Question 1

A new mother with which of these thyroid disorders would be strongly discouraged from breastfeeding?

Accepted Answer

A)  Hyperthyroidism 
B)  Phenylketonuria (PKU) 
C)  Hypothyroidism 
D)  Thyroid storm

Question 2

As related to the care of the patient with anemia,the nurse should be aware that:

Accepted Answer

A)  it is the most common medical disorder of pregnancy. 
B)  it can trigger reflex brachycardia. 
C)  the most common form of anemia is caused by folate deficiency. 
D)  thalassemia is a European version of sickle cell anemia.

Question 3

In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy,the nurse recognizes that further teaching is warranted when the patient states:

Accepted Answer

A)  "I will need to increase my insulin dosage during the first 3 months of pregnancy." 
B)  "Insulin dosage will likely need to be increased during the second and third trimesters." 
C)  "Episodes of hypoglycemia are more likely to occur during the first 3 months." 
D)  "Insulin needs should return to normal within 7 to 10 days after birth if I am bottle-feeding."

Question 4

When caring for a pregnant woman with cardiac problems,the nurse must be alert for signs and symptoms of cardiac decompensation,which include:

Accepted Answer

A)  a regular heart rate and hypertension. 
B)  an increased urinary output, tachycardia, and dry cough. 
C)  shortness of breath, bradycardia, and hypertension. 
D)  dyspnea; crackles; and an irregular, weak pulse.

Question 5

To manage her diabetes appropriately and ensure a good fetal outcome,the pregnant woman with diabetes will need to alter her diet by:

Accepted Answer

A)  eating six small equal meals per day. 
B)  reducing carbohydrates in her diet. 
C)  eating her meals and snacks on a fixed schedule. 
D)  increasing her consumption of protein.

Question 6

While providing care in an obstetric setting,the nurse should understand that after birth care of the woman with cardiac disease:

Accepted Answer

A)  is the same as that for any pregnant woman. 
B)  includes rest, stool softeners, and monitoring of the effect of activity. 
C)  includes ambulating frequently, alternating with active range of motion. 
D)  includes limiting visits with the infant to once per day.

Question 7

MATCHING
You are preparing to teach an antepartum patient with gestational diabetes the correct method of administering an intermediate acting insulin (NPH) with a short-acting insulin (regular). In the correct order from 1 through 6, match the step number with the action that you would take to teach the patient self-administration of this combination of insulin.

-Step 1

Accepted Answer

A) Without adding air, withdraw the correct dose of NPH insulin. 
B) Gently rotate the insulin to mix it, and wipe the stopper. 
C) Inject air equal to the dose of NPH insulin into the vial, and remove the syringe. 
D) Inject air equal to the dose of regular insulin into the vial, and withdraw the medication. 
E) Check the insulin bottles for the expiration date.
F)Wash hands.

Question 8

A woman with asthma is experiencing a after birth hemorrhage.Which drug would not be used to treat her bleeding because it may exacerbate her asthma?

Accepted Answer

A)  Pitocin 
B)  Nonsteroidal anti-inflammatory drugs (NSAIDs) 
C)  Hemabate 
D)  Fentanyl

Question 9

MATCHING
You are preparing to teach an antepartum patient with gestational diabetes the correct method of administering an intermediate acting insulin (NPH) with a short-acting insulin (regular). In the correct order from 1 through 6, match the step number with the action that you would take to teach the patient self-administration of this combination of insulin.

-Step 4

Accepted Answer

A) Without adding air, withdraw the correct dose of NPH insulin. 
B) Gently rotate the insulin to mix it, and wipe the stopper. 
C) Inject air equal to the dose of NPH insulin into the vial, and remove the syringe. 
D) Inject air equal to the dose of regular insulin into the vial, and withdraw the medication. 
E) Check the insulin bottles for the expiration date.
F)Wash hands.

Question 10

With one exception,the safest pregnancy is one in which the woman is drug and alcohol free.For women addicted to opioids,________________________ treatment is the current standard of care during pregnancy.

Accepted Answer

A)  methadone maintenance 
B)  detoxification 
C)  smoking cessation 
D)  4 Ps Plus

Question 11

MATCHING
You are preparing to teach an antepartum patient with gestational diabetes the correct method of administering an intermediate acting insulin (NPH) with a short-acting insulin (regular). In the correct order from 1 through 6, match the step number with the action that you would take to teach the patient self-administration of this combination of insulin.

-Step 2

Accepted Answer

A) Without adding air, withdraw the correct dose of NPH insulin. 
B) Gently rotate the insulin to mix it, and wipe the stopper. 
C) Inject air equal to the dose of NPH insulin into the vial, and remove the syringe. 
D) Inject air equal to the dose of regular insulin into the vial, and withdraw the medication. 
E) Check the insulin bottles for the expiration date.
F)Wash hands.

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 statistics,how often does cystic fibrosis occur in Caucasian live births?

Accepted Answer

A)  1 in 100 
B)  1 in 1200 
C)  1 in 2500 
D)  1 in 3000

Question 13

The use of methamphetamine (meth)has been described as a significant drug problem in the United States.In order to provide adequate nursing care to this patient population the nurse must be cognizant that methamphetamine:

Accepted Answer

A)  is similar to opiates. 
B)  is a stimulant with vasoconstrictive characteristics. 
C)  should not be discontinued during pregnancy. 
D)  is associated with a low rate of relapse.

Question 14

MATCHING
You are preparing to teach an antepartum patient with gestational diabetes the correct method of administering an intermediate acting insulin (NPH) with a short-acting insulin (regular). In the correct order from 1 through 6, match the step number with the action that you would take to teach the patient self-administration of this combination of insulin.

-Step 6

Accepted Answer

A) Without adding air, withdraw the correct dose of NPH insulin. 
B) Gently rotate the insulin to mix it, and wipe the stopper. 
C) Inject air equal to the dose of NPH insulin into the vial, and remove the syringe. 
D) Inject air equal to the dose of regular insulin into the vial, and withdraw the medication. 
E) Check the insulin bottles for the expiration date.
F)Wash hands.

Question 15

Diabetes refers to a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin action,insulin secretion,or both.Over time,diabetes causes significant changes in the microvascular and macrovascular circulations.These complications include: (Select all that apply.)

Accepted Answer

A)  atherosclerosis. 
B)  retinopathy. 
C)  IUFD. 
D)  nephropathy. 
E)  neuropathy.

Question 16

A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels.She shows the nurse her readings for the past few days.Which one should the nurse tell her indicates a need for adjustment (insulin or sugar)?

Accepted Answer

A)  75 mg/dL before lunch. This is low; better eat now. 
B)  115 mg/dL 1 hour after lunch. This is a little high; maybe eat a little less next time. 
C)  115 mg/dL 2 hours after lunch; This is too high; it is time for insulin. 
D)  60 mg/dL just after waking up from a nap. This is too low; maybe eat a snack before going to sleep.

Question 17

During a physical assessment of an at-risk patient,the nurse notes generalized edema,crackles at the base of the lungs,and some pulse irregularity.These are most likely signs of:

Accepted Answer

A)  euglycemia. 
B)  rheumatic fever. 
C)  pneumonia. 
D)  cardiac decompensation.

Question 18

Nurses caring for antepartum women with cardiac conditions should be aware that:

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 have 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 19

In planning for the care of a 30-year-old woman with pregestational diabetes,the nurse recognizes that the most important factor affecting pregnancy outcome is the:

Accepted Answer

A)  mother's age. 
B)  number of years since diabetes was diagnosed. 
C)  amount of insulin required prenatally. 
D)  degree of glycemic control during pregnancy.

Question 20

Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?

Accepted Answer

A)  Hypoglycemia 
B)  Hypercalcemia 
C)  Hypobilirubinemia 
D)  Hypoinsulinemia

Exam 11: High-Risk Perinatal Care: Preexisting Conditions

A new mother with which of these thyroid disorders would be strongly discouraged from breastfeeding?

As related to the care of the patient with anemia,the nurse should be aware that:

In assessing the knowledge of a pregestational woman with type 1 diabetes concerning changing insulin needs during pregnancy,the nurse recognizes that further teaching is warranted when the patient states:

When caring for a pregnant woman with cardiac problems,the nurse must be alert for signs and symptoms of cardiac decompensation,which include:

To manage her diabetes appropriately and ensure a good fetal outcome,the pregnant woman with diabetes will need to alter her diet by:

While providing care in an obstetric setting,the nurse should understand that after birth care of the woman with cardiac disease:

A woman with asthma is experiencing a after birth hemorrhage.Which drug would not be used to treat her bleeding because it may exacerbate her asthma?

With one exception,the safest pregnancy is one in which the woman is drug and alcohol free.For women addicted to opioids,________________________ treatment is the current standard of care during pregnancy.

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 statistics,how often does cystic fibrosis occur in Caucasian live births?

The use of methamphetamine (meth) has been described as a significant drug problem in the United States.In order to provide adequate nursing care to this patient population the nurse must be cognizant that methamphetamine:

Diabetes refers to a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin action,insulin secretion,or both.Over time,diabetes causes significant changes in the microvascular and macrovascular circulations.These complications include: (Select all that apply.)

A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels.She shows the nurse her readings for the past few days.Which one should the nurse tell her indicates a need for adjustment (insulin or sugar) ?

During a physical assessment of an at-risk patient,the nurse notes generalized edema,crackles at the base of the lungs,and some pulse irregularity.These are most likely signs of:

Nurses caring for antepartum women with cardiac conditions should be aware that:

In planning for the care of a 30-year-old woman with pregestational diabetes,the nurse recognizes that the most important factor affecting pregnancy outcome is the:

Which major neonatal complication is carefully monitored after the birth of the infant of a diabetic mother?