Pregnancy at Risk Practice Exam

A client with a blood pressure of 150/90 mm Hg, 3+ proteinuria, and edema of the hands and face is diagnosed with severe preeclampsia. Which other clinical findings support this diagnosis? Select all that apply. One, some, or all responses may be correct. 1 Headache 2 Constipation 3 Abdominal pain 4 Vaginal bleeding 5 Visual disturbances

1 Headache 3 Abdominal pain 5 Visual disturbances

Which is the nurse's concern when caring for a client just diagnosed with a ruptured tubal pregnancy? 1 Infection 2 Hypervolemia 3 Protein deficiency 4 Diminished cardiac output

Diminished cardiac output

Which position increases cardiac output in the obstetrical client with cardiac disease? 1 Trendelenburg 2 Low semi-Fowler 3 Lateral positioning 4 Supine with legs elevated

Lateral positioning

Which is a likely cause of painless vaginal bleeding during the last trimester of pregnancy? 1 Placenta previa 2 Abruptio placentae 3 Frequent sexual intercourse 4 Excessive alcohol ingestion

Placenta previa

Why would the primary health care provider instruct a woman at 38 weeks' gestation with slightly elevated blood pressure to remain in bed at home in a side-lying position? 1 "It increases blood flow to the fetus." 2 "It decreases intra-abdominal pressure." 3 "It increases the mean arterial pressure." 4 "It prevents the development of thrombosis."

"It increases blood flow to the fetus."

Which iron-rich foods would the nurse encourage the client with mild anemia in early pregnancy to eat? Select all that apply. One, some, or all responses may be correct. 1 Dark leafy green vegetables 2 Legumes 3 Dried fruits 4 Yogurt 5 Ground beef patty

1 Dark leafy green vegetables 2 Legumes 3 Dried fruits 5 Ground beef patty

When do the initial symptoms of a tubal pregnancy begin? 1 At 16 weeks' gestation 2 Immediately after implantation 3 About 6 weeks into the pregnancy 4 Toward the end of the second trimester

About 6 weeks into the pregnancy

Which clinical finding would the nurse expect when assessing a client with abruptio placentae? 1 Flaccid uterus 2 Painless bleeding 3 Boardlike abdomen 4 Bright red bleeding

Boardlike abdomen

At 32 weeks' gestation a client undergoes an ultrasound examination, which reveals a low-lying placenta. Which assessment finding would the nurse anticipate as the client's pregnancy approaches term? 1 Sharp abdominal pain 2 Painless vaginal bleeding 3 Increased lower back pain 4 Early rupture of membranes

Painless vaginal bleeding

Which factor in a client's history suggests a risk for preterm labor? 1 Primigravida 2 Android-shaped pelvis 3 Multiple urinary tract infections 4 Anticonvulsant medication therapy

Multiple urinary tract infections

Back pain is most often associated with which fetal position? 1 Breech 2 Transverse 3 Occiput anterior 4 Occiput posterior

Occiput posterior

The nurse admits a client with preeclampsia to the high-risk prenatal unit. Which is the next nursing action after the vital signs have been obtained? 1 Calling the primary health care provider 2 Checking the client's reflexes 3 Determining the client's blood type 4 Establishing an intravenous (IV) line

Checking the client's reflexes

A client who is in labor is admitted 30 hours after her membranes ruptured. Which condition is this client at increased risk for? 1 Cord prolapse 2 Placenta previa 3 Chorioamnionitis 4 Abruptio placentae

Chorioamnionitis

Which occurs immediately after birth that increases the risk for cardiac decompensation in a client with a compromised cardiac system? 1 Increased pressure is placed on the veins. 2 Intra-abdominal pressure is significantly increased. 3 The blood flow to the heart is decreased considerably. 4 Extravascular fluid is remobilized into the vascular compartment.

Extravascular fluid is remobilized into the vascular compartment.

Assessment of a primigravida at 32 weeks' gestation shows a blood pressure of 170/110 mm Hg, 4+ proteinuria, and edema of the face and extremities. With which complication are these findings consistent? 1 Eclampsia 2 Severe preeclampsia 3 Chronic hypertension 4 Gestational hypertension

Severe preeclampsia

For a pregnant client with type 1 diabetes, which action is most likely to reduce the risks of disease-related complications? 1 Monitor and control blood glucose levels. 2 Limit pregnancy weight gain to an average of 25 pounds. 3 Preplan for a cesarean section. 4 Attend all prenatal office visits.

1 Monitor and control blood glucose levels.

Which prenatal condition would the nurse expect to find in the history of a client with an abruptio placentae? 1 Cardiac disease 2 Hyperthyroidism 3 Gestational hypertension 4 Cephalopelvic disproportion

Gestational hypertension

Which nursing intervention may help prevent cardiac decompensation in a laboring client with heart disease? 1 Positioning her on the side with her head on a pillow 2 Positioning her on the side with her shoulders elevated 3 Administering the prescribed intravenous (IV) infusion of isotonic saline 4 Administering the prescribed IV piggyback infusion of oxytocin

Positioning her on the side with her shoulders elevated

Which factor contraindicates sexual intercourse during pregnancy? 1 Fetal tachycardia 2 Presence of leukorrhea 3 Premature rupture of membranes 4 Imminence of the estimated date of birth

Premature rupture of membranes

Within minutes of giving birth to a healthy infant, a client displays symptoms of respiratory distress, and an amniotic fluid embolism is suspected. For which other complication would the nurse assess this client? 1 Hypertension 2 Uterine atony 3 Thrombophlebitis 4 Uncontrolled bleeding

Uncontrolled bleeding

The nurse is assessing a client with a tentative diagnosis of hydatidiform mole. Which clinical finding would the nurse anticipate? 1 Hypotension 2 Decreased fetal heart rate 3 Unusual uterine enlargement 4 Painless, heavy vaginal bleeding

Unusual uterine enlargement

After an incomplete abortion, a client asks the nurse to tell her again what is meant by an "incomplete abortion." Which response by the nurse is appropriate? 1 "I don't think you should focus on this anymore." 2 "It's when the fetus dies but is retained in the uterus for at least 2 months." 3 "It's when the fetus is expelled but other parts of the pregnancy remain in the uterus." 4 "I think it's best for you to ask your primary health care provider for the answer to that question."

"It's when the fetus is expelled but other parts of the pregnancy remain in the uterus."

A client at 37 weeks' gestation is in the emergency department after a motor vehicle accident. Vital signs upon admission are BP 110/72 mm Hg, HR 98 beats/min. The client begins complaining of sudden, sharp abdominal pain, and repeated vital signs are BP 90/60 mm Hg, HR 108 beats/min. Which nursing intervention is the priority at this time? 1 Apply an electronic fetal monitor. 2 Prepare for a possible cesarean birth. 3 Draw blood for a type and cross-match. 4 Assess the amount of vaginal bleeding.

1 Apply an electronic fetal monitor.

Which finding would indicate infection in a pregnant client? Select all that apply. One, some, or all responses may be correct. 1 Chills 2 Fever 3 Diarrhea 4 Flank pain 5 Burning on urination

1 Chills 2 Fever 3 Diarrhea 4 Flank pain 5 Burning on urination

A woman is being seen in the prenatal clinic at 36 weeks' gestation. Which signs and symptoms by the client require further evaluation by the primary health care provider? Select all that apply. One, some, or all responses may be correct. 1 Decreased urine output 2 Blurred vision with spots 3 Urinary frequency without dysuria 4 Heartburn after eating a fatty meal 5 Contractions that are regular and 5 minutes apart 6 Shortness of breath after climbing a flight of stairs

1 Decreased urine output 2 Blurred vision with spots 5 Contractions that are regular and 5 minutes apart

A client with mild preeclampsia is admitted to the labor and birthing suite. Which signs or symptoms would the client be likely to display if she were developing hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome)? Select all that apply. One, some, or all responses may be correct. 1 Headache 2 Constipation 3 Right upper quadrant abdominal pain 4 Vaginal bleeding 5 Nausea and vomiting

1 Headache 3 Right upper quadrant abdominal pain 5 Nausea and vomiting

Which action would the nurse implement to enhance safety for a laboring client and fetus with a prolapsed cord? Select all that apply. One, some, or all responses may be correct. 1 Increasing the client's intravenous fluid drip rate 2 Placing the client in the extreme Trendelenburg position 3 Administering oxygen to the client via a nonrebreather mask 4 Immediately notifying the client's primary health care provider 5 Quickly gloving the examining hand and inserting two fingers into the vagina to the cervix

1 Increasing the client's intravenous fluid drip rate 2 Placing the client in the extreme Trendelenburg position 3 Administering oxygen to the client via a nonrebreather mask 4 Immediately notifying the client's primary health care provider 5 Quickly gloving the examining hand and inserting two fingers into the vagina to the cervix

Which are risk factors of diabetes in pregnancy? Select all that apply. One, some, or all responses may be correct. 1 Preterm birth 2 Hypertension 3 Cesarean birth 4 Placenta previa 5 Placental abruption

1 Preterm birth 2 Hypertension 3 Cesarean birth

A woman in the third trimester of pregnancy presents with vaginal bleeding and states she snorted cocaine approximately 2 hours ago. Which complication would this client profile suggest? 1 Placenta previa 2 Tubal pregnancy 3 Abruptio placentae 4 Spontaneous abortion

Abruptio placentae

The nurse in a prenatal clinic is assessing a woman at 34 weeks' gestation. The client's blood pressure is 166/100 mm Hg and her urine is +3 for protein. She states that she has a severe headache and occasional blurred vision. Her baseline blood pressure was 100/62 mm Hg. Which action would the nurse take in response to these findings? 1 Arrange transportation to the hospital. 2 Obtain a prescription for an antihypertensive. 3 Recheck the blood pressure within 30 minutes. 4 Obtain a prescription for acetaminophen to relieve the headache.

Arrange transportation to the hospital.

A client in early active labor at 40 weeks' gestation reports that her membranes ruptured 26 hours ago. Initial assessments of the fetal heart rate range between 168 and 174 beats/min. Which is the priority nursing action? 1 Assessing maternal vital signs 2 Planning for an emergency birth 3 Administering oxygen by way of nasal cannula 4 Preparing for fetal scalp blood sampling

Assessing maternal vital signs

When checking the cervical dilation of a client in labor, the nurse notes that the umbilical cord has prolapsed. Which action would the nurse take in response to this finding? 1 Check the fetal heart rate. 2 Turn the client on her side. 3 Cover the cord with a sterile saline-soaked cloth. 4 Assist the client into the Trendelenburg position.

Assist the client into the Trendelenburg position.

A client comes to the emergency room reporting severe abdominal cramping and heavy bleeding at 10 weeks' gestation. Cervical examination reveals heavy bleeding; the cervical os is open and tissue is present. Which type of abortion is the client experiencing? 1 Missed 2 Complete 3 Inevitable 4 Threatened

Inevitable

A 26-year-old primigravida experiencing severe abdominal pain is brought to the emergency department by ambulance with a suspected ruptured tubal pregnancy. Which is the priority nursing action? 1 Inserting an intravenous (IV) cathete 2 Asking the client to sign a surgical consent form 3 Determining whether a family member is present 4 Ascertaining the first day of the client's last menstrual period

Inserting an intravenous (IV) cathete

The nurse is caring for a client with class III heart disease who is beginning the second stage of labor. For which medical intervention would the nurse prepare the client at this time? 1 Elective cesarean birth to conserve energy 2 Pudendal anesthesia to prevent restlessness 3 Instrument extraction to ease a vaginal birth 4 Intravenous tocolytic medication to weaken contractions

Instrument extraction to ease a vaginal birth

Which intervention would the nurse question when caring for a client who has tested positive for human immunodeficiency virus (HIV)? 1 Sonogram 2 Nonstress test 3 Sterile vaginal examination 4 Internal fetal scalp electrode

Internal fetal scalp electrode

Which intervention becomes critical when a client's membranes spontaneously rupture at 37 weeks and she has no contractions? 1 Monitoring for fever 2 Checking for signs of preeclampsia 3 Assessing for heavy vaginal bleeding 4 Making preparations for fetal scalp pH sampling

Monitoring for fever

A client with hyperemesis gravidarum is to be maintained at home with rehydration infusion therapy. Which is the priority nursing activity for the home health nurse? 1 Determining fetal well-being 2 Monitoring for signs of infection 3 Monitoring the client for signs of electrolyte imbalance 4 Teaching about changes in nutritional needs during pregnancy

Monitoring the client for signs of electrolyte imbalance

For which reason may insulin requirements of a client with type 1 diabetes decrease during the first trimester? 1 Body metabolism is sluggish in the first trimester. 2 Morning sickness may result in decreased food intake. 3 Fetal requirements of glucose in this period are minimal. 4 Hormones of pregnancy increase the body's need for insulin.

Morning sickness may result in decreased food intake.

A client at 24 weeks' gestation arrives at the clinic for a routine examination. She tells the nurse, "I feel puffy all over." In light of this statement, which is the nurse's most important assessment? 1 Obtaining her blood pressure 2 Determining how much salt she uses 3 Asking the extent of her daily fluid intake 4 Reviewing her history for total weight gain

Obtaining her blood pressure

A client in preterm labor at 34 weeks' gestation is receiving intravenous tocolytic therapy. The infusion is discontinued when the frequency of her contractions increases to every 10 minutes, and her cervix dilates to 4 cm. Which is the priority goal of nursing care at this time? 1 Reduction of anxiety associated with preterm labor 2 Promotion of maternal and fetal well-being during labor 3 Supportive communication with the client and her partner 4 Helping the family cope with the impending preterm birth

Promotion of maternal and fetal well-being during labor

Three days of bed rest is prescribed for a client with mild preeclampsia. Which position would the nurse encourage the client to maintain while in bed? 1 Supine 2 Side-lying 3 Semi-Fowler 4 Slight Trendelenburg

Side-lying

During which week of gestation would a ruptured tubal pregnancy most commonly occur? 1 Sixth 2 Twelfth 3 Sixteenth 4 Eighteenth

Sixth

Which complication of severe preeclampsia necessitates diligent monitoring of the client's blood pressure? 1 Stroke 2 Hemorrhage 3 Precipitous labor

Stroke

When planning care for a client with type 1 diabetes, which change in insulin requirements would the nurse anticipate on the first postpartum day? 1 Slow decrease 2 Rapid increase 3 Sudden decrease 4 Gradual increase

Sudden decrease

For which reason is a client with heavy bleeding from a complete placenta previa placed in a lateral Trendelenburg position? 1 To prevent shock 2 To control bleeding 3 To keep pressure off the cervix 4 To move the placenta off the cervix

To prevent shock

For which reason is a client with worsening preeclampsia placed in a nonstimulating environment? 1 To limit respiratory effort 2 To decrease severity of frontal headaches 3 To reduce the probability of tonic-clonic seizures 4 To prolong the action of hypotensive medications

To reduce the probability of tonic-clonic seizures

Which safety measure would the nurse include when administering methotrexate? 1 Dispose of gloves used to administer methotrexate in a garbage bag. 2 Obtain the client's weight for calculation of the dose of methotrexate. 3 Wear two pair of gloves before removing the syringes from the plastic bag. 4 Expel additional air from the syringe of methotrexate and prime the needle.

Wear two pair of gloves before removing the syringes from the plastic bag.

A multipara whose membranes have ruptured is admitted in early labor. Assessment reveals a breech presentation, cervical dilation of 3 cm, and fetal station at -2. For which complication would the nurse assess when caring for this client? 1 Vaginal bleeding 2 Urinary tract infection 3 Prolapse of the umbilical cord 4 Meconium in the amniotic fluid

Prolapse of the umbilical cord

An amniotomy is performed in a laboring client at 42 weeks' gestation. Place the nursing care actions in their order of priority. 1. Checking the fetal heart rate tracings 2. Monitoring the client for signs of an infection 3. Inspecting the perineum for umbilical cord prolapse 4. Assessing the characteristics of the amniotic fluid

1. Checking the fetal heart rate tracings 3. Inspecting the perineum for umbilical cord prolapse 4. Assessing the characteristics of the amniotic fluid 2. Monitoring the client for signs of an infection

Which assessment findings correlate with a diagnosis of unruptured tubal pregnancy? Select all that apply. One, some, or all responses may be correct. 1 Rigid abdomen 2 Referred shoulder pain 3 Unilateral abdominal pain 4 History of a sexually transmitted infection (STI) 5 Ecchymotic blueness around the umbilicus

3 Unilateral abdominal pain 4 History of a sexually transmitted infection (STI)

Which maternal complications are associated with precipitous labor and birth? 1 Hypertension 2 Hypoglycemia 3 Chilling and shivering 4 Bleeding and infection

Bleeding and infection

The nurse is caring for a client in preterm labor who reports that she fell down the stairs. Bruises are apparent on the left part of the client's lower abdomen, the back of each shoulder, and on both wrists. After instituting electronic fetal monitoring, starting tocolytic therapy, and examining the monitor strips, which action would the nurse take next? 1 Ambulating the client to promote circulation 2 Inserting two small-bore intravenous catheters 3 Determining whether the client feels safe at home 4 Ensuring that the client has her glasses to ambulate

Determining whether the client feels safe at home

Which action would the nurse take based on receiving a laboratory report stating that a client receiving magnesium sulfate 2 g/h IV for preeclampsia has a magnesium level of 6.4 mEq/L (0.30 mmol/L)? 1 Stop the infusion. 2 Assess the client's deep tendon reflexes. 3 Assess the client's level of consciousness. 4 Document the level on the fetal monitoring strip.

Document the level on the fetal monitoring strip.

A pregnant client with severe abdominal pain and heavy bleeding is being prepared for a cesarean birth. Which is the priority intervention? 1 Teaching coughing and deep-breathing techniques 2 Cleansing the surgical site and administering an enema 3 Providing a sterile gown and inserting an indwelling catheter 4 Ensuring that an informed consent is obtained and that the client is assessed for medication allergies

Ensuring that an informed consent is obtained and that the client is assessed for medication allergies

Which client statement indicates understanding of prenatal instructions regarding when to consult with a health care provider? 1 "I'll call the clinic if I have abdominal pain." 2 "Mild, irregular contractions mean that my labor is starting." 3 "I need to call the clinic if my ankles start to swell in the evening." 4 "A whitish vaginal discharge means that I'm getting an infection."

"I'll call the clinic if I have abdominal pain."

After receiving a diagnosis of placenta previa, the client asks the nurse what this means. Which is an appropriate response? 1 "It's premature separation of a normally implanted placenta." 2 "Your placenta isn't implanted securely in place on the uterine wall." 3 "You have premature aging of a placenta that is implanted in your uterine fundus." 4 "The placenta is implanted in the lower uterine segment, and it's covering part or all of the cervical opening."

"The placenta is implanted in the lower uterine segment, and it's covering part or all of the cervical opening."

A pregnant client at 30 weeks' gestation with a partial placenta previa had experienced vaginal bleeding, which has now resolved. Which client activity will be the nurse's primary focus when providing discharge instructions? 1 Stay on bed rest. 2 Maintain a calm and quiet environment. 3 Do daily home fetal movement counts. 4 Avoid anything that may stimulate the cervix or uterus.

Avoid anything that may stimulate the cervix or uterus.

For which complication would a client who has had a spontaneous abortion be assessed? 1 Hemorrhage 2 Dehydration 3 Hypertension 4 Subinvolution

Hemorrhage

Which is the priority nursing action when a loop of umbilical cord protrudes from the vagina after rupture of a client's membranes? 1 Monitoring the fetal heart rate 2 Covering the cord with a saline dressing 3 Checking intensity and duration of contractions 4 Holding the presenting part away from the cord

Holding the presenting part away from the cord

Intravenous magnesium sulfate therapy is instituted for a client with severe preeclampsia who has a blood pressure of 170/110 mm Hg, a pulse of 108 beats/min, and a respiratory rate of 24 breaths/min. Eight hours later her blood pressure is 150/110 mm Hg, the pulse is 98 beats/min, the respiratory rate is 10 breaths/min, and the knee-jerk reflex is absent. Which action would the nurse take in response to these findings? 1 Stop the infusion of magnesium sulfate and notify the primary health care provider. 2 Administer calcium gluconate, because it is an antidote to magnesium sulfate. 3 Continue the magnesium sulfate infusion, because the blood pressure is still high. 4 Check vital signs and reflexes in 1 hour and then discontinue the infusion if necessary.

Stop the infusion of magnesium sulfate and notify the primary health care provider.

A client at her first visit to the prenatal clinic states that she has missed three menstrual periods and thinks that she is carrying twins because her abdomen is so large. She now has a brownish vaginal discharge. Her blood pressure is increased, indicating that she may have gestational hypertension. Which condition is suggested by this client profile? 1 Renal failure 2 Placenta previa 3 Hydatidiform mole 4 Abruptio placentae

Hydatidiform mole

A multiparous client with a history of gestational hypertension and previous history of abruption is in the transition phase of labor. The electronic fetal monitor shows bradycardia, and a change is seen in the contour of the client's abdomen. Which is the nurse's immediate action? 1 Checking the client's vital signs 2 Placing the client on her left side 3 Applying an internal scalp electrode on the fetus 4 Alerting staff to the need for immediate cesarean delivery

Alerting staff to the need for immediate cesarean delivery

A client measuring at 18 weeks' gestation visits the prenatal clinic stating that she is still very nauseated and vomits frequently. Physical examination reveals a brown vaginal discharge and a blood pressure of 148/90 mm Hg. There are absent fetal heart tones. Which condition does the nurse suspect the client is experiencing? 1 Dehydration 2 Choriocarcinoma 3 Hydatidiform mole 4 Threatened abortion

Hydatidiform mole

After a client's membranes rupture spontaneously, the umbilical cord is protruding from the vagina. What is the order of priority for the following nursing interventions? 1. Administer oxygen to the mother, and monitor fetal heart tones. 2. Call for assistance and don sterile gloves. 3. Insert two fingers into the vagina, and exert upward pressure against the fetal presenting part. 4. Put a rolled towel under one hip and place the client in the modified Sims position.

2. Call for assistance and don sterile gloves 3. Insert two fingers into the vagina, and exert upward pressure against the fetal presenting part. 4. Put a rolled towel under one hip and place the client in the modified Sims position. 1. Administer oxygen to the mother, and monitor fetal heart tones.

During a prenatal education class, the nurse discusses the importance of fetal movement awareness. Why is this an important concept to teach? 1 An increase in fetal movement indicates the onset of labor is near. 2 A decrease in fetal movement necessitates an evaluation of fetal well-being. 3 Fetal movement awareness increases the emotional bond of mother to fetus. 4 A perceived decrease in fetal movement is a symptom of preeclampsia.

A decrease in fetal movement necessitates an evaluation of fetal well-being.

A client's membranes rupture, and the nurse immediately detects the presence of a prolapsed umbilical cord. The primary health care provider has been notified. Place the following nursing interventions in the order in which they would be performed. 1. Checking the fetal heart rate 2. Administering oxygen by facemask 3. Moving the presenting part off the cord 4. Placing the client in the Trendelenburg position

3. Moving the presenting part off the cord 4 Placing the client in the Trendelenburg position 2. Administering oxygen by facemask 1. Checking the fetal heart rate

Which method would the nurse use to assess blood loss in a client with placenta previa? 1 Count or weigh perineal pads. 2 Monitor pulse and blood pressure. 3 Check hemoglobin and hematocrit values. 4 Measure or estimate the height of the fundus.

Count or weigh perineal pads.

The nurse is caring for a postpartum client with preeclampsia being managed with a magnesium sulfate infusion. Which is the priority nursing assessment? 1 Counting respiratory rate 2 Obtaining blood pressure 3 Eliciting deep tendon reflexes 4 Monitoring urine output

Counting respiratory rate

A client with gestational hypertension is receiving education from the nurse in self-care. Which instruction would the nurse give for this client? 1 Eat a low-protein diet 2 Ensure adequate sodium intake 3 Join a weight-reduction program 4 Follow the prescribed diuretic regimen

Ensure adequate sodium intake

A client with severe preeclampsia has audible crackles in the lower left lobe, slight blurring of vision in the right eye, generalized facial edema, and epigastric discomfort. Which of these clinical manifestations is most indicative of an impending seizure? 1 Audible crackles 2 Blurring of vision 3 Epigastric discomfort 4 Generalized facial edema

Epigastric discomfort

Which assessment finding in a pregnant client would prompt the nurse to notify the primary health care provider? 1 Slight dependent edema at 38 weeks' gestation 2 Fundal height at the umbilicus at 16 weeks' gestation 3 Fetal heart rate of 150 beats/min at 24 weeks' gestation 4 Maternal heart rate of 92 beats/min at 28 weeks' gestation

Fundal height at the umbilicus at 16 weeks' gestation

Which factor in a pregnant client's history would the nurse recognize as a risk factor for abruptio placentae? 1 Hydramnios 2 Hypertension 3 Cardiac disease 4 Diabetes mellitus

Hypertension

Which problem is suggested when a client at 37 weeks' gestation experiences a sudden sharp pain in her abdomen with a period of fetal hyperactivity followed by fundal tenderness and a small amount of dark-red bleeding? 1 True labor 2 Placenta previa 3 Partial abruptio placentae 4 Abdominal muscular injury

Partial abruptio placentae

Which significant clinical finding would the nurse expect when reviewing the history of a client with preeclampsia? 1 Proteinuria 2 Tachycardia 3 Increased serum glucose 4 Tonic-clonic movemen

Proteinuria

A client at 36 weeks' gestation has gained 5 lb (2.3 kg) in the previous week and has a pronounced increase in blood pressure. Which is the initial intervention upon admission of the client to the high-risk unit? 1 Preparing for an imminent cesarean birth 2 Providing a dark, quiet room with minimal stimuli 3 Initiating intravenous (IV) furosemide to promote diuresis 4 Administering calcium gluconate to lower the blood pressure

Providing a dark, quiet room with minimal stimuli

A client at 28 weeks' gestation visits the clinic for a routine examination. Which finding is of greatest concern to the nurse? 1 Puffy fingers 2 Glycosuria 1+ 3 Proteinuria 1+ 4 Dependent edema

Puffy fingers

A client being prepared for surgery because of a ruptured tubal pregnancy reports that she feels light-headed. Her pulse is rapid, and her color is pale. Which common complication of a ruptured tubal pregnancy is suggested by these findings? 1 Shock 2 Anxiety 3 Infection 4 Hyperoxygenation

Shock

Why is it important for the nurse to encourage a client with preeclampsia to lie in the left-lateral recumbent position? 1 Uterine and kidney perfusion are maximized, and compression of the major vessels is relieved. 2 Intra-abdominal pressure on the iliac veins is maximized, and there is increased blood flow to the pelvic area. 3 Aortic compression is maximized, thereby decreasing uterine arterial pressure and increasing uterine blood flow. 4 Hemoconcentration is maximized, thereby reducing blood volume and cardiac output and increasing placental perfusion.

Uterine and kidney perfusion are maximized, and compression of the major vessels is relieved.

Which nursing intervention holds the highest priority for a client with class I heart disease during the postpartum period? 1 Promoting early ambulation 2 Watching for signs of cardiac decompensation 3 Assessing the mother's emotional reaction to the birth 4 Instructing the mother about activity levels during the postpartum period

Watching for signs of cardiac decompensation

A client at 36 weeks' gestation presents with severe abdominal pain, heavy vaginal bleeding, a drop in blood pressure, and an increased pulse rate. Which complication of pregnancy is suggested by these signs and symptoms? 1 Hydatidiform mole 2 Vena cava syndrome 3 Marginal placenta previa 4 Complete abruptio placentae

Complete abruptio placentae

Which instruction regarding fluid and nutritional intake would the nurse give to a client with mild preeclampsia? 1 "Restrict fluid intake." 2 "Stay on a low-salt diet." 3 "Continue the pregnancy diet." 4 "Increase carbohydrate consumption."

"Continue the pregnancy diet."

Which statement by a woman with preeclampsia indicates the need for further teaching about needed dietary changes? 1 "I should avoid excess salt." 2 "I should limit my fluid intake." 3 "I should eat whole grains and raw produce." 4 "I should eat 60 to 70 grams of protein each day."

"I should limit my fluid intake."

Which is a clinical manifestation of worsening preeclampsia? 1 Polyuria 2 Vaginal spotting 3 Proteinuria of 3+ 4 Blood pressure of 130/80 mm Hg

Proteinuria of 3+

A primigravida at term has dark red vaginal bleeding and complains of pain continuing between contractions. The nurse palpates the abdomen, which is firm and shows no sign of relaxation. Which problem is suggested by these assessment findings? 1 Placenta previa 2 Precipitous birth 3 Abruptio placentae 4 Breech presentation

Abruptio placentae

The nurse caring for a client receiving magnesium sulfate observes respirations of 10 breaths/minute, heart rate of 68 beats/minute, and blood pressure of 88/50 mm Hg. After discontinuing the magnesium sulfate, which priority action would the nurse take? 1 Administer oxygen. 2 Initiate rescue breathing. 3 Initiate a bolus of intravenous (IV) fluid. 4 Administer calcium gluconate

Administer calcium gluconate

On entering the room of a client in active labor the nurse notes the client is ashen gray, dyspneic, and clutching her chest. Which is the nurse's immediate action after pressing the emergency light? 1 Administer oxygen by face mask. 2 Check for rupture of the membranes. 3 Begin cardiopulmonary resuscitation (CPR). 4 Increase the rate of intravenous (IV) fluids.

Administer oxygen by face mask.

A client in her 36th week of gestation is admitted with vaginal bleeding, severe abdominal pain, a rigid fundus, and signs of impending shock. For which intervention would the nurse prepare? 1 A high-forceps birth 2 An immediate cesarean birth 3 Insertion of an internal fetal monitor 4 Administration of an oxytocin infusion

An immediate cesarean birth

A client who reports that she has been following the recommended pregnancy diet is diagnosed with gestational hypertension. Which instruction would the nurse give about her diet at this time? 1 Limit proteins. 2 Change nothing. 3 Restrict sodium. 4 Increase carbohydrates.

Change nothing.