PrepU questions

A woman in labor suddenly reports sharp fundal pain accompanied by slight dark red vaginal bleeding. The nurse should prepare to assist with which situation? Premature separation of the placenta Preterm labor that was undiagnosed Placenta previa obstructing the cervix Possible fetal death or injury

Premature separation of the placenta

The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours. Why would the nurse do this? Pulmonary hypertension Pulmonary edema Pulmonary emboli Pulmonary atelectasis

Pulmonary edema

A pregnant client has an Rh-negative blood type. Following the birth of the client's infant, the nurse administers her Rho(D) immune globulin. The purpose of this is to: promote maternal D antibody formation. prevent maternal D antibody formation. stimulate maternal D immune antigens. prevent fetal Rh blood formation.

prevent maternal D antibody formation.

What would be the physiologic basis for a placenta previa? a loose placental implantation low placental implantation a placenta with multiple lobes a uterus with a midseptum

low placental implantation

A woman is admitted with a diagnosis of ectopic pregnancy. For which procedure should the nurse prepare? bed rest for the next 4 weeks intravenous administration of a tocolytic immediate surgery internal uterine monitoring

immediate surgery

A pregnant client with multiple gestation arrives at the maternity clinic for a regular antenatal check up. The nurse would be aware that client is at risk for which perinatal complication? postterm birth maternal hypotension congenital anomalies fetal nonimmune hydrops

congenital anomalies

A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priority for this client? Administer total parenteral nutrition. Administer an antiemetic. Set up for a percutaneous endoscopic gastrostomy. Administer IV NS with vitamins and electrolytes.

Administer IV NS with vitamins and electrolytes.

A 28-year-old client with a history of endometriosis presents to the emergency department with severe abdominal pain and nausea and vomiting. The client also reports her periods are irregular with the last one being 2 months ago. The nurse prepares to assess for which possible cause for this client's complaints? Healthy pregnancy Ectopic pregnancy Molar pregnancy Placenta previa

Ectopic pregnancy

The nurse is required to assess a pregnant client who is reporting vaginal bleeding. Which nursing action is the priority? monitoring uterine contractility assessing signs of shock determining the amount of funneling assessing the amount and color of the bleeding

assessing the amount and color of the bleeding

A pregnant woman with preeclampsia is to receive magnesium sulfate IV. Which assessment should the nurse prioritize before administering a new dose? blood pressure patellar reflex heart rate anxiety level

patellar reflex

A nurse is providing care to a multiparous client. The client has a history of cesarean births. The nurse anticipates the need to closely monitor the client for which condition? placenta accreta placenta abruption preeclampsia oligohydramnios

placenta accreta

A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy? high number of pregnancies multiple gestation pregnancy use of oral contraceptives use of IUD for contraception

use of IUD for contraception

The nurse is comforting and listening to a young couple who just suffered a miscarriage. When asked why this happened, which reason should the nurse share as a common cause? Maternal smoking Lack of prenatal care Chromosomal abnormality The age of the mother

Chromosomal abnormality

The nurse is caring for a pregnant client with severe preeclampsia. Which nursing intervention should a nurse perform to institute and maintain seizure precautions in this client? Provide a well-lit room. Keep head of bed slightly elevated. Place the client in a supine position. Keep the suction equipment readily available.

Keep the suction equipment readily available.

A nurse is assessing a pregnant client for the possibility of preexisting conditions that could lead to complications during pregnancy. The nurse suspects that the woman is at risk for hydramnios based on which preexisting condition? diabetes hypertension late maternal age isoimmunization

diabetes

A client has come to the office for a prenatal visit during her 22nd week of gestation. On examination, it is noted that her blood pressure has increased to 138/90 mm Hg. Her urine is negative for proteinuria. The nurse recognizes which factor as the potential cause? gestational hypertension chronic hypertension HELLP preeclampsia

gestational hypertension

A nurse is taking a history of a client at 5 weeks' gestation in the prenatal clinic; however, the client is reporting dark brown vaginal discharge, nausea, and vomiting. Which diagnosis should the nurse suspect? placenta previa hyperemesis gravidarum gestational trophoblastic disease pregnancy-induced depression

gestational trophoblastic disease

A pregnant client has been admitted with reports of brownish vaginal bleeding. On examination there is an elevated hCG level, absent fetal heart sounds, and a discrepancy between the uterine size and the gestational age. The nurse interprets these findings to suggest which condition? ectopic pregnancy placenta previa gestational trophoblastic disease abruption of placenta

gestational trophoblastic disease

A client has been admitted with abruptio placentae. She has lost 1,200 mL of blood, is normotensive, and ultrasound indicates approximately 30% separation. The nurse documents this as which classification of abruptio placentae? grade 2 grade 1 grade 3 grade 4

grade 2

A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply. hyperthermia hemolysis elevated liver enzymes leukocytosis low platelet count`

hemolysis elevated liver enzymes low platelet count

During a routine prenatal visit, a client is found to have proteinuria and a blood pressure rise to 140/90 mm Hg. The nurse recognizes that the client has which condition? mild preeclampsia gestational hypertension severe preeclampsia eclampsia

mild preeclampsia

A 44-year-old client has lost several pregnancies over the last 10 years. For the past 3 months, she has had fatigue, nausea, and vomiting. She visits the clinic and takes a pregnancy test; the results are positive. Physical examination confirms a uterus enlarged to 13 weeks' gestation; fetal heart tones are heard. Ultrasound reveals that the client is experiencing some bleeding. Considering the client's prenatal history and age, what does the nurse recognize as the greatest risk for the client at this time? premature birth hypertension pregnancy loss preterm labor

pregnancy loss

A woman in week 35 of her pregnancy with severe hydramnios is admitted to the hospital. The nurse recognizes that which concern is greatest regarding this client? preterm rupture of membranes followed by preterm birth development of eclampsia hemorrhaging development of gestational trophoblastic disease

preterm rupture of membranes followed by preterm birth

A 24-year-old client presents in labor. The nurse notes there is an order to administer RhoGAM after the birth of her infant. When asked by the client the reason for this injection, which reason should the nurse point out? promote maternal D antibody formation. prevent maternal D antibody formation. stimulate maternal D immune antigens. prevent fetal Rh blood formation.

prevent maternal D antibody formation.

A woman in labor is at risk for abruptio placentae. Which assessment would most likely lead the nurse to suspect that this has happened? sharp fundal pain and discomfort between contractions painless vaginal bleeding and a fall in blood pressure pain in a lower quadrant and increased pulse rate an increased blood pressure and oliguria

sharp fundal pain and discomfort between contractions

When assessing a pregnant woman with vaginal bleeding, the nurse would suspect a threatened abortion based on which finding? slight vaginal bleeding cervical dilation strong abdominal cramping passage of fetal tissue

slight vaginal bleeding

A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable abortion? strong abdominal cramping slight vaginal bleeding closed cervical os no passage of fetal tissue

strong abdominal cramping

The nurse is teaching a client who is diagnosed with preeclampsia how to monitor her condition. The nurse determines the client needs more instruction after making which statement? "If I have changes in my vision, I will lie down and rest." "I will weigh myself every morning after voiding before breakfast." "I will count my baby's movements after each meal." "If I have a severe headache, I'll call the clinic."

"If I have changes in my vision, I will lie down and rest."

A student nurse asks the instructor what percentage of clinically recognized pregnancies end in miscarriages during the first trimester. Which response from the nurse is the most accurate? 5% to 10% 15% to 20% 21% to 30% 31% to 40%

15% to 20%

A woman is to undergo labor induction. The nurse determines that the woman requires cervical ripening if her Bishop score is: 5. 6. 7. 9.

A Bishop score less than 6 usually indicates that a cervical ripening method should be used before labor induction.

A pregnant client is admitted to a health care unit with disseminated intravascular coagulation (DIC). Which prescription is the nurse most likely to receive regarding the therapy for such a client? Administer a ratio of 1 unit of blood to 4 units of frozen plasma. Administer cryoprecipitate and platelets. Aim at keeping the client's hematocrit above 20%. Give each unit of blood to raise the hematocrit by 3 g/dL.

Administer cryoprecipitate and platelets.

A 25-week-gestation client presents with a blood pressure of 152/99, pulse 78, no edema, and urine negative for protein. What would the nurse do next? Notify the health care provider Provide health education Assess the client for ketonuria Document the client's blood pressure

Notify the health care provider

The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 1, BP 148/110 mm Hg. What other priority physical assessments by the nurse should be implemented to assess for potential toxicity? Lung sounds Oxygen saturation Reflexes Magnesium sulfate level

Reflexes

A young woman presents at the emergency department reporting lower abdominal cramping and spotting at 12 weeks' gestation. The primary care provider performs a pelvic examination and finds that the cervix is closed. What does the care provider suspect is the cause of the cramps and spotting? Ectopic pregnancy Habitual abortion Cervical insufficiency Threatened abortion

Threatened abortion

A client with a history of cervical insufficiency is seen for reports of pink-tinged discharge and pelvic pressure. The primary care provider decides to perform a cervical cerclage. The nurse teaches the client about the procedure. Which client response indicates that the teaching has been effective? "Staples are put in the cervix to prevent it from dilating." "The cervix is glued shut so no amniotic fluid can escape." "Purse-string sutures are placed in the cervix to prevent it from dilating." "A cervical cap is placed so no amniotic fluid can escape."

"Purse-string sutures are placed in the cervix to prevent it from dilating."

A primigravida 28-year-old client is noted to have Rh negative blood and her husband is noted to be Rh positive. The nurse should prepare to administer RhoGAM after which diagnostic procedure? Contraction test Nonstress test Biophysical profile Amniocentesis

Amniocentesis

The nurse is assessing a new client who is being admitted with gestational hypertension. Which nursing diagnosis should the nurse prioritize for this client? Deficient fluid volume related to vasospasm of arteries Decreased reflexes due to medication administration Risk for injury related to fetal distress Imbalanced nutrition related to decreased sodium levels

Deficient fluid volume related to vasospasm of arteries

A client at 27 weeks' gestation is admitted to the OB unit afer reporting headaches and edema of her hands. Review of the prenatal notes reveals BP consistently above 136/90 mm Hg. The nurse anticipates the health care provider will order magneisum sulfate to accomplish which primary goal? Decrease blood pressure Decrease protein in urine Prevent maternal seizures Reverse edema

Prevent maternal seizures

A client at 37 weeks' gestation presents to the emergency department with a BP 150/108 mm Hg, 1+ pedal edema, 1+ proteinuria, and normal deep tendon reflexes. Which assessment should the nurse prioritize as the client is administered magnesium sulfate IV? Urine protein Ability to sleep Hemoglobin Respiratory rate

Respiratory rate

The nurse is caring for a woman at 32 weeks gestation with severe preeclampsia. Which assessment finding should the nurse prioritize after the administration of hydralazine to this client? Gastrointestinal bleeding Halos around lights Tachycardia Sweating

Tachycardia

A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission? performing a vaginal examination to assess the extent of bleeding helping the woman remain ambulatory to reduce bleeding assessing fetal heart tones by use of an external monitor assessing uterine contractions by an internal pressure gauge

assessing fetal heart tones by use of an external monitor

A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client? diminished reflexes elevated liver enzymes seizures serum magnesium level of 6.5 mEq/L

diminished reflexes

A nurse is caring for a client who just experienced a miscarriage in her first trimester. When asked by the client why this happened, which is the best response from the nurse? abnormal fetal development rejection of the embryo through an immune response implantation abnormality lack of sufficient progesterone produced by the corpus luteum

abnormal fetal development

A woman with severe preeclampsia is receiving magnesium sulfate. The woman's serum magnesium level is 9.0 mEq/L. Which finding would the nurse most likely note? diminished reflexes elevated liver enzymes seizures serum magnesium level of 6.5 mEq/L

diminished reflexes

A woman with an incomplete abortion is to receive misoprostol. The woman asks the nurse, "Why am I getting this drug?" The nurse responds to the client, integrating understanding that this drug achieves which effect? ensures passage of all the products of conception alleviates strong uterine cramping suppresses the immune response to prevent isoimmunization halts the progression of the abortion

ensures passage of all the products of conception

A woman at 10 weeks gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize? report of frequent mild nausea blood pressure of 120/84 mm Hg history of bright red spotting 6 weeks ago fundal height measurement of 18 cm

fundal height measurement of 18 cm

A 35-year-old client is seen for her 2-week postoperative appointment after a suction curettage was performed to evacuate a hydatidiform mole. The nurse explains that the human chorionic gonadotropin (hCG) levels will be reviewed every 2 weeks and teaches about the need for reliable contraception for the next 6 months to a year. The client states, "I'm 35 already. Why do I have to wait that long to get pregnant again?" What is the nurse's best response? "After a curettage procedure, it is recommended that you give your body some time to build up its stores." "A contraceptive is used so that a positive pregnancy test resulting from a new pregnancy will not be confused with the increased level of hCG that occurs with a developing malignancy." "Since you are at the end of your reproductive years, it is suggested that you don't try to have any more pregnancies." "You may need chemotherapy, so we don't want to risk pregnancy."

"A contraceptive is used so that a positive pregnancy test resulting from a new pregnancy will not be confused with the increased level of hCG that occurs with a developing malignancy."

A client at 11 weeks' gestation experiences pregnancy loss. The client asks the nurse if the bleeding and cramping that occurred during the miscarriage were caused by working long hours in a stressful environment. What is the most appropriate response from the nurse? "Your spontaneous bleeding is not work-related." "It is hard to know why a woman bleeds during early pregnancy." "I can understand your need to find an answer to what caused this. Let's talk about this further." "Something was wrong with the fetus."

"I can understand your need to find an answer to what caused this. Let's talk about this further."

After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between abruptio placentae and placenta previa. Which statement should the nurse include in the teaching? "Placenta previa causes painful, dark red bleeding during pregnancy due to an abnormally implanted placentae that is too close to or covers the cervix; abruptio placenta is associated with bright red painless bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor." "Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placentae is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor." "Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the fundus; abruptio placentae is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor." "Placenta previa causes painful, dark red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the fundus; abruptio placentae is associated with right red painless bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor."

"Placenta previa causes painful, dark red bleeding during pregnancy due to an abnormally implanted placentae that is too close to or covers the cervix; abruptio placenta is associated with bright red painless bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor."

A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom should the nurse prioritize? A systolic blood pressure increase of 10 mm Hg Weight gain of 1.2 lb (0.54 kg) during the past 1 week A dipstick value of 2+ for protein Pedal edema

A dipstick value of 2+ for protein

A 25-year-old client at 22 weeks' gestation is noted to have proteinuria and dependent edema on her routine prenatal visit. Which additional assessment should the nurse prioritize and alert the RN or health care provider? Initial BP 120/80mm Hg; current BP 130/88 mm Hg Initial BP 100/70 mm Hg; current BP 140/90 mm Hg Initial BP 140/85 mm Hg; current BP 130/80 mm Hg Initial BP 110/60 mm Hg; current BP 112/86 mm Hg

Initial BP 100/70 mm Hg; current BP 140/90 mm Hg

A pregnant woman has been admitted to the hospital due to severe preeclampsia. Which measure will be important for the nurse to include in the care plan? Institute and maintain seizure precautions. Institute NPO status. Admit the client to the middle of ICU where she can be constantly monitored. Plan for immediate induction of labor.

Institute and maintain seizure precautions.

The nurse is caring for a pregnant client with fallopian tube rupture. Which intervention is the priority for this client? Monitor the client's beta-hCG level. Monitor the mass with transvaginal ultrasound. Monitor the client's vital signs and bleeding. Monitor the fetal heart rate (FHR).

Monitor the client's vital signs and bleeding.

Which medication would the nurse prepare to administer if prescribed as treatment for an unruptured ectopic pregnancy? oxytocin promethazine ondansetron methotrexate

methotrexate