Mom & Baby Prep U questions 19, 20, 21, 22, 23, 24, 25
Tocolytic therapy
A young woman experiencing contractions arrives at the emergency department. After examining her, the nurse learns that the client is at 33 weeks' gestation. What treatment can the nurse expect this client to be prescribed?
ketoacidosis
The nurse is caring for a diabetic, postpartum client who has developed an infection.The nurse is aware that infections in diabetic clients tend to be more severe and can quickly lead to complications. Which complication should the nurse assess this client for?
Occipital (posterior)
The nurse is caring for a laboring mother. The mother continues to complain of back pain. The nurse instructs the mother the pain is occurring because the fetus is in which position?
oxytocoin
Oxytocin can lead to water intoxication. Therefore, a urine output of 20 mL/hour is below acceptable limits of 30 mL/hour and requires intervention. FHR of 150 beats/minute is within the accepted range of 120 to 160 beats/minute. Contractions should occur every 2 to 3 minutes, lasting 40 to 60 seconds.
Threaten abortion
Slight vaginal bleeding early in pregnancy and a closed cervical os are associated with
The nurse should assess the woman at least once hourly and report any dyspnea (not tachypnea), tachycardia (not bradycardia), productive cough, adventitious breath sounds, and absent or decreased deep tendon reflexes in a client receiving magnesium sulfate; these are all signs of possible magnesium toxicity
A client in preterm labor is receiving magnesium sulfate IV and appears to be responding well. Which finding on assessment should the nurse prioritize?
"Purse-string sutures are placed in the cervix to prevent it from dilating."
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
McRoberts maneuver
A laboring client has been pushing without delivering the fetal shoulders. The primary care provider determines the fetus is experiencing shoulder dystocia. What intervention can the nurse assist with to help with the birth?
The presenting part of the fetus The type of uterine incision Reason for the cesarean birth The fetal heart rate The mother's vital signs
A mother pregnant with her second baby is admitted to L&D for a vaginal birth after cesearean (VBAC). While obtaining an admission assessment, what important information is necessary for the labor and delivery nurse to obtain? Select all that apply.
lower than before she became pregnant
A nurse is about to give a client with type 2 diabetes insulin before breakfast on her first day postpartum. Which answer best describes insulin requirements immediately postpartum?
1.Client consumes a meal. 2.Client placed in left lateral recumbent position. 3.External electronic fetal-monitoring device applied. 4.Client is handed an event marker. 5.Fetal monitor strip marked for fetal movement.
A nurse is assigned to care for a pregnant client as she undergoes a nonstress test. Place the steps involved in conducting the nonstress test in the correct order from first to last. All options must be used.
he nurse should assess the client with heart disease for cardiac decompensation, which is most common from 28 to 32 weeks of gestation and in the first 48 hours postpartum.
A nurse is caring for a pregnant client with heart disease in a labor unit. Which intervention is mostimportant in the first 48 hours postpartum?
Prevention of crises, if possible, is the focus of treatment for the pregnant woman with sickle cell anemia. Maintaining adequate hydration, avoiding infection, getting adequate rest, and eating a balanced diet are all common-sense strategies that decrease the risk of a crisis.
A nurse is client teaching with a 30-year-old gravida 1 who has sickle cell anemia. Providing education on which topic is the highest nursing priority?
anovulation
A nurse is conducting a class for a group of couples about subfertility. When describing the causes of subfertility, which cause would the nurse include as being most common?
ndomethacin nifedipine magnesium sulfate
A nurse is conducting a review course on tocolytic therapy for perinatal nurses. After teaching the group, the nurse determines that the teaching was successful when they identify which drugs as being used for tocolysis? Select all that apply.
fetal genetic abnormalities
A nurse is conducting an in-service program for a group of nurses working at the women's health facility about the causes of spontaneous abortion. The nurse determines that the teaching was successful when the group identifies which condition as the most common cause of first trimester abortions?
Cytomegalovirus (CMV) CMV can cause microcephaly
A nurse is interviewing a pregnant woman who has come to the clinic for her first prenatal visit. During the interview, the client tells the nurse that she works in a day care center with 2- and 3-year olds. Based on the client's history, the nurse would be alert for the development of which condition?
fetal distress related to hypoxia
A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does the observation of meconium indicate?
HELLP is an acronym for hemolysis, elevated liver enzymes, and low platelets. elevated LDL
A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding?
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?
Cortocosteroids
A pregnant client in her 20th week of gestation, having systemic lupus erythematosus (SLE), is admitted to the healthcare unit for management of the exacerbation of SLE. Which of the following would be most appropriate to treat the client's condition?
The client is hypoglycemic when awakening in the morning. The nurse should provide glucose in the form of carbohydrate, such as crackers, and milk, and be prepared to reassess.
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 sickle cell crisis during pregnancy is usually managed by exchange transfusion, oxygen, and I.V. fluids.
A pregnant client with sickle cell anemia is admitted in crisis. Which nursing intervention should the nurse prioritize?
it may revel chromosomal abnormalities
A pregnant patient asks why an α-fetoprotein serum level has been ordered. What should the nurse explain to the patient about this test?
Assess fetal heart sounds with an external monitor.
A pregnant patient is diagnosed with placenta previa. Which action should the nurse implement immediately for this patient?
Use of an IUD with progesterone has a known increased risk for development of ectopic pregnancies
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?
Premature separation of placenta Placenta previa usually produces painless bright red bleeding. Preterm labor contractions are more often described as cramping.
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?
prednisone is considered safe int he dose provided by care giver
A woman is pregnant and has asthma. Her primary care provider has told her to continue taking prednisone during pregnancy, but she is concerned the drug may be teratogenic. What advice would be best to give her regarding this?
4 to 7 mEq/L are considered therapeutic, whereas levels more than 8 mEq/dL are generally considered toxic.
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?
sickle cell anemia is a recessively inheriated both parents have to carry the trait
A woman who has sickle cell anemia asks the nurse if her infant will develop sickle cell disease. The nurse would base the answer on which information?
"Be sure that your lupus is stable or in remission for 6 months before getting pregnant."
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?
"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."
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?
"I will be sure to avoid getting pregnant for at least 1 year."
After teaching a woman who has had an evacuation for gestational trophoblastic disease (hydatidiform mole or molar pregnancy) about her condition, which statement indicates that the nurse's teaching was successful?
abruptio placenta severe preeclampsia septicemia
Disseminated intravascular coagulation is a life-threatening condition that the nurse recognizes can occur as a complication secondary to which primary conditions? Select all that apply.
infection
Preterm premature rupture of membranes (PROM) can be a serious complication of labor. What is the most common cause of preterm PROM?
60 to 95 mg/dL
Recommended fasting blood glucose levels in pregnant clients with diabetes are ______
Herpes simplex virus
TORCH is an acronym for maternal infections associated with congenital malformations and disorders. Which of the following disorders does the H represent?
The BPP is an ultrasound that measures breathing, body movement, tone, and amniotic fluid volume.
The client is 32 weeks pregnant and has been referred for biophysical profile (BPP) after a nonreassuring nonstress test (NST). Which statement made by the client indicates that the nurse's explanation of the procedure was effective?
Folic acid anemia is a deficiency in folic acid. It is also called megaloblastic anemia, which means enlarged red blood cells. The mean corpuscular volume will be elevated. This deficiency takes several weeks to develop, so it may not be apparent until the second trimester of pregnancy.
The health care provider has diagnosed a pregnant client with megaloblastic anemia and has prescribed treatment. When questioned by the client as to what this means, which is the bestresponse from the nurse?
Leopoldo presentation
The mother comes to her prenatal appointment. She tells the nurse that it feels like the baby is kicking on her bladder and it is harder to breathe. The nurse suspects the fetus is in breech position. Which procedure would the nurse implement to determine the position of the baby?
cardiogenic shock.
The mother has suffered an amniotic fluid embolism. She has a sudden onset of tachycardia, weak thready pulses, is pale and diaphoretic. The nurse recognizes these symptoms as:
500ml
The nurse determines that a woman is experiencing postpartum hemorrhage after a vaginal birth when the blood loss is greater than which amount?
uncertainty of the baby's father unwanted pregnancy unemployed mother
The nurse educator is teaching new nurses on risk factors for intimate partner violence to watch for when caring for pregnant clients. Which risk factors will the nurse include in the teaching? Select all that apply.
dyspnea, crackles, and irregular weak pulse
The nurse is assessing a pregnant client with a known history of congestive heart failure who is in her third trimester. Which assessment findings should the nurse prioritize?
A woman with diabetes, vaginal birth, HR 110, temperature 101.7° F (38.7° C) on the third postpartum day. The next day, appears ill; temperature now 102.9° F (39.3° C); WBC 31,500 cells/mm&$176;3; negative blood cultures.
The nurse is caring for several postpartum clients and notes various warning signs that are concerning. Which client should the nurse suspect is developing endometritis?
Sharp fundal pain and discomfort between contractions
The nurse is concerned that a pregnant patient is experiencing abruptio placentae. What did the nurse assess in this patient?
shorten
The nurse is reviewing the physical examination findings for a client who is to undergo labor induction. Which finding would indicate to the nurse that a woman's cervix is ripe in preparation for labor induction?
bi-monthly visits until 28 weeks, then weekly visits
When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which schedule would be most appropriate?
calcium gluconate
Which compound would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia?
Recurrent pelvic infections
Which information on a client's health history would the nurse identify as contributing to the client's risk for an ectopic pregnancy?
prepregnancy obesity diabetes mellitus postdates gestation
Which maternal factors should the nurse consider contributory to a newborn being large for gestational age? Select all that apply.
An underweight woman should increase her caloric intake by 500 to 1000 calories a day.
Which of the following statements regarding weight and pregnancy is correct?
Diabetic clients may breast-feed; insulin requirements may decrease from breast-feeding
Which response is most appropriate for a client with diabetes who wants to breast-feed but is concerned about the effects of breastfeeding on her health?
Pain underneath the ribs, especially on the right, may be epigastric pain. Epigastric pain can be a late sign of preeclampsia.
Which symptom may indicate a complication (not a common discomfort) in the second or third trimester of pregnancy?
SOB history of diabetes difficulty obtaining fetal HR a condition in which excess amniotic fluid accumulates during pregnancy. can lead to preterm rupture of membrane followed by preterm brith
While assessing a pregnant woman, the nurse suspects that the client may be at risk for hydramnios based on which factor? Select all that apply.
f the loss of blood is extremely copious, a woman will quickly begin to exhibit symptoms of hypovolemic shock such as a weak and rapid pulse. The skin will be pale and clammy, and the blood pressure will fall. Respiratory rate will be increased and shallow.
he nurse is concerned that a postpartum patient with a cervical laceration is developing hypovolemic shock. What did the nurse assess in this patient?
Uterus
the uterus is firm-to-rigid to the touch with abruptio placentae. It is soft and relaxed with placenta previa.
Oxygenation
A woman with gestational hypertension experiences a seizure. Which intervention would the nurse identify as the priority?
take your anti-nausea medication around the clock
A 25-year-old pregnant client has just been diagnosed with hyperemesis gravidarum. Which instruction should the nurse prioritize during a teaching session?
direct Coombs blood type hemoglobin bilirubin levels
A 32 weeks' gestation newborn in the neonatal intensive care is being assessed for hyperbilirubinemia. Which diagnostic tests would the nurse expect to be done? Select all that apply.
palpate the funds, and check fetal HR
A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm/Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next?
"I'll let the doctor know so you can discuss your medications. In the meantime, I'll give you a list of folate-rich foods you can add to your diet."
A 32-year-old woman with epilepsy mentions to the nurse during a routine well-visit that she would like to have children and asks the nurse for advice. Which response is most appropriate from the nurse?
ectopic pregnancy
A 38-year-old client presents to the clinic desiring to get pregnant. She reports she had a tubal ligation in her early 20s after two babies and a divorce. After learning that the client recently underwent a reversal of the tubal ligation, the nurse will warn the client of which potential risk?
uterine rupture
A G2P1 woman is in labor attempting a VBAC, when she suddenly complains of light-headedness and dizziness. An increase in pulse and decrease in blood pressure is noted as a change from the vital signs obtained 15 minutes prior. The nurse should investigate further for additional signs or symptoms of which complication?
Hemoglobin level and hematocrit decrease during pregnancy as the increase in plasma volume exceeds the increase in red blood cell production physiological anemia
A client in her fifth month of pregnancy is having a routine clinic visit. The nurse should assess the client for which common second trimester condition?
The client delivers a full-term fetus at 39 weeks' gestation.
A pregnant patient with a history of premature cervical dilatation undergoes cervical cerclage. Which outcome indicates that this procedure has been successful?
28-32 weeks
A pregnant woman diagnosed with cardiac disease 4 years ago is told that her pregnancy is a high-risk pregnancy. The nurse then explains that the danger occurs primarily because of the increase in circulatory volume. The nurse informs the client that the most dangerous time for her is when?
strong abdominal cramping
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?
identical
A pregnant woman has just found out that she is having twin girls. She asks the nurse the difference between fraternal and identical twins. The nurse explains that with one set of twins there is fertilization of two ova, and with the other set one fertilized ovum splits. What type of twins result from the split ovum?
You should continue taking this drug, because penicillin is not known to be a fetal teratogen."
A pregnant woman who has been taking penicillin prophylactically because she had rheumatic fever as a child tells the nurse that she wants to stop taking it now that she is pregnant. Which of the following is the best response by the nurse?
anticoagulant
A pregnant woman with a history of mitral stenosis is to be prescribed medication as treatment. Which of the following medication classes would the nurse expect the patient to begin taking?
low birth weight
In women with cardiac failure, the maternal blood pressure becomes insufficient to provide an adequate supply of blood to the placenta. The infant will likely experience some undesired effects, including which of the following?
Mild hypertension
Over the past 20 weeks, the following blood pressure readings are documented for a pregnant client with chronic hypertension: week 16 - 124/86 mm Hg; week 20 - 138/90 mm Hg; week 24 - 140/92 mm Hg; and week 28 - 142/94 mm Hg. The nurse interprets these findings as indicating which classification of her blood pressure?
Bishop score
The duration of labor is inversely correlated with the Bishop score: a score over 8 indicates a successful vaginal birth. Therefore the woman with a Bishop score of 11 would have the greatest chance for success. Bishop scores of less than 6 usually indicate that a cervical ripening method should be used prior to induction.
gestational hypertension
The nurse would be alert for possible placental abruption during labor when assessment reveals which finding?
