OB Mini quiz 7

When assessing a pregnant woman with heart disease throughout the antepartal period, the nurse would be especially alert for signs and symptoms of cardiac decompensation at which time? A. 20 to 24 weeks' gestation B. 24 to 28 weeks' gestation C. 16 to 20 weeks' gestation D. 28 to 32 weeks' gestation

28 to 32 weeks' gestation Feedback: A pregnant woman with heart disease is most vulnerable for cardiac decompensation from 28 to 32 weeks' gestation.

A nurse is providing prenatal care to a pregnancy client. At which time would the nurse expect to screen the client for group B streptococcus infection? A. 36 weeks' gestation B. 32 weeks' gestation C. 28 weeks' gestation D. 16 weeks' gestation

36 Weeks' gestation Feedback: According to the CDC guidelines, all pregnant women should be screened for group B streptococcus infection at 35 to 37 weeks' gestation.

After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicates successful teaching? A. "I need to eat foods high in fiber." B. "I should avoid drinking orange juice." C. "I should take my iron with milk." D. "I'll call the primary care provider if my stool is black and tarry."

A. "I need to eat foods high in fiber." Feedback: Iron supplements can lead to constipation, so the woman needs to increase her intake of fluids and high-fiber foods. Milk inhibits absorption and should be discouraged. Vitamin C-containing fluids such as orange juice are encouraged because they promote absorption. Ideally the woman should take the iron on an empty stomach to improve absorption, but many women cannot tolerate the gastrointestinal discomfort it causes. In such cases, the woman should take it with meals. Iron typically causes the stool to become black and tarry; there is no need for the woman to notify her doctor.

A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which signs would the nurse assess? Select all that apply. A. tremors B. hypertonicity C. overly vigorous sucking D. lethargy E. excessive sneezing F. low whimpering cry

A. Tremors B. Hypertonicity E. Excessive sneezing Feedback: Signs and symptoms of withdrawal, or neonatal abstinence syndrome, include: irritability, hypertonicity, excessive and often high-pitched crying, vomiting, diarrhea, feeding disturbances, respiratory distress, disturbed sleeping, excessive sneezing and yawning, nasal stuffiness, diaphoresis, fever, poor sucking, tremors, and seizures.

A nurse has been invited to speak at a local high school about adolescent pregnancy. When developing the presentation, the nurse would incorporate information related to which aspect? Select all that apply. A. loss of self-esteem as a major impact B. majority of teen pregnancies in the 15- to 17-year-old age group C. latinas as having the highest teen birth rate D. peer pressure to become sexually active E. rise in teen birth rates over the years.

A. loss of self-esteem as a major impact C. latinas as having the highest teen birth rate D. peer pressure to become sexually active Feedback: Adolescent pregnancies account for 10% of all births and as such adolescent pregnancy is a major health problem. Peer pressure to become sexually active is a factor that contributes to adolescent pregnancy. Although the incidence of teenage pregnancy has steadily declined since the early 1990s, it continues to be higher in the United States than in any other industrialized country (Alan Guttmacher Institute, 2012b). Teen birth rates in the United States have declined but remain high, especially among Black and Hispanic teens and in southern states. The Latina teen birth rate is the highest of any ethnic group in the United States. The most important impact lies in the psychosocial area as it contributes to a loss of self-esteem, a destruction of life projects, and the maintenance of the circle of poverty. Two-thirds of all teen pregnancies occur among 18-19-year olds.

After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse determines that the teaching was successful when the woman identifies which food as being good sources of iron in her diet? Select all that apply. A. milk B. dried fruits C. meats D. white bread E. peanut butter

B, C, E Feedback: Foods high in iron include meats, green leafy vegetables, legumes, dried fruits, whole grains, peanut butter, bean dip, whole-wheat fortified breads and cereals.

A nurse is conducting a program for pregnant women with gestational diabetes about reducing complications. The nurse determines that the teaching was successful when the group identifies which factor as being most important in helping to reduce complications associated with pregnancy and diabetes? A. control of blood urea nitrogen (BUN) levels for optimal kidney function B. reduction in retinopathy risk by frequent ophthalmologic evaluations C. degree of blood glucose control achieved during the pregnancy D. stability of the woman's emotional and psychological status

C Feedback: Therapeutic management for the woman with diabetes focuses on tight glucose control, thereby minimizing the risks to the mother, fetus, and neonate. The woman's emotional and psychological status is highly variable and may or may not affect the pregnancy. Evaluating for long-term diabetic complications such as retinopathy or nephropathy, as evidenced by laboratory testing such as BUN levels, is an important aspect of preconception care to ensure that the mother enters the pregnancy in an optimal state.

A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which statement by the nurse would be most appropriate? A. "Antibodies cross the placenta and provide immunity to the newborn." B. "You'll probably have a cesarean birth to prevent exposing your newborn." C. "Antiretroviral medications are available to help reduce the risk of transmission." D. "Wait until after the infant is born, and then something can be done."

C. "Antiretroviral medications are available to help reduce the risk of transmission." Feedback: Drug therapy is the mainstay of treatment for pregnant women infected with HIV. The goal of therapy is to reduce the viral load as much as possible; this reduces the risk of transmission to the fetus. Decisions about the method of delivery should be based on the woman's viral load, duration of ruptured membranes, progress of labor, and other pertinent clinical factors. The newborn is at risk for HIV because of potential perinatal transmission. Waiting until after the infant is born may be too late.

A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world? A. cytomegalovirus B. hepatitis B C. rubella D. parvovirus B19

Cytomegalovirus Feedback: Although rubella, hepatitis B, and parvovirus B19 can affect pregnant women and their fetuses, cytomegalovirus (CMV) is the most common congenital and perinatal viral infection in the world. CMV is the leading cause of congenital infection, with morbidity and mortality at birth and sequelae. Each year approximately 1-7% of pregnant women acquire a primary CMV infection. Of these, about 30-40% transmits infection to their fetuses.

Which medication would the nurse question if ordered to control a pregnant woman's asthma? A) Budesonide B) Albuterol C) Salmeterol D) Oral prednisone

Oral Prednisone Feedback: Oral corticosteroids such as prednisone are not preferred in the treatment of asthma during pregnancy. However, they can be used to treat severe asthma attacks during pregnancy. Budesonide, albuterol, and salmeterol are recommended for use during pregnancy to control asthma.