Deck 20: Nursing Management of the Pregnancy at Risk

Question 1

The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse's teaching was successful?

A) "I'll basically follow the same diet that I was following before I became pregnant."
B) "Because I need extra protein, I'll have to increase my intake of milk and meat."
C) "Pregnancy affects insulin production, so I'll need to make adjustments in my diet."
D) "I'll adjust my diet and insulin based on the results of my urine tests for glucose."

Answer 1

"Pregnancy affects insulin production, so I'll need to make adjustments in my diet."

Question 2

A nurse is developing a program for pregnant women with diabetes about reducing complications. Which factor would the nurse identify as being most important in helping to reduce the maternal/fetal/neonatal complications associated with pregnancy and diabetes?

A) Stability of the woman's emotional and psychological status
B) Degree of glycemic control achieved during the pregnancy
C) Evaluation of retinopathy by an ophthalmologist
D) Blood urea nitrogen level (BUN. within normal limits

Answer 2

Degree of glycemic control achieved during the pregnancy

Question 3

Because a pregnant client's diabetes has been poorly controlled throughout her pregnancy, the nurse would be alert for which of the following in the neonate at birth?

A) Macrosomia
B) Hyperglycemia
C) Low birth weight
D) Hypobilirubinemia

Answer 3

Macrosomia

Question 4

A woman with diabetes is considering becoming pregnant. She asks the nurse whether she will be able to take oral hypoglycemics when she is pregnant. The nurse's response is based on the understanding that oral hypoglycemics:

A) Can be used as long as they control serum glucose levels
B) Can be taken until the degeneration of the placenta occurs
C) Are usually suggested primarily for women who develop gestational diabetes
D) Show promising results but more studies are needed to confirm their effectiveness

Question 5

A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1C. level of 13%. At this time the nurse should be most concerned about which of the following possible fetal outcomes?

A) Congenital anomalies
B) Incompetent cervix
C) Placenta previa
D) Abruptio placentae

Question 6

After teaching a group of students about the use of antiretroviral agents in pregnant women who are HIV-positive, the instructor determines that the teaching was successful when the group identifies which of the following as the underlying rationale?

A) Reduction in viral loads in the blood
B) Treatment of opportunistic infections
C) Adjunct therapy to radiation and chemotherapy
D) Can cure acute HIV/AIDS infections

Question 7

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

A) Marijuana
B) Alcohol
C) Heroin
D) Cocaine

Question 8

When teaching a class of pregnant women about the effects of substance abuse during pregnancy, which of the following would the nurse most likely include?

A) Low-birth-weight infants
B) Excessive weight gain
C) Higher pain tolerance
D) Longer gestational periods

Question 9

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 of the following statements by the nurse would be most appropriate?

A) "You'll probably have a cesarean birth to prevent exposing your newborn."
B) "Antibodies cross the placenta and provide immunity to the newborn."
C) "Wait until after the infant is born and then something can be done."
D) "Antiretroviral medications are available to help reduce the risk of transmission."

Question 10

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) 16 to 20 weeks' gestation
B) 20 to 24 weeks' gestation
C) 24 to 28 weeks' gestation
D) 28 to 32 weeks' gestation

Question 11

When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which of the following would be most appropriate?

A) Monthly visits until 32 weeks, then bi-monthly visits
B) Bi-monthly visits until 28 weeks, then weekly visits
C) Monthly visits until 20 weeks, then bi-monthly visits
D) Bi-monthly visits until 36 weeks, then weekly visits

Question 12

Which medication would the nurse question if ordered to control a pregnant woman's asthma?

A) Budesonide
B) Albuterol
C) Salmeterol
D) Oral prednisone

Question 13

After teaching a pregnant woman with iron deficiency anemia about her prescribed iron supplement, which statement indicates successful teaching?

A) "I should take my iron with milk."
B) "I should avoid drinking orange juice."
C) "I need to eat foods high in fiber."
D) "I'll call the doctor if my stool is black and tarry."

Question 14

A nurse is providing care to several pregnant women at the clinic. The nurse would screen for group B streptococcus infection in a client at:

A) 16 weeks' gestation
B) 28 week' gestation
C) 32 weeks' gestation
D) 36 weeks' gestation

Question 15

The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion?

A) Wide large eyes
B) Thin upper lip
C) Protruding jaw
D) Elongated nose

Question 16

After teaching a group of nursing students about the impact of pregnancy on the older woman, the instructor determines that the teaching was successful when the students state which of the following?

A) "The majority of women who become pregnant over age 35 experience complications."
B) "Women over the age of 35 who become pregnant require a specialized type of assessment."
C) "Women over age 35 and are pregnant have an increased risk for spontaneous abortions."
D) "Women over age 35 are more likely to have substance abuse problems."

Question 17

A group of students are reviewing information about sexually transmitted infections and their effect on pregnancy. The students demonstrate understanding of the information when they identify which infection as being responsible for ophthalmia neonatorum?

A) Syphilis
B) Gonorrhea
C) Chlamydia
D) HPV

Question 18

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) Rubella
B) Hepatitis B
C) Cytomegalovirus
D) Parvovirus B19

Question 19

A pregnant woman asks the nurse, "I'm a big coffee drinker. Will the caffeine in my coffee hurt my baby?" Which response by the nurse would be most appropriate?

A) "The caffeine in coffee has been linked to birth defects."
B) "Caffeine has been shown to cause growth restriction in the fetus."
C) "Caffeine is a stimulant and needs to be avoided completely."
D) "If you keep your intake to less than 300 mg/day, you should be okay."

Question 20

A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of withdrawal. Which of the following would the nurse assess? (Select all that apply.)

A) Low whimpering cry
B) Hypertonicity
C) Lethargy
D) Excessive sneezing
E) Overly vigorous sucking
F) Tremors

Question 21

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 of the following? (Select all that apply.)

A) Peer pressure to become sexually active
B) Rise in teen birth rates over the years.
C) Latinas as having the highest teen birth rate
D) Loss of self-esteem as a major impact
E) Majority of teen pregnancies in the 15-17-year-old age group

Question 22

A nurse is counseling a pregnant woman with rheumatoid arthritis about medications that can be used during pregnancy. Which drug would the nurse emphasize as being contraindicated at this time?

A) Hydroxychloroquine
B) Nonsteroidal anti-inflammatory drug
C) Glucocorticoid
D) Methotrexate

Question 23

A nurse is preparing a teaching program for a group of pregnant women about preventing infections during pregnancy. When describing measures for preventing cytomegalovirus infection, which of the following would the nurse most likely include?

A) Frequent handwashing
B) Immunization
C) Prenatal screening
D) Antibody titer screening

Question 24

A pregnant woman tests positive for HBV. Which of the following would the nurse expect to administer?

A) HBV immune globulin
B) HBV vaccine
C) Acylcovir
D) Valacyclovir

Question 25

A group of nursing students are preparing a presentation for their class about measures to prevent toxoplasmosis. Which of the following would the students be least likely to include? Select all that apply.

A) Washing raw fruits and vegetables before eating them
B) Cooking all meat to an internal temperature of 140° F
C) Wearing gardening gloves when working in the soil
D) Avoiding contact with a cat's litter box.

Question 26

A pregnant woman with gestational diabetes comes to the clinic for a fasting blood glucose level. When reviewing the results, the nurse determines that which result indicates good glucose control?

A) 90 mg/dL
B) 100 mg/dL
C) 110 mg /dL
D) 120 mg/dL