Question 1

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. As a result 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

A)  Increased oxygen consumption
B)  Increased heart rate
C)  Decreased gastric motility
D)  Displacement of abdominal viscera
E)  Increase in clotting factors D

Question 2

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

A)   Multiple sclerosis
B)   SLE
C)   Antiphospholipid syndrome
D)   Rheumatoid arthritis
E)   Myasthenia gravis B,C,D,E

Question 3

A woman has experienced iron deficiency anemia during her pregnancy.She had been taking iron for 3 months before the birth.The client gave birth by cesarean 2 days earlier and has been having problems with constipation.After assisting her back to bed from the bathroom,the nurse notes that the woman's stools are dark (greenish-black).What should the nurse's initial action be?

Accepted Answer

A)   Perform a guaiac test, and record the results.
B)   Recognize the finding as abnormal, and report it to the primary health care provider.
C)   Recognize the finding as a normal result of iron therapy.
D)   Check the woman's next stool to validate the observation. C

Question 4

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

Accepted Answer

A)   The plan of care for a postpartum client is the same as the plan for any pregnant woman.
B)   The plan of care includes rest, stool softeners, and monitoring of the effect of activity.
C)   The plan of care includes frequent ambulating, alternating with active range-of-motion exercises.
D)   The plan of care includes limiting visits with the infant to once per day.

Question 5

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

Accepted Answer

A)   Cardiomyopathy
B)   Rheumatic heart disease
C)   Congenital heart disease
D)   Mitral valve prolapse

Question 6

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. As a result 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

A)  Increased oxygen consumption
B)  Increased heart rate
C)  Decreased gastric motility
D)  Displacement of abdominal viscera
E)  Increase in clotting factors

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

A)   Bell palsy is the sudden development of bilateral facial weakness.
B)   Women with Bell palsy have an increased risk for hypertension.
C)   Pregnant women are affected twice as often as nonpregnant women.
D)   Bell palsy occurs most frequently in the first trimester.

Question 8

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

Accepted Answer

A)   Cleft lip
B)   Congenital heart disease
C)   Neural tube defects
D)   Gastroschisis
E)   Diaphragmatic hernia

Question 9

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

A)   PUPPP is associated with decreased maternal weight gain.
B)   The rate of hypertension decreases with PUPPP.
C)   This common pregnancy-specific condition is associated with a poor fetal outcome.
D)   The goal of therapy is to relieve discomfort.

Question 10

A woman at 28 weeks of gestation experiences blunt abdominal trauma as the result of a fall.The nurse must closely observe the client for what?

Accepted Answer

A)   Alteration in maternal vital signs, especially blood pressure
B)   Complaints of abdominal pain
C)   Placental absorption
D)   Hemorrhage

Question 11

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

Accepted Answer

A)   Intake and output (I&O)  and intravenous (IV)  site
B)   Signs and symptoms of infection
C)   Vital signs and incision
D)   Fetal heart rate (FHR)  and uterine activity

Question 12

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

A)   1 in 100
B)   1 in 1000
C)   1 in 2000
D)   1 in 3200

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

A)   Oxytocin (Pitocin) 
B)   Nonsteroidal antiinflammatory drugs (NSAIDs) 
C)   Hemabate
D)   Fentanyl

Question 14

Which condition would require prophylaxis to prevent subacute bacterial endocarditis (SBE)both antepartum and intrapartum?

Accepted Answer

A)   Valvular heart disease
B)   Congestive heart disease
C)   Arrhythmias
D)   Postmyocardial infarction

Question 15

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

A)   Marfan syndrome
B)   Eisenmenger syndrome
C)   Heart transplant
D)   Ventricular septal defect (VS
D)

Question 16

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

A)   Embolism and preeclampsia
B)   Trauma and motor vehicle accidents (MVAs) 
C)   Hemorrhage and infection
D)   Underlying chronic conditions

Question 17

Which information regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand?

Accepted Answer

A)   Stress on the heart is greatest in the first trimester and the last 2 weeks before labor.
B)   Women with class II cardiac disease should avoid heavy exertion and any activity that causes even minor symptoms.
C)   Women with class III cardiac disease should get 8 to 10 hours of sleep every day and limit housework, shopping, and exercise.
D)   Women with class I cardiac disease need bed rest through most of the pregnancy and face the possibility of hospitalization near term.

Question 18

In caring for a pregnant woman 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

A)   Fever
B)   Endometritis
C)   Abdominal pain
D)   Joint pain
E)   Urinary tract infection (UTI)

Question 19

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

A)   Regular heart rate and hypertension
B)   Increased urinary output, tachycardia, and dry cough
C)   Shortness of breath, bradycardia, and hypertension
D)   Dyspnea, crackles, and an irregular, weak pulse

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. As a result 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

A)  Increased oxygen consumption
B)  Increased heart rate
C)  Decreased gastric motility
D)  Displacement of abdominal viscera
E)  Increase in clotting factors

Exam 30: Medical-Surgical Disorders

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

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

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

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

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 at 28 weeks of gestation experiences blunt abdominal trauma as the result of a fall.The nurse must closely observe the client for what?

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

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?

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

Which condition would require prophylaxis to prevent subacute bacterial endocarditis (SBE) both antepartum and intrapartum?

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?

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 regarding the care of antepartum women with cardiac conditions is most important for the nurse to understand?

In caring for a pregnant woman 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) .

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?