than 35 e. client of African-American lineage

B, C, D, E

In preparing a class for a group of pregnant couples, the nurse includes information about possible newborn complications associated with smoking during pregnancy. Which complications will the nurse include? Select all that apply. a. Trisomy 21 b. Cerebral palsy c. Low birth weight d. Cleft lip and palate e. Sudden infant death syndrome

A, B, E

The nurse is caring for a pregnant woman with diabetes mellitus. Which potential fetal complications should the nurse monitor the client for as she presents for her scheduled visits? Select all that apply. a. congenital malformations b. macrosomia c. fetus with juvenile diabetes d. smaller than gestational age baby e. respiratory disorder

B, C, D

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. a. Decreased birth weight b. Increased risk of spontaneous abortion c. Polyhydramnios d. Hypertension e. Cystic fibrosis

C

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

C

Which should the nurse identify as a risk associated with anemia during pregnancy? a. newborn with heart problems b. fetal asphyxia c. preterm birth d. newborn with an enlarged liver