Question 1

A potential effect of diabetes on pregnancy and the fetus or neonate includes which of these risks?

Accepted Answer

A)  euglycemia
B)  congenital anomalies
C)  HELLP syndrome
D)  hyperglycemia B

Question 2

When a client in the third trimester of pregnancy develops a rigid,painful abdomen,it is likely the client has developed which of these conditions?

Accepted Answer

A)  central abruptio placenta
B)  marginal abruptio placenta
C)  incomplete placenta previa
D)  placenta previa A

Question 3

When a pregnant woman with phenylketonuria (PKU)has a poorly regulated phenylalanine level,it causes an increase in the incidence of which condition in the fetus or neonate?

Accepted Answer

A)  pulmonary defects
B)  intrauterine growth retardation (IUGR) 
C)  hydrocephalus
D)  PKU B

Question 4

To prevent fetal infection,a cesarean birth is required for the pregnant client who is infected with which of these organisms at the time of delivery?

Accepted Answer

A)  cytomegalovirus
B)  herpes genitalis
C)  rubella
D)  toxoplasmosis

Question 5

What is the treatment of choice for a woman whose pregnancy history includes habitual abortions as the result of an incompetent cervix?

Accepted Answer

A)  a dilation and curettage or suction evacuation
B)  induction with oxytocin
C)  surgical treatment with cerclage at 16 weeks followed by cesarean delivery at term
D)  treatment with tocolytics to halt the process and bed rest until viability can be reached

Question 6

A pregnant cardiac client may have two or three prenatal care appointments a week between 28 and 32 weeks' gestation because:

Accepted Answer

A)  pregnancy-induced hypertension develops during that gestational time frame
B)  placental insufficiency may develop and compromise the fetus
C)  the normal increase in blood volume may result in congestive heart failure
D)  weight gain begins to accelerate and may increase the heart's workload

Question 7

A client has painless vaginal bleeding at 35 weeks' gestation and is scheduled for an ultrasound to confirm a diagnosis of placenta previa.In addition to monitoring the client's vital signs and fetal heart rate,nursing management of this client would include:

Accepted Answer

A)  preparation for immediate cesarean delivery
B)  frequent vaginal examinations
C)  bed rest with bathroom privileges if no bleeding occurs
D)  administration of antibiotics and antiemetics

Question 8

The nurse is explaining fetus viability to a client considering terminating her pregnancy.The nurse explains that a fetus is usually considered viable and can survive with medical interventions at how many weeks' gestation?

Accepted Answer

A)  16
B)  18
C)  24
D)  28

Question 9

In which of these situations can Rh incompatibility develop?

Accepted Answer

A)  Both the mother and fetus are Rh negative.
B)  The mother is Rh negative,and the fetus is Rh positive.
C)  The mother is Rh positive,and the fetus is Rh negative.
D)  Both the mother and fetus are Rh positive.

Question 10

Women who desire future fertility and who have an unruptured ectopic pregnancy less than 4 centimeters in size are candidates for which of these procedures?

Accepted Answer

A)  methotrexate therapy
B)  salpingostomy
C)  laparotomy and salpingectomy
D)  vacuum extraction of the products of conception

Question 11

Which of these obstetrical problems may precipitate a client developing disseminated intravascular coagulation (DIC)?

Accepted Answer

A)  hyperemesis gravidarum
B)  preterm labor
C)  spontaneous abortion
D)  pregnancy-induced hypertension

Question 12

A client is admitted at 18 weeks' gestation with a probable diagnosis of hydatidiform mole.Her signs and symptoms include high-serum human chorionic gonadotropin (HCG)levels,pregnancy-induced hypertension (PIH),uterine enlargement greater than expected for the estimated gestational period,and vaginal bleeding.For the client's nursing diagnosis of Fear related to the possible development of choriocarcinoma,which of these nursing interventions is appropriate?

Accepted Answer

A)  Allow the client to express her feelings,and refer her to support sources.
B)  Educate the client regarding the need for weekly blood tests for HCG levels.
C)  Explain the need for follow-up physical examinations and chest X-rays.
D)  Stress the importance of delaying another pregnancy.

Question 13

A nurse teaches a high-risk pregnant client the Cardiff method of fetal movement documentation.In which of these situations should the client contact the health care provider?

Accepted Answer

A)  fewer than 10 movements in 12 hours
B)  no movements for 4 hours
C)  sudden violent movements followed by the usual number of movements noted previously
D)  three or more movements in 30 minutes

Question 14

A 35-year-old gravida V para IV is admitted at 36 weeks' gestation with a diagnosis of severe preeclampsia.She is started on magnesium sulfate (MgSO₄)IV.Which of these signs would indicate to the nurse that the client has developed magnesium sulfate toxicity?

Accepted Answer

A)  Deep tendon reflexes are normal.
B)  Blood pressure remains unchanged.
C)  Respirations are 10 per minute.
D)  Urine output is 40 cc per hour.

Question 15

A pregnant client has a nonstress test (NST)that is "nonreactive." The nurse should recognize that this means

Accepted Answer

A)  the fetus has adequate oxygenation and an intact central nervous system
B)  the fetus is asleep or is having problems
C)  there is inadequate fetal activity
D)  there were decelerations of the fetal heart rate (FHR)

Question 16

Which of the following does NOT demonstrate high-risk factors in pregnancy in general classification?

Accepted Answer

A)  17-year-old female
B)  abortion
C)  dropped out of school
D)  unmarried

Question 17

A client with mild preeclampsia is ordered to stay on bed rest at home,lying on either side.Why is client teaching essential to improve her compliance with this plan of care?

Accepted Answer

A)  The client generally feels well and may not recognize the potential seriousness of this diagnosis.
B)  The client may feel guilty for having others care for her.
C)  The client may think that the symptoms of this condition are normal at this stage of pregnancy.
D)  The client will have alternating periods of vomiting and feeling well.

Question 18

Which of these biochemical assessments on maternal serum indicates fetoplacental function?

Accepted Answer

A)  lecithin-to-sphingomyelin ratio
B)  human placental lactogen
C)  estriol
D)  maternal serum alpha-fetoprotein

Question 19

A client states that she may have appendicitis because she started having pain in her side last week,and it is becoming progressively more severe.During the nursing assessment,the client tells the nurse she missed her period a month ago and has experienced nausea and breast tenderness.The nurse should report this information to the health care provider immediately,because the client may have developed which of these complications?

Accepted Answer

A)  abruptio placentae
B)  ectopic pregnancy
C)  hydatidiform mole
D)  placenta previa

Question 20

What is often the first clue of a multiple pregnancy?

Accepted Answer

A)  fundal height greater than expected for gestational weeks
B)  an elevated alpha-fetoprotein level
C)  more severe nausea and vomiting and other discomforts of pregnancy
D)  two or more heartbeats heard

Exam 55: Complications of Pregnancy