Sherpath questions - wk 5
Which statement made by a woman diagnosed with gestational diabetes indicates to the nurse that the teaching about dietary practices was effective? "If I feel like the baby's not moving a lot, I drink soda." "I have been eating three small meals and two snacks every day." "If I run out of insulin, I can use my husband's metformin once a day until I can get to the pharmacy." "I know my baby needs healthy foods to grow, so I have been eating extra fruit and breads."
"I have been eating three small meals and two snacks every day."
A patient who is positive for human immunodeficiency virus (HIV) is about to be discharged from the hospital with her new infant. Which patient statement indicates that further patient teaching is required? "I'm glad I'll still be able to breastfeed my baby." "It's still possible that I gave my baby HIV, even though I took all my medication." "I will go to the pharmacy right now to fill my antiretroviral drug." "Even though I don't feel sick, I should plan on bottle-feeding my baby."
"I'm glad I'll still be able to breastfeed my baby."
A primigravida Hispanic patient asks why she needs to be screened for gestational diabetes when she is not a diabetic. Which response by the nurse is appropriate? "Many patients with gestational diabetes show no symptoms. It is an important way to help you have a healthy pregnancy." "We test all patients for diabetes because today's diet makes you more likely to get diabetes." "Your race makes you more likely to develop gestational diabetes, so we are screening you just in case." "Because this is your first pregnancy, we don't know what to expect, so we are going to test you just in case."
"Many patients with gestational diabetes show no symptoms. It is an important way to help you have a healthy pregnancy."
A patient with gestational diabetes experiences rupture of membranes at 36 weeks gestation. Which patient teaching statement regarding this condition is accurate? "Rupture of membranes is more common in women with gestational diabetes because of the excess amounts of glucose in your urine." "Rupture of membranes at this time in your pregnancy is normal and sometimes happens before labor begins." "Your membranes likely ruptured because of excess ketones in your blood." "Preterm rupture of membranes is more common in women with gestational diabetes, and it might be related to overdistention of your uterus."
"Preterm rupture of membranes is more common in women with gestational diabetes, and it might be related to overdistention of your uterus."
A nurse is educating a pregnant patient on sexually transmitted infections. Which statement is appropriate for the nurse to make? "You don't need to use condoms now that you are already pregnant." "Prenatal testing for sexually transmitted infections is not necessary." "Sexually transmitted infections can pose serious health risks for you and your pregnancy." "Sexually transmitted infections do not cross the placenta and do not pose a risk to your baby."
"Sexually transmitted infections can pose serious health risks for you and your pregnancy."
Which patient teaching statement regarding potential newborn complications resulting from uncontrolled diabetes is accurate? "Gestational diabetes leads to hyperbilirubinemia because of the breakdown of excess glucose in utero." "The fetus compensates for lack of oxygen in utero by making additional erythrocytes. When these are broken down after birth, it can lead to jaundice and hyperbilirubinemia." "Hyperinsulinemia in the fetus can impair cortisol production, which has been shown to lead to hyperbilirubinemia." "Hypoglycemia after birth leads to increased bilirubin levels in the neonate."
"The fetus compensates for lack of oxygen in utero by making additional erythrocytes. When these are broken down after birth, it can lead to jaundice and hyperbilirubinemia."
Which statements by the nurse are the most appropriate to make to a patient who has recently had a miscarriage? Select all that apply. "When it is meant to happen, it will happen." "The fetus likely had a congenital anomaly that was incompatible with life." "Don't worry; nature has a way of taking care of mistakes. It is for the best." "This is often a consequence of unavoidable factors, and it is important to realize this is not your fault." "I am very sorry for your loss. Having a miscarriage must be so emotionally painful. How are you feeling?"
"This is often a consequence of unavoidable factors, and it is important to realize this is not your fault." "I am very sorry for your loss. Having a miscarriage must be so emotionally painful. How are you feeling?"
Which patient teaching statement regarding the long-term effect of gestational diabetes is accurate? "Up to 70% of women may go on to develop type 2 diabetes mellitus." "Many women who develop gestational diabetes will require insulin after delivery for the rest of their lives." "Once you are diagnosed with gestational diabetes, every subsequent pregnancy will also be complicated by gestational diabetes." "You may need to periodically check your glucose levels after delivery to make sure your gestational diabetes has gone away."
"Up to 70% of women may go on to develop type 2 diabetes mellitus."
Which teaching information would the nurse provide a pregnant patient with human immunodeficiency virus (HIV) regarding infant feeding? "You should not breastfeed your infant." "You need to pasteurize your breast milk before feeding it to your infant." You can breastfeed as long as you wear a nipple shield." "Bottle-feeding can exacerbate the proliferation of the HIV virus and cause your baby to develop the condition."
"You should not breastfeed your infant."
When teaching a patient with a body mass index (BMI) of 20 about recently prescribed subcutaneous insulin, which statement is correct? "You will need to insert the needle at a 45-degree angle to ensure it is delivered to the subcutaneous tissue." "If you need to deliver more than 0.5 mL of insulin, you will need to use two injection sites." "If you use the no-pinch method, you should use an 8-mm needle." "Gently massage the injection site with sterile gauze after administration to ensure the medication is absorbed."
"You will need to insert the needle at a 45-degree angle to ensure it is delivered to the subcutaneous tissue."
____ is considered to be a perfect score on a biophysical profile assessment.
10/10
Which characteristic describes the cause of type 1 diabetes mellitus? Inability of the body's cells to store glucose as glucagon Inability of the body's cells to use glucose Complete or partial inability of the body to produce insulin Early gluconeogenesis
Complete or partial inability of the body to produce insulin
Which type of placenta previa would the nurse recognize as being most dangerous? Concealed previa Marginal previa Complete previa Partial previa
Complete previa
Which cause of spontaneous abortion is the most common? Infection Congenital anomalies Vaginal bleeding Anomalies of the maternal reproductive tract
Congenital anomalies
Which viral illnesses in pregnant women can lead to low birth weight? Select all that apply. Human immunodeficiency virus (HIV) Cytomegalovirus (CMV) Rubella Influenza Varicella-zoster virus
Cytomegalovirus Rubella Varicella-zoster virus
Which nursing intervention would be included in the care of a woman with lupus during her first trimester of pregnancy? Monitor for liver function. Monitor for increased joint pain and fatigue. Provide patient education on remission of lupus. Administer subcutaneous heparin for thrombosis prevention.
Monitor for liver function.
The nurse is preparing to educate a woman with an abnormal 1-hour glucose tolerance test. Which additional diagnostic test would the nurse anticipate the health care provider to order? Fasting glucose test Hemoglobin A1C test Repeat finger-stick glucose test 3-hour glucose tolerance test
3-hour glucose tolerance test
A woman, 1 day postpartum, is being carefully monitored after a significant postpartum hemorrhage (PPH). Which finding would the nurse report to the health care provider? Urine output of 160 mL for the past 8 hours Weight loss of 2 lb since delivery Pulse rate of 68 beats/min Fundus firm at the umbilicus
Urine output of 160 mL for the past 8 hours
The nurse understands that women age ___ and above have a significantly increased risk for maternal mortality as a result of cardiovascular disease.
40
After a vaginal delivery, an estimated blood loss greater than ____ mL would indicate a diagnosis of a postpartum hemorrhage.
500
The nurse recognizes that a steady trickle of bright red blood from the vagina in the presence of a firm fundus may indicate which condition? Uterine atony Retained placenta Infection of the uterus A laceration within the genital tract
A laceration within the genital tract
Which patient is most at risk for placental abruption (abruptio placentae)? A patient who is a primipara A 35-year-old Asian woman A patient whose first child was delivered by cesarean birth A patient with a blood pressure reading of 160/90 mm Hg
A patient with a blood pressure reading of 160/90 mm Hg
An Rh-negative woman needs an amniocentesis. The nurse understands which statement to be true based upon the information provided? The amniocentesis will determine if the mother needs a blood transfusion. A shot of Rho(D) immune globulin will be required for this procedure. A Coombs test should be performed immediately after the procedure. The fetus is likely Rh-positive, so delivery should be expedited.
A shot of Rho(D) immune globulin will be required for this procedure.
Which antihypertensive classifications are contraindicated in pregnancy? Select all that apply. Beta blockers Angiotensin-converting enzyme (ACE) inhibitors Calcium channel blockers Vasodilators Angiotensin receptor blockers (ARBs)
Angiotensin-converting enzyme (ACE) inhibitors Angiotensin receptor blockers (ARBs)
A patient in early pregnancy presents with heavy bleeding and blood clots. Her hemoglobin and hematocrit are low. Based upon the information given, which order would the nurse anticipate? Prepare for emergency cesarean birth. Administer 650 mg acetaminophen for pain stat. Transfuse 1 unit packed red blood cells stat. Massage the fundus.
Transfuse 1 unit packed red blood cells stat.
Which methods can all women use to reduce risk in the preconception period? Select all that apply. Increasing saturated fats in their diet Abstaining from alcohol Taking a folic acid supplement Learning about inherited conditions that can affect pregnancy Achieving a healthy weight Waiting to update vaccines until after pregnancy to prevent exposure to teratogens
Abstaining from alcohol Taking a folic acid supplement Learning about inherited conditions that can affect pregnancy Achieving a healthy weight
A woman tests positive for group B streptococcus (GBS) at 36 weeks gestation before a vaginal birth. Which interventions would the nurse include in the plan of care? Select all that apply. Retest for GBS upon admission to labor and delivery. Instruct the patient to use condoms until the infection clears. Administer antibiotics during labor until delivery as prescribed. Monitor the neonate for signs and symptoms of respiratory distress. Inspect the perineum carefully for lesions upon admission for labor and delivery.
Administer antibiotics during labor until delivery as prescribed. Monitor the neonate for signs and symptoms of respiratory distress.
A nurse is monitoring a new mother in the postpartum period for signs of hemorrhage. Which sign, if noted in the mother, indicates excessive blood loss? An increase in the pulse from 88 to 110 beats/min A blood pressure change from 130/88 to 124/80 mm Hg An increase in the respiratory rate from 18 to 20 breaths/min A change in the O2 saturation from 99% to 96%
An increase in the pulse from 88 to 110 beats/min
When cardiovascular disease is severe during pregnancy, which health care providers may be a part of the interdisciplinary care team? Select all that apply. Anesthesiologists Nurses Dermatologists Neonatologists Obstetricians Maternal-fetal medicine specialists
Anesthesiologists Nurses Neonatologists Obstetricians Maternal-fetal medicine specialists
Which types of assessments are examples of biophysical assessments for high-risk pregnancy? Select all that apply. Blood, body fluid, and tissue analysis Amniocentesis Maternal assay analysis Ultrasonography Fetal kick counts
Ultrasonography Fetal kick counts
Which considerations would the nurse recognize for a pregnant patient with human immunodeficiency virus (HIV)? Select all that apply. A second test toward the end of the third trimester is not recommended. Vaginal delivery is always contraindicated. Antiretroviral therapy for the mother and neonate helps reduce transmission at birth. Testing all pregnant women for HIV at the beginning of pregnancy is a best practice. Breastfeeding should be avoided. An elective cesarean birth at 38 weeks helps prevent transmission to the neonate.
Antiretroviral therapy for the mother and neonate helps reduce transmission at birth. Testing all pregnant women for HIV at the beginning of pregnancy is a best practice. Breastfeeding should be avoided. An elective cesarean birth at 38 weeks helps prevent transmission to the neonate.
A woman delivered a 9-lb, 10-oz baby 1 hour ago. When the nurse arrives to perform the 15-minute assessment, the patient says that she "feels all wet underneath." The nurse discovers that both perineal pads are completely saturated and that the patient is lying in a 6-inch-diameter puddle of blood. After calling for help, which action would the nurse take next? Assess the fundus for firmness. Estimate the blood loss by weighing the perineal pads. Check the perineum for lacerations. Manually remove any contents in the uterus.
Assess the fundus for firmness.
A patient reports a fishy, greenish, malodorous vaginal discharge after intercourse. The nurse understands these findings to be classic symptoms of which condition? Genital warts (condyloma) Chlamydia Bacterial vaginosis (Gardnerella) Vaginal yeast infections (Candidiasis)
Bacterial vaginosis (Gardnerella)
Methylergonovine is prescribed for a woman to treat postpartum hemorrhage (PPH). Before administration of this medication, which nursing assessment is the priority? Deep tendon reflexes Uterine tone Amount of lochia Blood pressure
Blood pressure
In the fourth stage of labor, the nurse recognizes that a full bladder increases the risk for which postpartum complication? Retained placenta Boggy uterus Infection Shock
Boggy uterus
Which description is true of congenital cytomegalovirus (CMV)? Can lead to severe maternal anemia Can lead to neonatal hearing loss Often causes severe flulike symptoms in the mother Causes weeping skin lesions on the neonate
Can lead to neonatal hearing loss
The nurse understands that which concurrent condition during pregnancy is the leading cause of maternal mortality in the United States today? Cytomegalovirus (CMV) Human immunodeficiency virus (HIV) Cardiovascular disease Anemia secondary to blood loss
Cardiovascular disease
Which characteristics are associated with sickle cell anemia? Select all that apply. Causes frequent hospitalization throughout the life span Characterized by distorted and decreased erythrocytes Can lead to preterm birth Causes severe pain Commonly leads to fetal neural tube defects May be cured with diet and supplementation
Causes frequent hospitalization throughout the life span Characterized by distorted and decreased erythrocytes Can lead to preterm birth Causes severe pain
Match the sexually transmitted infection to the corresponding correct statement. Cesarean delivery is required during an outbreak. Infection is usually asymptomatic. All infants are treated with ophthalmic antibiotic to prevent transmission. Penicillin G is the primary treatment.
Cesarean delivery is required during an outbreak. - Genital Herpes Infection is usually asymptomatic. - Chlamydia All infants are treated with ophthalmic antibiotic to prevent transmission. - Gonorrhea Penicillin G is the primary treatment. - Syphilis
Which risk factor places a woman at risk for subinvolution of the uterus? Chorioamnionitis Forceful traction of the umbilical cord Vacuum extraction Precipitous delivery
Chorioamnionitis
Which condition would the nurse recognize as a fetal condition of high-risk pregnancy? Prenatal hyperglycemia Chromosomal abnormalities Placenta previa Preeclampsia
Chromosomal abnormalities
Which signs would the nurse recognize as indicative of missed abortion? Select all that apply. Vaginal bleeding Products of conception partially expelled Decrease in uterine size Absent fetal heart rate Subsiding nausea Absence of breast tenderness
Decrease in uterine size Absent fetal heart rate Subsiding nausea Absence of breast tenderness
Which condition is related to the increased risk for respiratory distress in neonates born to mothers with gestational diabetes? Hyperinsulinemia after birth Recurrent fetal hypoxia and subsequent increased production of erythrocytes Decreased fetal cortisol levels and therefore insufficient surfactant Decreased maternal magnesium levels
Decreased fetal cortisol levels and therefore insufficient surfactant
Upon reviewing the health history of an infant, the nurse notes the infant's birth weight to be 3.5 lb, with diagnoses of spina bifida and an abnormal heart rate. Which maternal condition may best explain the findings? Epilepsy Graves disease Systemic lupus erythematosus (SLE) Hypothyroid disorder
Epilepsy
Which major concern regarding epilepsy in pregnancy would the nurse recognize? Many antiseizure medications are known teratogens. There is an increased risk for miscarriage and preeclampsia. A woman who has been seizure-free for many years may have a severe exacerbation in pregnancy. Epilepsy in pregnancy may lead to Graves disease.
Many antiseizure medications are known teratogens.
The nurse understands that which physiologic changes in the thyroid are considered abnormal in pregnancy? Select all that apply. Fatigue, edema, and muscle aches may be the result of thyroid activity in pregnancy. The thyroid gland enlarges and becomes palpable. Thyroid-stimulating hormone (TSH) decreases in the first trimester. Free thyroxine (T4) levels increase. Increased free thyroxine (T4) levels lead to weight loss and goiter.
Fatigue, edema, and muscle aches may be the result of thyroid activity in pregnancy. The thyroid gland enlarges and becomes palpable. Increased free thyroxine (T4) levels lead to weight loss and goiter.
Which assessments may be performed using ultrasonography? Select all that apply. Fetal anatomy Fetal Rh status Gestational age Chromosomal disorders Fetal heart activity Amniotic fluid index
Fetal anatomy Gestational age Chromosomal disorders Fetal heart activity Amniotic fluid index
Which components are included in the complete biophysical profile used to determine fetal well-being in high-risk pregnancies? Select all that apply. Fetal head circumference Fetal breathing movements Fetal tone Nonstress test Amniotic fluid index
Fetal breathing movements Fetal tone Nonstress test Amniotic fluid index
Which method would the nurse recognize as a low-tech assessment of fetal well-being? Fetal aneuploidy screening Fetal kick counts Ultrasonography Biophysical profile assessment
Fetal kick counts
Gestational diabetes may cause congenital abnormalities in the fetus. Match the congenital malformation with its definition. Fetal size greater than 4000 g Malformations in heart structures Abnormal closure of spinal cord Malformation of lower spine and lower extremities
Fetal size greater than 4000 g - macrosomia Malformations in heart structures - cardiac defects Abnormal closure of spinal cord - neural tube defects Malformation of lower spine and lower extremities - caudal regression syndrome
Which supplement would the nurse recommend to prevent fetal neural tube defects as a result of pernicious anemia? Folic acid Calcium carbonate Magnesium hydroxide Red raspberry leaf tea
Folic acid
A nurse is caring for the following labor patients. Which patients would the nurse be prepared to monitor closely for signs of postpartum hemorrhage (PPH)? Select all that apply. G1 P0000, delivered a 29-week fetal demise vaginally after 8 hours in labor G2 P1001, delivered a 4200-g neonate vaginally after 4 hours of labor G2 P0010, delivered a 3750-g neonate by cesarean section for breech presentation G4 P3003, delivered a 3500-g neonate by cesarean section with a placenta accreta G3 P0200, delivered a 3900-g neonate vaginally after 36 hours in labor
G2 P1001, delivered a 4200-g neonate vaginally after 4 hours of labor G4 P3003, delivered a 3500-g neonate by cesarean section with a placenta accreta G3 P0200, delivered a 3900-g neonate vaginally after 36 hours in labor
Which form of diabetes has two subgroups: one type that is controlled with diet, and another type that is controlled by medication?\ Gestational diabetes mellitus Type 1 diabetes mellitus Type 2 diabetes mellitus Community-acquired diabetes mellitus
Gestational diabetes mellitus
Which statements are true regarding hyperglycemia? Select all that apply. Glucose levels in the blood may be elevated, but at the cellular level glucose may be low with some forms of diabetes. In gestational diabetes, hyperglycemia always leads to polydipsia. The body attempts to dilute the glucose load, resulting in polyuria. Glycosuria can occur. Glucose is stored in the pancreas when hyperglycemia occurs.
Glucose levels in the blood may be elevated, but at the cellular level glucose may be low with some forms of diabetes. The body attempts to dilute the glucose load, resulting in polyuria. Glycosuria can occur.
Which laboratory result would be an expected finding in a patient who is pregnant and has anemia? Hemoglobin of 9 g/dL White blood cell count of 6.5 billion cells/L Platelet count of 300,000/mcL Total iron binding capacity (TIBC) of 350,000 mcg/dL
Hemoglobin of 9 g/dL
The nurse is responsible for intake history at an obstetrics and gynecology (OB/GYN) office. Which medical conditions would the nurse recognize as high-risk conditions that could have adverse outcomes on a pregnancy? Select all that apply. Hemophilia Type 1 diabetes mellitus Human immunodeficiency virus (HIV) Chronic hypertension Xeroderma
Hemophilia Type 1 diabetes mellitus Human immunodeficiency virus (HIV) Chronic hypertension
Which factors increase a woman's risk for developing gestational diabetes? Select all that apply. History of migraines High blood pressure Advanced maternal age Family history of heart disease Family history of type 2 diabetes mellitus Middle Eastern descent
High blood pressure Advanced maternal age Family history of type 2 diabetes mellitus
A pregnant woman presents with clumpy, white vaginal discharge, vulvar pruritus, and burning. Which treatment would the nurse expect for this patient? Clindamycin Miconazole Metronidazole Imiquimod
Miconazole
Which statement is true regarding women with cardiovascular disease in the postpartum period? Hypertension usually resolves in women with cardiovascular disease after birth. The risk for death decreases significantly after birth. If a woman shows no evidence of cardiac compromise during labor and birth, she is still at risk for death. The risk for postpartum heart failure decreases if there is no evidence of cardiac compromise during pregnancy.
If a woman shows no evidence of cardiac compromise during labor and birth, she is still at risk for death.
Match the viral infection to the correct corresponding statement. Infects most humans and is usually asymptomatic Has a characteristic "slapped-cheek" rash Titers of less than 1:8 demonstrate ineffective immunity Also known as varicella-zoster virus
Infects most humans and is usually asymptomatic - cytomegalovirus Has a characteristic "slapped-cheek" rash - fifth disease Titers of less than 1:8 demonstrate ineffective immunity - rubella Also known as varicella-zoster virus - chickenpox
Which action would the nurse take if a pregnant patient opts out of prenatal human immunodeficiency virus (HIV) testing? Report the mother to child protective services. Inform the mother that the baby will likely be screened for HIV after birth. Collect the sample anyway. Request that the patient's sexual partners come in for screening.
Inform the mother that the baby will likely be screened for HIV after birth.
When caring for a patient with a postpartum hemorrhage, which interventions would the nurse initiate to improve the patient's status? Select all that apply. Insertion of an indwelling catheter Fundal massage Pad count Administration of tocolytic drugs Intravenous (IV) fluid replacement
Insertion of an indwelling catheter Fundal massage Intravenous (IV) fluid replacement
The nurse understands that which action after the birth of the newborn can prevent a postpartum hemorrhage? Administration of broad-spectrum antibiotics Inspection of the placenta Manual removal of the placenta after birth Pulling on the umbilical cord to hasten delivery of the placenta
Inspection of the placenta
Which statement is true of hyperthyroid disease? Thyroid-stimulating hormone (TSH) is increased. Symptoms include fatigue and constipation. Free thyroxine (T4) levels are decreased. It can lead to thyrotoxicosis.
It can lead to thyrotoxicosis.
Which factors associated with gestational diabetes may predispose the pregnant woman to spontaneous abortion in the first trimester? Select all that apply. Ketosis Glucosuria Hypoglycemia Hyperglycemia Uterine distention
Ketosis Hypoglycemia Hyperglycemia
Match the type of diabetes with its characterization. Lack of insulin secretion Insulin resistance Early gluconeogenesis
Lack of insulin secretion - T1DM Insulin resistance - T2DM Early gluconeogenesis GDM
A woman with gestational diabetes who is at 34 weeks gestation voices concern regarding fetal compromise related to her diagnosis of gestational diabetes. Which recommendation would the nurse make to the woman to monitor for potential fetal complications? Assess blood sugar once daily. Purchase a handheld Doppler. Increase the amount of juice and fruit in her diet. Lie down and count the number of kicks felt in an hour.
Lie down and count the number of kicks felt in an hour.
A patient presents with bleeding caused by placenta previa in late pregnancy. Which physical assessments are the most important for the nurse to perform? Select all that apply. Monitor urinary output. Monitor vaginal bleeding. Assess vital signs for the patient. Monitor fetal heart rate and contraction patterns. Perform digital vaginal examination for dilation. Measure fundal height.
Monitor urinary output. Monitor vaginal bleeding. Assess vital signs for the patient. Monitor fetal heart rate and contraction patterns.
A multiparous woman is admitted to the postpartum unit after a rapid labor and birth of a 4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the woman void and massages her fundus, but the patient's fundus remains difficult to find and the lochia remains bright red and heavy. Which action would the nurse take next? Vigorously massage the fundus Notify the health care provider Recheck the vital signs Insert an indwelling catheter
Notify the health care provider
A multiparous woman is admitted to the postpartum unit after a rapid labor and birth of a 4000-g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the woman void and massages her fundus, but the fundus remains difficult to find, and the rubra lochia remains heavy. Which action would the nurse take next? Continue to vigorously massage the fundus. Notify the health care provider. Recheck vital signs. Insert a Foley catheter.
Notify the health care provider.
Which findings would the nurse expect upon assessment of a patient with severe iron deficiency anemia? Select all that apply. Warm hands and feet Pallor Weakness Shortness of breath Fatigue Dizziness
Pallor Weakness Shortness of breath Fatigue Dizziness
The nurse understands which statements to be true regarding preconception counseling? Select all that apply. Patients may not be aware of this type of visit. It can reduce a patient's categorical risk for adverse pregnancy outcomes. Men and women should be involved in preconception care. It is a form of preventative care. It is designed for couples that are having trouble conceiving naturally.
Patients may not be aware of this type of visit. It can reduce a patient's categorical risk for adverse pregnancy outcomes. Men and women should be involved in preconception care. It is a form of preventative care.
A patient who is positive for human immunodeficiency virus (HIV) is 36 weeks pregnant. Which management strategy would be used to reduce the risk for transmission of the infection to the fetus? Early induction of labor Administration of penicillin Administration of intravenous zidovudine just before vaginal delivery Performance of a scheduled cesarean delivery at 38 weeks gestation
Performance of a scheduled cesarean delivery at 38 weeks gestation
Which physiologic change in pregnancy increases the risk for anemia in pregnancy? Platelet count increases. Plasma volume increases. The ferritin level increases. White blood cell volume increases.
Plasma volume increases.
Which conditions are risk factors for uterine atony? Select all that apply. Primiparous birth Polyhydramnios Precipitous birth Fetal macrosomia Chorioamnionitis
Polyhydramnios Fetal macrosomia Chorioamnionitis
The nurse assessing for hypoglycemia in a neonate would monitor for which symptoms? Select all that apply. Poor feeding Flexion of the arms and legs Hypothermia Tremors Bluish hands and feet Rooting
Poor feeding Hypothermia Tremors
A pregnant patient reports sensitivity to light, pain in the knees and wrists, and a facial rash. The patient is at risk for which conditions that may affect the health of the fetus? Select all that apply. Preeclampsia Hypertension Renal complications Folate deficiency Impaired neuropsychological development
Preeclampsia Hypertension Renal complications
The nurse notes recurrent late decelerations that do not respond to intrauterine resuscitation on the fetal monitor attached to a patient with a concealed placental abruption. Which order would the nurse anticipate? Administer pain medication as prescribed. Prepare for emergency cesarean birth. Turn the patient to the left lateral position. Palpate the fundal tone.
Prepare for emergency cesarean birth.
Which would the nurse assess at a routine prenatal visit for a patient that has gestational diabetes? Select all that apply. Presence of bacteria, ketones, protein, and glucose in urine Fetal movement by palpation and patient report Serum calcium levels Blood pressure Fundal height
Presence of bacteria, ketones, protein, and glucose in urine Fetal movement by palpation and patient report Blood pressure Fundal height
Which patient history places the woman at the highest risk for placenta previa? Domestic violence Abdominal trauma Previous placental abruption Previous incomplete abortion
Previous incomplete abortion
Match the identified risk factor to its risk category. Psychosocial factors Biophysical factors Sociodemographic factors Environmental factors
Psychosocial factors - smoking Biophysical factors - multiple gestation pregnancy Sociodemographic factors - income Environmental factors - occupational exposure
The nurse caring for a pregnant patient with gestational diabetes at 33 weeks gestation assesses the fundal height at 36 cm. Which actions by the nurse are correct regarding this finding? Select all that apply. Assure the patient that the fetus is growing appropriately for its age. Recommend that the health care provider order an ultrasound. Educate the patient on the importance of limiting weight gain for the remainder of the pregnancy. Perform a fetal nonstress test and report the findings to the health care provider. Assist the patient with scheduling a cesarean delivery at 37 weeks.
Recommend that the health care provider order an ultrasound. Perform a fetal nonstress test and report the findings to the health care provider.
Which newborn consequence of group B streptococcus (GBS) infection would the nurse recognize? Encephalitis Microcephaly Severe fetal anemia Respiratory problems
Respiratory problems
Which possible complications of amniocentesis would the nurse explain to the patient before the procedure? Select all that apply. Chromosomal abnormality in the fetus Rh isoimmunization Labor Risk for infection Fetal death
Rh isoimmunization Labor Risk for infection Fetal death
Which viral infection can result in neonatal brain complications? Herpes infection Rubella infection Varicella-zoster infection Cytomegalovirus infection
Rubella infection
Which sign would lead the nurse to suspect ectopic pregnancy in a patient with a missed period? Severe, localized abdominal pain in the left lower abdominal quadrant Vaginal bleeding after intercourse Nausea and vomiting Painless, bright-red vaginal bleeding
Severe, localized abdominal pain in the left lower abdominal quadrant
The nurse understands that which conditions are risks for a uterine inversion? Select all that apply. Precipitous delivery Short umbilical cord Polyhydramnios Fundal implantation of the placenta Prolonged labor
Short umbilical cord Fundal implantation of the placenta Prolonged labor
Which type of anemia is an inherited anemia? Sickle cell anemia Aplastic anemia Iron deficiency anemia Pernicious anemia
Sickle cell anemia
The nurse understands that which factors increase a woman's risk for having an ectopic pregnancy? Select all that apply. History of placental abruption Smoking History of gonorrhea Presence of an intrauterine device History of induced abortions Use of oral contraceptives
Smoking History of gonorrhea Presence of an intrauterine device History of induced abortions
A patient with a suspected ectopic pregnancy presents with intermittent abdominal pain and small amounts of vaginal bleeding. The nurse would suspect the pregnancy is in which location? The cervix The distal end of the fallopian tube The ovary The abdominal cavity
The distal end of the fallopian tube
Which statements are true regarding rubella in pregnancy? Select all that apply. Women develop a "slapped-cheek rash." Titers less than 1:8 demonstrate immunity. The virus can cross the placental barrier. Most women of childbearing age in the United States have received this vaccine already. If a woman is not immune, she can be offered the vaccine during pregnancy.
The virus can cross the placental barrier. Most women of childbearing age in the United States have received this vaccine already.
Which classic findings would the nurse identify in a patient with placental abruption (abruptio placentae)? Select all that apply. Absent vaginal bleeding Uterine irritability with low-intensity contractions Severe abdominal cramping Painless vaginal bleeding Boardlike abdomen
Uterine irritability with low-intensity contractions Severe abdominal cramping Boardlike abdomen
Match the subcategory of spontaneous abortion to its description. Vaginal bleeding with fetal heartbeat and a closed cervix Asymptomatic early pregnancy loss Vaginal bleeding and some products of conception remain in the uterus Rupture of membranes and cervical dilation; may or may not have bleeding
Vaginal bleeding with fetal heartbeat and a closed cervix -threatened Asymptomatic early pregnancy loss - missed Vaginal bleeding and some products of conception remain in the uterus - incomplete Rupture of membranes and cervical dilation; may or may not have bleeding - inevitable
On assessment, the postpartum nurse notes a firm fundus, bright red blood oozing from the vagina, and a saturated perineal pad. What diagnosis would the nurse expect based on these assessment findings? Vaginal hematoma Placenta accreta Vaginal laceration Uterine inversion
Vaginal laceration
Which patient teaching information would the nurse include regarding viral infections during pregnancy? Viral infections occur rarely in pregnancy. Viral infections may be treated with antibiotics. Viral infections always cause symptoms in the mother. Viral infections can result in serious consequences for the fetus and newborn.
Viral infections can result in serious consequences for the fetus and newborn.
Which type of hematoma is most common in vaginal births and is visible from the outside? Vaginal Vulvar Cervical Retroperitoneal
Vulvar
Which statement is true regarding testing for human immunodeficiency virus (HIV) in pregnancy? Written or verbal informed consent is necessary before obtaining a specimen. A woman may not refuse the test in pregnancy. Testing is governed by federal, not state law. A positive HIV test cannot be reported to the state health department because of patient confidentiality laws.
Written or verbal informed consent is necessary before obtaining a specimen.
Which risk factor is linked to increased rates of maternal mortality related to cardiovascular disease in pregnancy? Caucasian race Obesity Renal impairment Age 35 or greater
obesity
