Question 1

A pregnant woman at term is transported to the emergency department (ED)after a severe vehicular accident.The obstetric nurse responds and rushes to the ED with a fetal monitor.Cardiopulmonary arrest occurs as the obstetric nurse arrives.What is the highest priority for the trauma team?

Accepted Answer

When cardiopulmonary arrest occurs, the highest priority of the trauma team is to start cardiopulmonary resuscitation (CPR) to attempt to save the woman's life. Obtaining IV access and starting fluid resuscitation can occur concurrently with CPR, and the fetal monitor can be applied once the woman's condition stabilizes. The possibility of an emergency cesarean delivery can be discussed once the woman's condition is stable and it has been determined whether the fetus survived the accident.

Question 2

Since the gene for cystic fibrosis was identified in 1989,data can be collected for the purposes of genetic counseling for couples regarding carrier status.According to the most recent statistics,how often does cystic fibrosis occur in Caucasian live births?

Accepted Answer

Cystic fibrosis occurs in approximately 1 in every 3200 Caucasian live births. This number can vary by ethnicity, with a higher incidence in populations such as Ashkenazi Jews. Genetic counseling and carrier testing can help couples understand their risk of having a child with cystic fibrosis and make informed decisions about family planning.

Question 3

Which neurologic condition would require preconception counseling,if possible?

Accepted Answer

Epilepsy requires preconception counseling to discuss the risks of medication and potential seizure activity during pregnancy.

Question 4

Because most pregnant women continue their usual activities,trauma remains a common complication during pregnancy.Approximately 1 in 12 pregnancies in the United States are complicated by trauma each year.Because of the physiologic alterations that accompany pregnancy,special considerations for the mother and fetus are necessary when trauma occurs.Match the maternal system adaptation in pregnancy with the clinical response to trauma.

-Increased risk of thrombus formation

Accepted Answer

Pregnancy causes an increase in clotting factors, which can increase the risk of thrombus formation. Trauma can further exacerbate this risk.

Question 5

Postoperative care of the pregnant woman who requires abdominal surgery for appendicitis includes which additional assessment?

Accepted Answer

Care for the pregnant woman who has had abdominal surgery for appendicitis includes assessment of the fetal heart rate and uterine activity to detect any signs of fetal distress or preterm labor. Intake and output and IV site, signs of infection, and vital signs and incision are all important assessments in postoperative care, but are not specific to the pregnant woman's needs.

Question 6

A pregnant woman at 33 weeks of gestation is brought to the birthing unit after a minor automobile accident.The client is experiencing no pain and no vaginal bleeding,her vital signs are stable,and the fetal heart rate (FHR)is 132 beats per minute with variability.What is the nurse's highest priority?

Accepted Answer

Continuous electronic fetal monitoring (EFM) for a minimum of 4 hours is the highest priority as it ensures the baby's well-being after the accident. While monitoring for a ruptured spleen may be necessary, it is not the highest priority in this situation. Discharging the woman home without adequate fetal monitoring would not be appropriate, and monitoring for 24 hours is not necessary unless there are further concerns or complications.

Question 7

Bell palsy is an acute idiopathic facial paralysis,the cause for which remains unknown.Which statement regarding this condition is correct?

Accepted Answer

The answer of Bell palsy is an acute idiopathic facial...

Question 8

Autoimmune disorders often occur during pregnancy because a large percentage of women with an autoimmune disorder are of childbearing age.Which disorders fall into the category of collagen vascular disease? (Select all that apply. )

Accepted Answer

The answer of Autoimmune disorders often occur during pregnancy because...

Question 9

Which important component of nutritional counseling should the nurse include in health teaching for a pregnant woman who is experiencing cholecystitis?

Accepted Answer

Cholecystitis is an inflammation of the gallbladder often associated with the presence of gallstones. The treatment for cholecystitis generally requires a low-fat diet that avoids fried and fatty foods. Adequate calorie and protein intake is important for a pregnant woman, but it is not necessarily the most important component when managing cholecystitis. Bulking up on protein may not be suitable for a pregnant woman who is experiencing cholecystitis.  A low-cholesterol, low-salt diet may be useful for some individuals, but it is not the recommended treatment for cholecystitis.

Question 10

It is extremely rare for a woman to die in childbirth;however,it can happen.In the United States,the annual occurrence of maternal death is 12 per 100,000 cases of live birth.What are the leading causes of maternal death?

Accepted Answer

The answer of It is extremely rare for a woman...

Question 11

Which information should the nurse take into consideration when planning care for a postpartum client with cardiac disease?

Accepted Answer

Postpartum clients with cardiac disease require additional considerations for their plan of care, including rest to prevent stress on the heart, stool softeners to prevent straining and increased intra-abdominal pressure, and monitoring the effect of activity on heart function. Frequent ambulating and active range-of-motion exercises may be contraindicated, and limiting visits with the infant may have negative psychological effects on both the mother and the baby.

Question 12

Another common pregnancy-specific condition is pruritic urticarial papules and plaques of pregnancy (PUPPP).A client asks the nurse why she has developed this condition and what can be done.What is the nurse's best response?

Accepted Answer

Pruritic urticarial papules and plaques of pregnancy (PUPPP) is a common pregnancy-specific condition characterized by itchy, raised, and reddish patches on the skin. The goal of therapy is to relieve discomfort, and treatment options may include topical steroids, oral antihistamines, and/or oatmeal baths. PUPPP is not associated with decreased maternal weight gain or a decrease in hypertension rates, and it is usually not associated with a poor fetal outcome.

Question 13

A woman with asthma is experiencing a postpartum hemorrhage.Which drug should be avoided when treating postpartum bleeding to avoid exacerbating asthma?

Accepted Answer

15-methyl PGF2α (a form of prostaglandin) can exacerbate asthma by causing bronchoconstriction, making it a less suitable choice for a patient with asthma experiencing postpartum hemorrhage.

Question 14

The client makes an appointment for preconception counseling.The woman has a known heart condition and is unsure if she should become pregnant.Which is the only cardiac condition that would cause concern?

Accepted Answer

Eisenmenger syndrome is the only cardiac condition that would cause concern for a woman considering pregnancy. It is a type of pulmonary hypertension where the shunt in the heart reverses direction, leading to decreased oxygen in the blood and increased strain on the heart. Pregnancy further increases the risk of complications and mortality for both the mother and baby. Women with other cardiac conditions may still be able to have a safe pregnancy with proper planning and medical management.

Question 15

Because most pregnant women continue their usual activities,trauma remains a common complication during pregnancy.Approximately 1 in 12 pregnancies in the United States are complicated by trauma each year.Because of the physiologic alterations that accompany pregnancy,special considerations for the mother and fetus are necessary when trauma occurs.Match the maternal system adaptation in pregnancy with the clinical response to trauma.

-Decreased placental perfusion in the supine position

Accepted Answer

Increased heart rate in pregnancy can lead to decreased placental perfusion, especially in the supine position, due to compression of the inferior vena cava by the gravid uterus, reducing venous return and cardiac output.

Question 16

In caring for a pregnant woman diagnosed with sickle cell anemia,the nurse must be aware of the signs and symptoms of a sickle cell crisis.What do these include? (Select all that apply. )

Accepted Answer

The signs and symptoms of a sickle cell crisis include fever, abdominal pain, and joint pain. Endometritis and UTI are not typically associated with sickle cell crisis, so they are not the best choices.

Question 17

What form of heart disease in women of childbearing years generally has a benign effect on pregnancy?

Accepted Answer

Mitral valve prolapse is the only form of heart disease in women of childbearing years that generally has a benign effect on pregnancy. It is a condition in which the valve between the left upper and lower chambers of the heart doesn't close properly, but it often causes no symptoms and doesn't require treatment. However, in rare cases, it can lead to complications such as heart palpitations or an increased risk of developing infective endocarditis during pregnancy.

Question 18

When caring for a pregnant woman with cardiac problems,the nurse must be alert for the signs and symptoms of cardiac decompensation.Which critical findings would the nurse find on assessment of the client experiencing this condition?

Accepted Answer

Edema, crackles, and cyanosis of nails and lips are signs of fluid overload and decreased oxygenation, which are characteristic symptoms of cardiac decompensation in a pregnant woman with cardiac problems. A regular heart rate and hypertension may be normal or expected during pregnancy, and shortness of breath, bradycardia, and hypertension are not typically associated with cardiac decompensation. Increased urinary output and tachycardia are not specific enough to suggest cardiac decompensation without the presence of other signs and symptoms.

Question 19

Which congenital anomalies can occur because of the use of antiepileptic drugs (AEDs)in pregnancy? (Select all that apply. )

Accepted Answer

Antiepileptic drugs (AEDs) are known to increase the risk of congenital anomalies such as cleft lip, congenital heart disease, and neural tube defects when used during pregnancy.

Question 20

Because most pregnant women continue their usual activities,trauma remains a common complication during pregnancy.Approximately 1 in 12 pregnancies in the United States are complicated by trauma each year.Because of the physiologic alterations that accompany pregnancy,special considerations for the mother and fetus are necessary when trauma occurs.Match the maternal system adaptation in pregnancy with the clinical response to trauma.

-Altered pain referral

Accepted Answer

Displacement of abdominal viscera can lead to difficulty in assessing internal injuries and can cause compression of the inferior vena cava, leading to hypotension and decreased blood flow to the fetus.

Quiz 30: Medical-Surgical Disorders

A pregnant woman at term is transported to the emergency department (ED) after a severe vehicular accident.The obstetric nurse responds and rushes to the ED with a fetal monitor.Cardiopulmonary arrest occurs as the obstetric nurse arrives.What is the highest priority for the trauma team?

Since the gene for cystic fibrosis was identified in 1989,data can be collected for the purposes of genetic counseling for couples regarding carrier status.According to the most recent statistics,how often does cystic fibrosis occur in Caucasian live births?

Which neurologic condition would require preconception counseling,if possible?

Postoperative care of the pregnant woman who requires abdominal surgery for appendicitis includes which additional assessment?

Bell palsy is an acute idiopathic facial paralysis,the cause for which remains unknown.Which statement regarding this condition is correct?

Autoimmune disorders often occur during pregnancy because a large percentage of women with an autoimmune disorder are of childbearing age.Which disorders fall into the category of collagen vascular disease? (Select all that apply. )

Which important component of nutritional counseling should the nurse include in health teaching for a pregnant woman who is experiencing cholecystitis?

It is extremely rare for a woman to die in childbirth;however,it can happen.In the United States,the annual occurrence of maternal death is 12 per 100,000 cases of live birth.What are the leading causes of maternal death?

Which information should the nurse take into consideration when planning care for a postpartum client with cardiac disease?

Another common pregnancy-specific condition is pruritic urticarial papules and plaques of pregnancy (PUPPP) .A client asks the nurse why she has developed this condition and what can be done.What is the nurse's best response?

A woman with asthma is experiencing a postpartum hemorrhage.Which drug should be avoided when treating postpartum bleeding to avoid exacerbating asthma?

The client makes an appointment for preconception counseling.The woman has a known heart condition and is unsure if she should become pregnant.Which is the only cardiac condition that would cause concern?

In caring for a pregnant woman diagnosed with sickle cell anemia,the nurse must be aware of the signs and symptoms of a sickle cell crisis.What do these include? (Select all that apply. )

What form of heart disease in women of childbearing years generally has a benign effect on pregnancy?

When caring for a pregnant woman with cardiac problems,the nurse must be alert for the signs and symptoms of cardiac decompensation.Which critical findings would the nurse find on assessment of the client experiencing this condition?

Which congenital anomalies can occur because of the use of antiepileptic drugs (AEDs) in pregnancy? (Select all that apply. )