Practice Quesstion for Exam 2

Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular
menstrual periods all her life. he has a history of smoking appro!imately one pa"k of "igarettes a
day, but she tells you that she is trying to "ut down. #er laboratory data are within normal limits.
$hat diagnosti" te"hni%ue "ould be used with this pregnant woman at this time&
a. 'ltrasound e!amination
b. (aternal serum alpha-fetoprotein s"reening )(A*+,
". Amnio"entesis
d. -onstress test )-.,
____ /. .he nurse sees a woman for the first time when she is 30 weeks pregnant. .he woman has smoked
throughout the pregnan"y, and fundal height measurements now are suggestive of growth restri"tion
in the fetus. 1n addition to ultrasound to measure fetal si2e, what would be another tool useful in
"onfirming the diagnosis&
a. 3oppler blood flow analysis ". Amnio"entesis
b. 4ontra"tion stress test )4., d. 3aily fetal movement "ounts
____ 3. A 51-week pregnant multigravida presents in the labor and delivery unit after a nonstress test
indi"ated that her fetus "ould be e!perien"ing some diffi"ulties in utero. $hi"h diagnosti" tool
would yield more detailed information about the fetus&
a. 'ltrasound for fetal anomalies
b. 6iophysi"al profile )6++,
". (aternal serum alpha-fetoprotein s"reening )(A*+,
d. +er"utaneous umbili"al blood sampling )+'6,
____ 5. At 37 weeks of pregnan"y a woman e!perien"es preterm labor. Although to"olyti"s are administered
and she is pla"ed on bed rest, she "ontinues to e!perien"e regular uterine "ontra"tions, and her "ervi!
is beginning to dilate and effa"e. $hat would be an important test for fetal well-being at this time&
a. +er"utaneous umbili"al blood sampling )+'6,
b. 'ltrasound for fetal si2e
". Amnio"entesis for fetal lung maturity
d. -onstress test
____ 7. A 50-year-old woman is 10 weeks pregnant. $hi"h diagnosti" tool would be appropriate to suggest
to her at this time&
a. 6iophysi"al profile
b. Amnio"entesis
". (aternal serum alpha-fetoprotein )(A*+,
d. .ransvaginal ultrasound
____ 8. A woman is undergoing a nipple-stimulated "ontra"tion stress test )4.,. he is having "ontra"tions
that o""ur every 3 minutes. .he fetal heart rate )*#9, has a baseline of appro!imately 1/0 beats:min
without any de"elerations. .he interpretation of this test is said to be;
a. -egative. ". atisfa"tory.
b. +ositive. d. 'nsatisfa"tory.
____ <. A woman is 8 weeks pregnant. he has had a previous spontaneous abortion at 15 weeks of gestation
and a pregnan"y that ended at 38 weeks with the birth of a stillborn girl. $hat is her gravidity and
parity using the =.+A> system&
a. /-0-0-1-1 ". 3-1-0-1-0
b. /-1-0-1-0 d. 3-0-1-1-0
____ 8. A woman at 10 weeks of gestation who is seen in the prenatal "lini" with presumptive signs and
symptoms of pregnan"y likely will have;
a. Amenorrhea. ". 4hadwi"k?s sign.
b. +ositive pregnan"y test. d. #egar?s sign.
____ 9. .he nurse tea"hes a pregnant woman about the presumptive, probable, and positive signs of
pregnan"y. .he woman demonstrates understanding of the nurse?s instru"tions if she states that a
positive sign of pregnan"y is;
a. A positive pregnan"y test.
b. *etal movement palpated by the nurse-midwife.
". 6ra!ton #i"ks "ontra"tions.
d. @ui"kening.
____ 10. A woman is at 15 weeks of gestation. .he nurse would e!pe"t to palpate the fundus at whi"h level&
a. -ot palpable above the symphysis at this time
b. lightly above the symphysis pubis
". At the level of the umbili"us
d. lightly above the umbili"us
____ 11. 3uring a "lient?s physi"al e!amination the nurse notes that the lower uterine segment is soft on
palpation. .he nurse would do"ument this finding as;
a. #egar?s sign ". 4hadwi"k?s sign
b. ("3onald?s sign d. =oodell?s sign
____ 1/. A number of "hanges in the integumentary system o""ur during pregnan"y. $hat "hange persists
after birth&
a. Apulis ". .elangie"tasia
b. 4hloasma d. triae gravidarum
____ 13. .he nurse "aring for the pregnant "lient must understand that the hormone essential for maintaining
pregnan"y is;
a. Astrogen.
b. #uman "horioni" gonadotropin )h4=,.
". B!yto"in.
d. +rogesterone.
____ 15. A woman who has "ompleted one pregnan"y with a fetus )or fetuses, rea"hing the stage of fetal
viability is "alled a;
a. +rimipara. ". (ultipara.
b. +rimigravida. d. -ulligravida.
____ 17. .he mu"ous plug that forms in the endo"ervi"al "anal is "alled the;
a. Bper"ulum. ". *uni" souffle.
b. >eu"orrhea. d. 6allottement.
____ 18. .o reassure and edu"ate pregnant "lients about "hanges in their "ardiovas"ular system, maternity
nurses should be aware that;
a. A pregnant woman e!perien"ing disturbed "ardia" rhythm, su"h as sinus
arrhythmia re%uires "lose medi"al and obstetri" observation, no matter how healthy
she otherwise may appear.
b. 4hanges in heart si2e and position and in"reases in blood volume "reate auditory
"hanges from /0 weeks to term.
". +alpitations are twi"e as likely to o""ur in twin gestations.
d. All of the above "hanges likely will o""ur.
____ 1<. ome pregnant "lients may "omplain of "hanges in their voi"e and impaired hearing. .he nurse "an
tell these "lients that these are "ommon rea"tions to;
a. A de"reased estrogen level.
b. 3ispla"ement of the diaphragm, resulting in thora"i" breathing.
". 4ongestion and swelling, whi"h o""ur be"ause the upper respiratory tra"t has
be"ome more vas"ular.
d. 1n"reased blood volume.
____ 18. A first-time mother at 18 weeks of gestation is in for her regularly s"heduled prenatal visit. .he
"lient tells the nurse that she is afraid that she is going into premature labor be"ause she is beginning
to have regular "ontra"tions. .he nurse e!plains that this is the Braxton Hicks sign and tea"hes the
"lient that this type of "ontra"tion;
a. 1s painless. ". 4auses "ervi"al dilation.
b. 1n"reases with walking. d. 1mpedes o!ygen flow to the fetus.
____ 19. A woman arrives at the "lini" for a pregnan"y test. .he first day of her last menstrual period )>(+,
was *ebruary 15, /010. #er e!pe"ted date of birth )A36, would be;
a. eptember 1<, /010. ". -ovember /1, /010.
b. -ovember <, /010. d. 3e"ember 1<, /010.
____ /0. +renatal testing for the human immunodefi"ien"y virus )#1C, is re"ommended for;
a. All women, regardless of risk fa"tors.
b. A woman who has had more than one se!ual partner.
". A woman who has had a se!ually transmitted infe"tion.
d. A woman who is monogamous with her partner.
____ /1. $hi"h symptom is "onsidered a first-trimester warning sign and should be reported immediately by
the pregnant woman to her health "are provider&
a. -ausea with o""asional vomiting ". 'rinary fre%uen"y
b. *atigue d. Caginal bleeding
____ //. $hi"h blood pressure )6+, finding during the se"ond trimester indi"ates a risk for pregnan"y-
indu"ed hypertension&
a. 6aseline 6+ 1/0:80, "urrent 6+ 1/8:87
b. 6aseline 6+ 100:<0, "urrent 6+ 130:87
". 6aseline 6+ 150:87, "urrent 6+ 130:80
d. 6aseline 6+ 110:80, "urrent 6+ 110:80
____ /3. A pregnant woman at 18 weeks of gestation "alls the "lini" to report that she has been e!perien"ing
o""asional ba"ka"hes of mild-to-moderate intensity. .he nurse would re"ommend that she;
a. 3o Degel e!er"ises. ". 'se a softer mattress.
b. 3o pelvi" ro"k e!er"ises. d. tay in bed for /5 hours.
____ /5. *or what reason would breastfeeding be "ontraindi"ated&
a. #epatitis 6
b. Averted nipples
". #istory of breast "an"er 3 years ago
d. #uman immunodefi"ien"y virus )#1C, positive
____ /7. .he nurse should be aware that the partner?s main role in pregnan"y is to;
a. +rovide finan"ial support.
b. +rote"t the pregnant woman from Eold wives? tales.F
". upport and nurture the pregnant woman.
d. (ake sure the pregnant woman keeps prenatal appointments.
____ /8. $hat represents a typi"al progression through the phases of a woman?s establishing a relationship
with the fetus&
a. A""epts the fetus as distin"t from herselfGa""epts the biologi" fa"t of pregnan"y
Ghas a feeling of "aring and responsibility
b. *antasi2es about the "hild?s gender and personalityGviews the "hild as part of
herselfGbe"omes introspe"tive
". Ciews the "hild as part of herselfGhas feelings of well-beingGa""epts the
biologi" fa"t of pregnan"y
d. E1 am pregnant.FG E1 am going to have a baby.FGE1 am going to be a mother.F
____ /<. .he nurse should be aware that the pin"h test is used to;
a. 4he"k the sensitivity of the nipples.
b. 3etermine whether the nipple is everted or inverted.
". 4al"ulate the adipose buildup in the abdomen.
d. ee whether the fetus has be"ome ina"tive.
____ /8. .he phenomenon of someone other than the mother-to-be e!perien"ing pregnan"y-like symptoms
su"h as nausea and weight gain applies to the;
a. (other of the pregnant woman. ". ister of the pregnant woman.
b. 4ouple?s teenage daughter. d. A!pe"tant father.
____ /9. A //-year-old woman pregnant with a single fetus has a pre"on"eption body mass inde! )6(1, of
/5. $hen she was seen in the "lini" at 15 weeks of gestation, she had gained 1.8 kg )5 lb, sin"e
"on"eption. #ow would the nurse interpret this&
a. .his weight gain indi"ates possible gestational hypertension.
b. .his weight gain indi"ates that the woman?s infant is at risk for intrauterine growth
restri"tion )1'=9,.
". .his weight gain "annot be evaluated until the woman has been observed for
several more weeks.
d. .he woman?s weight gain is appropriate for this stage of pregnan"y.
____ 30. $hi"h nutrient?s re"ommended dietary allowan"e )93A, is higher during la"tation than during
pregnan"y&
a. Anergy )k"al, ". Citamin A
b. 1ron d. *oli" a"id
____ 31. A pregnant woman?s diet "onsists almost entirely of whole grain breads and "ereals, fruits, and
vegetables. .he nurse would be most "on"erned about this woman?s intake of;
a. 4al"ium. ". Citamin 61/.
b. +rotein. d. *oli" a"id.
____ 3/. A woman has "ome to the "lini" for pre"on"eption "ounseling be"ause she wants to start trying to get
pregnant in 3 months. he "an e!pe"t the following advi"e;
a. E3is"ontinue all "ontra"eption now.F
b. E>ose weight so that you "an gain more during pregnan"y.F
". EHou may take any medi"ations you have been taking regularly.F
d. E(ake sure that you in"lude ade%uate foli" a"id in your diet.F
____ 33. $omen with an inade%uate weight gain during pregnan"y are at higher risk of giving birth to an
infant with;
a. pina bifida. ". 3iabetes mellitus.
b. 1ntrauterine growth restri"tion. d. 3own syndrome.
____ 35. $ith regard to protein in the diet of pregnant women, nurses should be aware that;
a. (any protein-ri"h foods are also good sour"es of "al"ium, iron, and 6 vitamins.
b. (any women need to in"rease their protein intake during pregnan"y.
". As with "arbohydrates and fat, no spe"ifi" re"ommendations e!ist for the amount
of protein in the diet.
d. #igh-protein supplements "an be used without risk by women on ma"robioti"
diets.
____ 37. 1n assessing the knowledge of a pregestational woman with type 1 diabetes "on"erning "hanging
insulin needs during pregnan"y, the nurse re"ogni2es that further tea"hing is warranted when the
"lient states;
a. E1 will need to in"rease my insulin dosage during the first 3 months of pregnan"y.F
b. E1nsulin dosage will likely need to be in"reased during the se"ond and third
trimesters.F
". EApisodes of hypogly"emia are more likely to o""ur during the first 3 months.F
d. E1nsulin needs should return to normal within < to 10 days after birth if 1 am bottle-
feeding.F
____ 38. 1n planning for the "are of a 30-year-old woman with pregestational diabetes, the nurse re"ogni2es
that the most important fa"tor affe"ting pregnan"y out"ome is the;
a. (other?s age.
b. -umber of years sin"e diabetes was diagnosed.
". Amount of insulin re%uired prenatally.
d. 3egree of gly"emi" "ontrol during pregnan"y.
____ 3<. 1n tea"hing the woman with pregestational diabetes about desired glu"ose levels, the nurse e!plains
that a normal fasting glu"ose level, su"h as before breakfast, is in the range of _____ mg:dl.
a. 80 to 90 ". 1/0 to 170
b. 90 to 1/0 d. 170 to 180
____ 38. 1n terms of the in"iden"e and "lassifi"ation of diabetes, maternity nurses should know that;
a. .ype 1 diabetes is most "ommon.
b. .ype / diabetes often goes undiagnosed.
". =estational diabetes mellitus )=3(, means that the woman will be re"eiving
insulin treatment until 8 weeks after birth.
d. .ype 1 diabetes may be"ome type / during pregnan"y.
____ 39. (etaboli" "hanges throughout pregnan"y that affe"t glu"ose and insulin in the mother and the fetus
are "ompli"ated but important to understand. -urses should know that;
a. 1nsulin "rosses the pla"enta to the fetus only in the first trimester, after whi"h the
fetus se"retes its own.
b. $omen with insulin-dependent diabetes are prone to hypergly"emia during the
first trimester be"ause they are "onsuming more sugar.
". 3uring the se"ond and third trimesters pregnan"y e!erts a diabetogeni" effe"t that
ensures an abundant supply of glu"ose for the fetus.
d. (aternal insulin re%uirements steadily de"line during pregnan"y.
____ 50. $ith regard to the asso"iation of maternal diabetes and other risk situations affe"ting mother and
fetus, nurses should be aware that;
a. 3iabeti" ketoa"idosis )3DA, "an lead to fetal death at any time during pregnan"y.
b. #ydramnios o""urs appro!imately twi"e as often in diabeti" pregnan"ies.
". 1nfe"tions o""ur about as often and are "onsidered about as serious in diabeti" and
nondiabeti" pregnan"ies.
d. Aven mild-to-moderate hypogly"emi" episodes "an have signifi"ant effe"ts on fetal
well-being.
____ 51. An 18-year-old "lient who has rea"hed 18 weeks of gestation was re"ently diagnosed with
pregestational diabetes. he attends her "entering appointment a""ompanied by one of her
girlfriends. .his young woman appears more "on"erned about how her pregnan"y will affe"t her
so"ial life rather than her re"ent diagnosis of diabetes. A number of nursing diagnoses are appli"able
to assist in planning ade%uate "are. .he most appropriate diagnosis at this time is;
a. 9isk for inIury to the fetus related to birth trauma.
b. -on"omplian"e related to la"k of understanding of diabetes and pregnan"y and
re%uirements of the treatment plan.
". 3efi"ient knowledge related to insulin administration.
d. 9isk for inIury to the mother related to hypogly"emia or hypergly"emia.
____ 5/. $hen "aring for a pregnant woman with "ardia" problems, the nurse must be alert for signs and
symptoms of "ardia" de"ompensation, whi"h are;
a. A regular heart rate and hypertension.
b. An in"reased urinary output, ta"hy"ardia, and dry "ough.
". hortness of breath, brady"ardia, and hypertension.
d. 3yspneaJ "ra"klesJ and an irregular, weak pulse.
____ 53. 1n providing nutritional "ounseling for the pregnant woman e!perien"ing "hole"ystitis, the nurse
would;
a. Assess the woman?s dietary history for ade%uate "alories and proteins.
b. 1nstru"t the woman that the bulk of "alories should "ome from proteins.
". 1nstru"t the woman to eat a low-fat diet and avoid fried foods.
d. 1nstru"t the woman to eat a low-"holesterol, low-salt diet.
____ 55. 1n "aring for a pregnant woman with si"kle "ell anemia with in"reased blood vis"osity, the nurse is
"on"erned about the development of a thromboembolism. -ursing "are would in"lude;
a. (onitoring the "lient for a negative #omans? sign.
b. (assaging her "alves when the woman "omplains of pain.
". Applying antiemboli" sto"kings.
d. (aintaining a restri"tion on fluid intake.
____ 57. $ith what heart "ondition is pregnan"y not usually "ontraindi"ated&
a. +eripartum "ardiomyopathy ". #eart transplant
b. Aisenmenger syndrome d. All of these "ontraindi"ate pregnan"y.
____ 58. (arfan syndrome is an autosomal dominant geneti" disorder that displays as weakness of the
"onne"tive tissue, Ioint deformities, o"ular dislo"ation, and weakness to the aorti" wall and root.
$hile providing "are to a "lient with (arfan syndrome during labor, whi"h intervention should the
nurse "omplete first&
a. Antibioti" prophyla!is ". urgery
b.
-6lo"kers
d. 9egional anesthesia
____ 5<. $omen with hyperemesis gravidarum;
a. Are a maIority, be"ause <0K of all pregnant women suffer from it at some time.
b. #ave vomiting severe and persistent enough to "ause weight loss, dehydration, and
ele"trolyte imbalan"e.
". -eed intravenous )1C, fluid and nutrition for most of their pregnan"y.
d. Bften inspire similar, milder symptoms in their male partners and mothers.
____ 58. 6e"ause pregnant women may need surgery during pregnan"y, nurses should be aware that;
a. .he diagnosis of appendi"itis may be diffi"ult, be"ause the normal signs and
symptoms mimi" some normal "hanges in pregnan"y.
b. 9upture of the appendi! is less likely in pregnant women be"ause of the "lose
monitoring.
". urgery for intestinal obstru"tions should be delayed as long as possible be"ause it
usually affe"ts the pregnan"y.
d. $hen pregnan"y takes over, a woman is less likely to have ovarian problems that
re%uire invasive responses.
____ 59. A primigravida is being monitored in her prenatal "lini" for pree"lampsia. $hat finding should
"on"ern her nurse&
a. 6lood pressure )6+, in"rease to 138:88 mm #g
b. $eight gain of 0.7 kg during the past / weeks
". A dipsti"k value of 3L for protein in her urine
d. +itting pedal edema at the end of the day
____ 70. A woman with pree"lampsia has a sei2ure. .he nurse?s primary duty during the sei2ure is to;
a. 1nsert an oral airway.
b. u"tion the mouth to prevent aspiration.
". Administer o!ygen by mask.
d. tay with the "lient and "all for help.
____ 71. A pregnant woman has been re"eiving a magnesium sulfate infusion for treatment of severe
pree"lampsia for /5 hours. Bn assessment the nurse finds the following vital signs; temperature of
3<.3M 4, pulse rate of 88 beats:min, respiratory rate of 10 breaths:min, blood pressure )6+, of 158:90
mm #g, absent deep tendon refle!es, and no ankle "lonus. .he "lient "omplains, E1?m so thirsty and
warm.F .he nurse;
a. 4alls for a stat magnesium sulfate level.
b. Administers o!ygen.
". 3is"ontinues the magnesium sulfate infusion.
d. +repares to administer hydrala2ine.
____ 7/. A woman with severe pree"lampsia has been re"eiving magnesium sulfate by intravenous infusion
for 8 hours. .he nurse assesses the woman and do"uments the following findings; temperature of
3<.1M 4, pulse rate of 98 beats:min, respiratory rate of /5 breaths:min, blood pressure )6+, of
177:11/ mm #g, 3L deep tendon refle!es, and no ankle "lonus. .he nurse "alls the physi"ian,
anti"ipating an order for;
a. #ydrala2ine. ". 3ia2epam.
b. (agnesium sulfate bolus. d. 4al"ium glu"onate.
____ 73. $hat nursing diagnosis would be the most appropriate for a woman e!perien"ing severe
pree"lampsia&
a. 9isk for inIury to the fetus related to uteropla"ental insuffi"ien"y
b. 9isk for e"lampsia
". 9isk for defi"ient fluid volume related to in"reased sodium retention se"ondary to
administration of (gB5
d. 9isk for in"reased "ardia" output related to use of antihypertensive drugs
____ 75. -urses should be aware that #A>>+ syndrome;
a. 1s a mild form of pree"lampsia.
b. 4an be diagnosed by a nurse alert to its symptoms.
". 1s "hara"teri2ed by hemolysis, elevated liver en2ymes, and low platelets.
d. 1s asso"iated with preterm labor but not perinatal mortality.
____ 77. .he perinatal nurse is giving dis"harge instru"tions to a woman, status postsu"tion "urettage
se"ondary to a hydatidiform mole. .he woman asks why she must take oral "ontra"eptives for the
ne!t 1/ months. .he best response from the nurse would be;
a. E1f you get pregnant within 1 year, the "han"e of a su""essful pregnan"y is very
small. .herefore, if you desire a future pregnan"y, it would be better for you to use
the most reliable method of "ontra"eption available.F
b. E.he maIor risk to you after a molar pregnan"y is a type of "an"er that "an be
diagnosed only by measuring the same hormone that your body produ"es during
pregnan"y. 1f you were to get pregnant, it would make the diagnosis of this "an"er
more diffi"ult.F
". E1f you "an avoid a pregnan"y for the ne!t year, the "han"e of developing a se"ond
molar pregnan"y is rare. .herefore, to improve your "han"e of a su""essful
pregnan"y, it is better not to get pregnant at this time.F
d. EBral "ontra"eptives are the only form of birth "ontrol that will prevent a
re"urren"e of a molar pregnan"y.F
____ 78. (ethotre!ate is re"ommended as part of the treatment plan for whi"h obstetri" "ompli"ation&
a. 4omplete hydatidiform mole ". 'nruptured e"topi" pregnan"y
b. (issed abortion d. Abruptio pla"entae
____ 7<. A /8-year-old pregnant woman, gravida /, para 1-0-0-1 is /8 weeks pregnant when she e!perien"es
bright red, painless vaginal bleeding. Bn her arrival at the hospital, what would be an e!pe"ted
diagnosti" pro"edure&
a. Amnio"entesis for fetal lung maturity ". 4ontra"tion stress test )4.,
b. 'ltrasound for pla"ental lo"ation d. 1nternal fetal monitoring
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 78. A woman is in for a routine prenatal "he"kup. Hou are assessing her urine for proteinuria. Hou know
that whi"h findings are "onsidered normal& 4hoose all that apply.
a. 3ipsti"k assessment of tra"e to L1 ". 3ipsti"k assessment of L/
b. N300 mg:/5 hours d. O300 mg:/5 hours
____ 79. A woman has Iust moved to the 'nited tates from (e!i"o. he is 3 months pregnant and has
arrived for her first prenatal visit. 3uring her assessment interview, you dis"over that she has not had
any immuni2ations. $hi"h immuni2ations should she re"eive at this point in her pregnan"y& 4hoose
all that apply.
a. .etanus
b. 3iphtheria
". 4hi"kenpo!
d. 9ubella
e. #epatitis 6
Completion
Complete each statement.
80. A"hieving and maintaining "onstant ____________________, with blood glu"ose levels in the range
of 80 to 1/0 mg:dl, is the primary goal of medi"al therapy for the pregnant woman with diabetes.
.his is a"hieved through a "ombination of diet, insulin, e!er"ise, and blood glu"ose monitoring.
Practice Quesstion for Exam 2
Answer Section
MULTIPLE C!ICE
1. A-; A
An ultrasound e!amination "ould be done to "onfirm the pregnan"y and determine the gestational
age of the fetus. 1t is too early in the pregnan"y to perform the (A*+, an amnio"entesis, or an -..
.he (A*+ is performed at 18 to 18 weeks of gestation, followed by amnio"entesis if the (A*+
levels are abnormal or if fetal:maternal anomalies are dete"ted. An -. is performed to assess fetal
well-being in the third trimester.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; 195
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
/. A-; A
3oppler blood flow analysis allows the e!aminer to study the blood flow noninvasively in the fetus
and the pla"enta. 1t is a helpful tool in the management of high risk pregnan"ies be"ause of
intrauterine growth restri"tion )1'=9,, diabetes mellitus, multiple fetuses, or preterm labor. 6e"ause
of the potential risk of indu"ing labor and "ausing fetal distress, a 4. is not performed on a woman
whose fetus is preterm. 1ndi"ations for an amnio"entesis in"lude diagnosis of geneti" disorders or
"ongenital anomalies, assessment of pulmonary maturity, and the diagnosis of fetal hemolyti"
disease, not 1'=9. *etal ki"k "ount monitoring is performed to monitor the fetus in pregnan"ies
"ompli"ated by "onditions that may affe"t fetal o!ygenation. Although this may be a useful tool at
some point later in this woman?s pregnan"y, it is not used to diagnose 1'=9.
+.; 1 31*; 4ognitive >evel; Analysis 9A*; 198
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e
.B+; -ursing +ro"ess; Assessment, 3iagnosis
3. A-; 6
9eal-time ultrasound permits detailed assessment of the physi"al and physiologi" "hara"teristi"s of
the developing fetus and "ataloging of normal and abnormal biophysi"al responses to stimuli. .he
6++ is a noninvasive, dynami" assessment of a fetus that is based on a"ute and "hroni" markers of
fetal disease. An ultrasound for fetal anomalies would most likely have o""urred earlier in the
pregnan"y. 1t is too late in the pregnan"y to perform an (A*+. *urthermore, it does not provide
information related to fetal well-being. 1ndi"ations for +'6 in"lude prenatal diagnosis or inherited
blood disorders, karyotyping of malformed fetuses, dete"tion of fetal infe"tion, determination of the
a"id-base status of the fetus with 1'=9, and assessment and treatment of isoimmuni2ation and
thrombo"ytopenia in the fetus.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; 198, 199
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e
.B+; -ursing +ro"ess; Assessment, 3iagnosis
5. A-; 4
Amnio"entesis would be performed to assess fetal lung maturity in the event of a preterm birth.
1ndi"ations for +'6 in"lude prenatal diagnosis or inherited blood disorders, karyotyping of
malformed fetuses, dete"tion of fetal infe"tion, determination of the a"id-base status of the fetus with
intrauterine growth restri"tion, and assessment and treatment of isoimmuni2ation and
thrombo"ytopenia in the fetus. .ypi"ally fetal si2e is determined by ultrasound during the se"ond
trimester and is not indi"ated in this s"enario. A nonstress test measures the fetal response to fetal
movement in a non"ontra"ting mother.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /0/
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Avaluation
7. A-; 3
An ultrasound is the method of biophysi"al assessment of the infant that would be performed at this
gestational age. A biophysi"al profile would be a method of biophysi"al assessment of fetal well-
being in the third trimester. An amnio"entesis is performed after the fourteenth week of pregnan"y.
An (A*+ test is performed from week 17 to week // of the gestation )weeks 18 to 18 are ideal,.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; 195
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; +lanning
8. A-; A
Ade%uate uterine a"tivity ne"essary for a 4. "onsists of the presen"e of three "ontra"tions in a 10-
minute time frame. 1f no de"elerations are observed in the *#9 pattern with the "ontra"tions, the
findings are "onsidered to be negative. A positive 4. indi"ates the presen"e of repetitive later *#9
de"elerations. Satisfactory and unsatisfactory are not appli"able terms.
+.; 1 31*; 4ognitive >evel; Analysis 9A*; /08
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e
.B+; -ursing +ro"ess; Assessment, 3iagnosis
<. A-; 4
.he "orre"t "al"ulation of this woman?s gravidity and parity is 3-1-0-1-0.
'sing the =+.A> system e!plained in %uestion 1, this "lient?s gravidity and parity information is
"al"ulated as follows;
G: .otal number of times the woman has been pregnant )she is pregnant for the third time,
: -umber of pregnan"ies "arried to term )she has had only one pregnan"y that resulted in a fetus at
term,
!: -umber of pregnan"ies that resulted in a preterm birth )none,
": Abortions or mis"arriages before the period of viability )she has had one,
#: -umber of "hildren born who are "urrently living )she has no living "hildren,
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /11
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; 3iagnosis
8. A-; A
Amenorrhea is a presumptive sign of pregnan"y. +resumptive signs of pregnan"y are those felt by
the woman. A positive pregnan"y test, the presen"e of 4hadwi"k?s sign, and the presen"e of #egar?s
sign would all be probable signs of pregnan"y.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /13
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
9. A-; 6
+ositive signs of pregnan"y are those that are attributed to the presen"e of a fetus, su"h as hearing
the fetal heartbeat or palpating fetal movement. A positive pregnan"y test and 6ra!ton #i"ks
"ontra"tions would be probable signs of pregnan"y. @ui"kening would be a presumptive sign of
pregnan"y.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /13
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; +lanning
10. A-; 6
1n normal pregnan"ies the uterus grows at a predi"table rate. 1t may be palpated above the symphysis
pubis sometime between the twelfth and fourteenth weeks of pregnan"y. As the uterus grows, it may
be palpated above the symphysis pubis sometime between the twelfth and fourteenth weeks of
pregnan"y. .he uterus rises gradually to the level of the umbili"us at // to /5 weeks of gestation.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /13
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
11. A-; A
At appro!imately 8 weeks of gestation, softening and "ompressibility of the lower uterine segment
o""urJ this is "alled He$ar%s si$n. ("3onald?s sign indi"ates a fast food restaurant. 4hadwi"k?s sign
is the blue-violet "oloring of the "ervi! "aused by in"reased vas"ularityJ this o""urs around the
fourth week of gestation. oftening of the "ervi"al tip is "alled =oodell?s sign, whi"h may be
observed around the si!th week of pregnan"y.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /13
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e
.B+; -ursing +ro"ess; Assessment, 1mplementation
1/. A-; 3
triae gravidarum, or stret"h marks, refle"t separation within the underlying "onne"tive tissue of the
skin. After birth they usually fade, although they never disappear "ompletely. An epulis is a red,
raised nodule on the gums that bleeds easily. 4hloasma, or mask of pregnan"y, is a blot"hy, brown
hyperpigmentation of the skin over the "heeks, nose, and forehead, espe"ially in dark-"omple!ioned
pregnant women. 4hloasma usually fades after the birth. .elangie"tasia, or vas"ular spiders, are tiny,
star-shaped or bran"hlike, slightly raised, pulsating end-arterioles usually found on the ne"k, thora!,
fa"e, and arms. .hey o""ur as a result of elevated levels of "ir"ulating estrogen. .hese usually
disappear after birth.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; //3
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; +lanning
13. A-; 3
+rogesterone is essential for maintaining pregnan"yJ it does so by rela!ing smooth mus"les. .his
redu"es uterine a"tivity and prevents mis"arriage. Astrogen plays a vital role in pregnan"y, but it is
not the primary hormone for maintaining pregnan"y. h4= levels rise at implantation but de"line after
80 to <0 days. B!yto"in stimulates uterine "ontra"tions.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /3<
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
15. A-; A
A primipara is a woman who has "ompleted one pregnan"y with a viable fetus. .o remember terms,
keep in mind; $ra&ida is a pregnant womanJ para "omes from parity' meaning a viable fetusJ primi
means firstJ multi means manyJ and null means none. A primi$ra&ida is a woman pregnant for the
first time. A multipara is a woman who has "ompleted two or more pregnan"ies with a viable fetus.
A nulli$ra&ida is a woman who has never been pregnant.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /10
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; 3iagnosis
17. A-; A
.he oper"ulum prote"ts against ba"terial invasion. >eu"orrhea is the mu"us that forms the
endo"ervi"al plug )the oper"ulum,. .he funi" souffle is the sound of blood flowing through the
umbili"al vessels. 6allottement is a te"hni%ue for palpating the fetus.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; /18
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; Assessment
18. A-; 6
Aus"ultatory "hanges should be dis"ernible after /0 weeks of gestation. A healthy woman with no
underlying heart disease does not need any therapy. .he maternal heart rate in"reases in the third
trimester, but palpitations may not ne"essarily o""ur, let alone double. Auditory "hanges are
dis"ernible at /0 weeks.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /18
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; +lanning
1<. A-; 4
Astrogen levels in"rease, "ausing the upper respiratory tra"t to be"ome more vas"ularJ thus produ"es
swelling and "ongestion in the nose and ears and therefore voi"e "hanges and impaired hearing. .he
diaphragm is displa"ed and the volume of blood is in"reased. #owever, the main "on"ern is
in"reased estrogen levels.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; //1
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; +lanning
18. A-; A
oon after the fourth month of gestation uterine "ontra"tions "an be felt through the abdominal wall.
6ra!ton #i"ks "ontra"tions are regular and painless and "ontinue throughout the pregnan"y.
Although they are not painful, some women "omplain that they are annoying. 6ra!ton #i"ks
"ontra"tions usuall "eases with walking or e!er"ise. .hey "an be mistaken for true laborJ however,
they do not in"rease in intensity, fre%uen"y, or "ause "ervi"al dilation. 1n addition, they fa"ilitate
uterine blood flow through the intervillous spa"es of the pla"enta and thereby promote o!ygen
delivery to the fetus.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /13, /15
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; +lanning
19. A-; 4
'sing -Qgele?s rule, -ovember /1, /010, is the "orre"t e!pe"ted date of birth. .he A36 is
"al"ulated by subtra"ting 3 months from the first day of the >(+ and adding < days L 1 year to the
day of the >(+. .herefore, with an >(+ of *ebruary 15, /010;
*ebruary 15, /010 R 3 months S -ovember 15, /009 L < days S -ovember /1, /009 L 1 year S
-ovember /1, /010
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; /30
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
/0. A-; A
.esting for the antibody to #1C is strongly re"ommended for all pregnant women. An #1C test is
re"ommended for all women, regardless of risk fa"tors. .he in"iden"e of perinatal transmission from
an #1C-positive mother to her fetus ranges from /7K to 37K. $omen who test positive for #1C "an
then be treated.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /51
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; +lanning
/1. A-; 3
igns and symptoms that must be reported in"lude severe vomiting, fever and "hills, burning on
urination, diarrhea, abdominal "ramping, and vaginal bleeding. .hese symptoms may be signs of
potential "ompli"ations of the pregnan"y. -ausea with o""asional vomiting, fatigue, and urinary
fre%uen"y are normal first-trimester "omplaints. Although they may be worrisome or annoying to the
mother, they usually are not indi"ations of pregnan"y problems.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /53
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; +lanning
//. A-; 6
An in"rease in the systoli" 6+ of 30 mm #g or more over the baseline pressure or an in"rease in the
diastoli" 6+ of 17 mm #g or more over the baseline pressure is a signifi"ant finding, regardless of
the absolute values. A "urrent 6+ of 130:87 indi"ates that su"h in"reases have o""urred in both the
diastoli" and systoli" pressures. A slight in"rease in 6+ of 1/8:87 does not meet the "riteria for
"on"ern. Although the baseline 6+ is worrisome )an absolute systoli" 6+ of 150 mm #g or higher or
a diastoli" 6+ of 90 mm #g or higher suggests hypertension,, the subse%uent pressures have
de"reased, not in"reased. .he 6+ of 110:80 is within normal limits for both values and is not a
"on"ern.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; /53
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; 3iagnosis
/3. A-; 6
+elvi" ro"k e!er"ises may help stret"h and strengthen the abdominal and lower ba"k mus"les and
relieve low ba"k pain. Degel e!er"ises in"rease the tone of the pelvi" area, not the ba"k. A softer
mattress may not provide the support needed to maintain proper alignment of the spine and may
"ontribute to ba"k pain. tret"hing and other e!er"ises to relieve ba"k pain should be performed
several times a day.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; /59, /78
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
/5. A-; 3
$omen who are #1C positive are dis"ouraged from breastfeeding. Although hepatitis 6 antigen has
not been shown to be transmitted through breast milk, as an added pre"aution infants born to
#6sAg-positive women should re"eive the hepatitis 6 va""ine and immune globulin immediately
after birth. Averted nipples are fun"tional for breastfeeding. -ewly diagnosed breast "an"er would be
a "ontraindi"ation to breastfeeding.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /58
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
/7. A-; 4
.he partner?s main role in pregnan"y is to nurture the pregnant woman and respond to her feelings of
vulnerability. 1n older so"ieties the man ena"ted the ritual cou&ade. 4hanging "ultural and
professional attitudes have en"ouraged fathers? parti"ipation in the birth e!perien"e over the past 30
years.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /33
B6P; 4lient -eeds; +sy"hoso"ial 1ntegrity .B+; -ursing +ro"ess; Assessment
/8. A-; 3
.he woman first "enters on herself as pregnant, then on the baby as an entity separate from herself,
and then on her responsibilities as a mother. .he e!pressions, E1 am pregnant,F E1 am going to have a
baby,F and E1 am going to be a motherF sum up the progression through the three phases.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; /3/
B6P; 4lient -eeds; +sy"hoso"ial 1ntegrity .B+; -ursing +ro"ess; 3iagnosis
/<. A-; 6
.he pin"h test is used to determine whether the nipple is everted or inverted. -ipples must be
everted to allow breastfeeding.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; /5<
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
/8. A-; 3
An e!pe"tant father?s e!perien"ing of his partner?s pregnan"y-like symptoms is "alled the cou&ade
syndrome.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; /33
B6P; 4lient -eeds; +sy"hoso"ial 1ntegrity .B+; -ursing +ro"ess; 3iagnosis
/9. A-; 3
.he woman?s weight gain is appropriate for this stage of pregnan"y is an a""urate statement. .his
woman?s 6(1 is in the normal range. 3uring the first trimester the average total weight gain is only
1 to /.7 kg. Although weight gain does indi"ate possible gestational, it does not apply to this "lient.
.he desirable weight gain during pregnan"y varies among women. .he primary fa"tor to "onsider in
making a weight gain re"ommendation is the appropriateness of the prepregnan"y weight for the
woman?s height. A "ommonly used method of evaluating the appropriateness of weight for height is
the 6(1. .his woman has gained the appropriate amount of weight for her si2e at this point in her
pregnan"y. Although weight gain does indi"ate risk for 1'=9, it does not apply to this "lient. .he
desirable weight gain during pregnan"y varies among women. .he primary fa"tor to "onsider in
making a weight gain re"ommendation is the appropriateness of the prepregnan"y weight for the
woman?s height. A "ommonly used method of evaluating the appropriateness of weight for height is
the 6(1. .his woman has gained the appropriate amount of weight for her si2e at this point in her
pregnan"y. $eight gain should take pla"e throughout the pregnan"y. .he optimal rate of weight gain
depends on the stage of the pregnan"y.
+.; 1 31*; 4ognitive >evel; Analysis 9A*; /<<, /81
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
30. A-; A
-eeds for energy, protein, "al"ium, iodine, 2in", the 6 vitamins, and vitamin 4 remain greater than
nonpregnant needs.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; /87
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; +lanning
31. A-; 4
.his diet is "onsistent with that followed by a stri"t vegetarian )vegan,. Cegans "onsume only plant
produ"ts. 6e"ause vitamin 61/ is found in foods of animal origin, this diet is defi"ient in vitamin 61/.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; /93
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; Assessment
3/. A-; 3
A healthy diet before "on"eption is the best way to ensure that ade%uate nutrients are available for
the developing fetus. A woman?s folate or foli" a"id intake is of parti"ular "on"ern in the
peri"on"eption period. -eural tube defe"ts are more "ommon in infants of women with a poor foli"
a"id intake. 3epending on the type of "ontra"eption used, dis"ontinuing all "ontra"eption may not be
an a""urate statement. >osing weight is not appropriate advi"e. 3epending on the type of medi"ation
the woman is taking, "ontinuing its use may not be an a""urate statement.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; /85
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; +lanning
33. A-; 6
6oth normal-weight and underweight women with inade%uate weight gain have an in"reased risk of
giving birth to an infant with intrauterine growth restri"tion. pina bifida, diabetes mellitus, and
3own syndrome are not asso"iated with inade%uate maternal weight gain.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /<<
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
35. A-; A
=ood protein sour"es su"h as meat, milk, eggs, and "heese have a lot of "al"ium and iron. (ost
women already eat a high-protein diet and do not need to in"rease their intake. +rotein is suffi"iently
important that spe"ifi" servings of meat and dairy are re"ommended. #igh-protein supplements are
not re"ommended be"ause they have been asso"iated with an in"reased in"iden"e of preterm births.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; /<9
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; +lanning
37. A-; A
1nsulin needs are redu"ed in the first trimester be"ause of in"reased insulin produ"tion by the
pan"reas and in"reased peripheral sensitivity to insulin. E1nsulin dosage will likely need to be
in"reased during the se"ond and third trimesters,F EApisodes of hypogly"emia are more likely to
o""ur during the first 3 months,F and E1nsulin needs should return to normal within < to 10 days after
birth if 1 am bottle-feedingF are a""urate statements and signify that the woman has understood the
tea"hings regarding "ontrol of her diabetes during pregnan"y.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; /9<
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; Avaluation
38. A-; 3
$omen with e!"ellent glu"ose "ontrol and no blood vessel disease should have good pregnan"y
out"omes.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /98
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; +lanning
3<. A-; A
.arget glu"ose levels during a fasting period are 80 to 90 mg:dl. A glu"ose level of 90 to 1/0 mg:dl
is "onsistent with e!pe"ted levels at bedtime. A glu"ose level of 1/0 to 170 mg:dl is "onsidered
elevated for a fasting glu"ose level. A glu"ose level of 170 to 180 mg:dl is "onsidered elevated for a
fasting glu"ose level and indi"ates poor gly"emi" "ontrol.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; 301
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
38. A-; 6
.ype / often goes undiagnosed be"ause hypergly"emia develops gradually and often is not severe.
.ype /, sometimes "alled adult onset diabetes' is the most "ommon. =3( refers to any degree of
glu"ose intoleran"e first re"ogni2ed during pregnan"y. 1nsulin may or may not be needed. +eople do
not go ba"k and forth between types 1 and / diabetes.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; /98
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; Assessment
39. A-; 4
+regnant women develop in"reased insulin resistan"e during the se"ond and third trimesters. 1nsulin
never "rosses the pla"entaJ the fetus starts making its own around the tenth week. As a result of
normal metaboli" "hanges during pregnan"y, insulin-dependent women are prone to hypogly"emia
)low levels,. (aternal insulin re%uirements may double or %uadruple by the end of pregnan"y.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /9<
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; Assessment
50. A-; A
+rompt treatment of 3DA is ne"essary to save the fetus and the mother. #ydramnios o""urs 10 times
more often in diabeti" pregnan"ies. 1nfe"tions are more "ommon and more serious in pregnant
women with diabetes. (ild-to-moderate hypogly"emi" episodes do not appear to have signifi"ant
effe"ts on fetal well-being.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /99
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; +lanning
51. A-; 6
6efore a treatment plan is developed or goals for the out"ome of "are are outlined, this "lient must
"ome to an understanding of diabetes and the potential effe"ts on her pregnan"y. he appears to have
greater "on"ern for "hanges to her so"ial life than adoption of a new self-"are regimen. 9isk for
inIury to the fetus related to either pla"ental insuffi"ien"y or birth trauma may "ome mu"h later in
the pregnan"y. At this time the "lient is having diffi"ulty a"knowledging the adIustments that she
needs to make to her lifestyle to "are for herself during pregnan"y. .he "lient may not yet be on
insulin. 1nsulin re%uirements in"rease with gestation. .he importan"e of gly"emi" "ontrol must be
part of health tea"hing for this "lient. #owever, she has not yet a"knowledged that "hanges to her
lifestyle need to be made and may not parti"ipate in the plan of "are until understanding takes pla"e.
+.; 1 31*; 4ognitive >evel; Analysis 9A*; /98
B6P; 4lient -eeds; +sy"hoso"ial 1ntegrity .B+; -ursing +ro"ess; 3iagnosis
5/. A-; 3
igns of "ardia" de"ompensation in"lude dyspneaJ "ra"klesJ an irregular, weak, rapid pulseJ rapid
respirationsJ a moist, fre%uent "oughJ generali2ed edemaJ in"reasing fatigueJ and "yanosis of the lips
and nail beds. A regular heart rate and hypertension are not generally asso"iated with "ardia"
de"ompensation. .a"hy"ardia would indi"ate "ardia" de"ompensation, but in"reased urinary output
and a dry "ough would not. hortness of breath would indi"ate "ardia" de"ompensation, but
brady"ardia and hypertension would not.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; 318
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; Assessment
53. A-; 4
1nstru"ting the woman to eat a low-fat diet and avoid fried foods is appropriate nutritional
"ounseling for this "lient. 4alori" and protein intake do not predispose a woman to the development
of "hole"ystitis. .he woman should be instru"ted to limit protein intake and "hoose foods that are
high in "arbohydrates. A low-"holesterol diet may be the result of limiting fats. #owever, a low-salt
diet is not indi"ated.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; 3/7
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; 1mplementation
55. A-; 4
Applying antiemboli" sto"kings would be an appropriate nursing a"tion. .he nurse would monitor
the "lient for #omans? sign. (assaging the "alves is not appropriate be"ause this may dislodge a
thromboembolism into the bloodstream )if one is present,. Appropriate nursing "are would in"lude
maintaining ade%uate hydration, not restri"ting fluid intake.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; 3/3
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; 1mplementation
57. A-; 4
+regnan"y is "ontraindi"ated for peripartum "ardiomyopathy and Aisenmenger syndrome. $omen
who have had heart transplants are su""essfully having babies. #owever, "on"eption should be
postponed for at least 1 year after transplantation.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; 315
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
58. A-; A
6e"ause of the potential for "ardia" involvement during the third trimester and after birth, treatment
with prophyla"ti" antibioti"s is highly re"ommended. -6lo"kers and restri"ted a"tivity are
re"ommended as treatment modalities earlier in the pregnan"y. 9egional anesthesia is well tolerated
by "lients with (arfan syndromeJ however, it is not essential to "are. Ade%uate labor support may be
all that is ne"essary if an epidural is not part of the woman?s birth plan. urgery for "ardiovas"ular
"hanges su"h as mitral valve prolapse, aorti" regurgitation, root dilation, or disse"tion may be
ne"essary. (ortality rates may be as high as 70K in women who have severe "ardia" disease.
+.; 1 31*; 4ognitive >evel; Analysis 9A*; 315
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; 1mplementation
5<. A-; 6
$omen with hyperemesis gravidarum have severe vomitingJ however, treatment for several days
sets things right in most "ases. Although <0K of pregnant women e!perien"e nausea and vomiting,
fewer than 1K pro"eed to this severe level. 1C administration may be used at first to restore fluid
levels, but they are seldom needed for very long. $omen suffering from this "ondition want
sympathy, be"ause some authorities believe that diffi"ult relationships with mothers and:or partners
may be the "ause.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; 359
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; Assessment
58. A-; A
6oth appendi"itis and pregnan"y are linked with nausea, vomiting, and in"reased white blood "ell
"ount. 9upture of the appendi! is two to three times more likely in pregnant women. urgery to
remove obstru"tions should be done right away. 1t usually does not affe"t the pregnan"y. +regnan"y
predisposes a woman to ovarian problems.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; 388
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; Assessment
59. A-; 4
+roteinuria is defined as a "on"entration of 1L or greater via dipsti"k measurement. A dipsti"k value
of 3L should alert the nurse that additional testing or assessment should be made. =enerally
hypertension is defined as a 6+ of 150:90 or an in"rease in systoli" pressure of 30 mm #g or 17 mm
#g diastoli" pressure. +ree"lampsia may be manifested as a rapid weight gain of more than / kg in 1
week. Adema o""urs in many normal pregnan"ies and in women with pree"lampsia. .herefore the
presen"e of edema is no longer "onsidered diagnosti" of pree"lampsia.
+.; 1 31*; 4ognitive >evel; Analysis 9A*; 337, 338
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; 3iagnosis
70. A-; 3
1f a "lient be"omes e"lampti", the nurse should stay with him or her and "all for help.
1nsertion of an oral airway during sei2ure a"tivity is no longer the standard of "are. .he nurse should
attempt to keep the airway patent by turning the "lient?s head to the side to prevent aspiration. Bn"e
the sei2ure has ended, it may be ne"essary to su"tion the "lient?s mouth. B!ygen would be
administered after the "onvulsion has ended.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; 35<
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; 1mplementation
71. A-; 4
.he "lient is displaying "lini"al signs and symptoms of magnesium to!i"ity. (agnesium should be
dis"ontinued immediately. 1n addition, "al"ium glu"onate, the antidote for magnesium, may be
administered. #ydrala2ine is an antihypertensive "ommonly used to treat hypertension in severe
pree"lampsia. .ypi"ally it is administered for a systoli" 6+ over 180 mm #g or a diastoli" 6+ over
110 mm #g.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; 350
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; 1mplementation
7/. A-; A
#ydrala2ine is an antihypertensive "ommonly used to treat hypertension in severe pree"lampsia.
.ypi"ally it is administered for a systoli" 6+ over 180 mm #g or a diastoli" 6+ over 110 mm #g. An
additional bolus of magnesium sulfate may be ordered for in"reasing signs of "entral nervous system
irritability related to severe pree"lampsia )e.g., "lonus, or if e"lampsia develops. 3ia2epam
sometimes is used to stop or shorten e"lampti" sei2ures. 4al"ium glu"onate is used as the antidote
for magnesium sulfate to!i"ity. .he "lient is not "urrently displaying any signs or symptoms of
magnesium to!i"ity.
+.; 1 31*; 4ognitive >evel; Analysis 9A*; 358
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; +lanning
73. A-; A
(isk for in)ury to the fetus related to uteroplacental insufficiency is the most appropriate nursing
diagnosis for this "lient s"enario. Bther diagnoses in"lude risk to fetus related to preterm birth and
abruptio pla"entae. A"lampsia is a medi"al, not a nursing, diagnosis. .here would be a risk for
e!"ess, not defi"ient, fluid volume related to in"reased sodium retention. .here would be a risk for
de"reased, not in"reased, "ardia" output related to the use of antihypertensive drugs.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; 338
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; 3iagnosis
75. A-; 4
.he a"ronym #A>>+ stands for hemolysis )#,, elevated liver en2ymes )A>,, and low platelets )>+,.
#A>>+ syndrome is a variant of severe pree"lampsia. #A>>+ syndrome is diffi"ult to identify
be"ause the symptoms often are not obvious. 1t must be diagnosed in the laboratory. +reterm labor is
greatly in"reased and so is perinatal mortality.
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; 338
B6P; 4lient -eeds; +hysiologi" 1ntegrity
.B+; -ursing +ro"ess; 3iagnosis, +lanning
77. A-; 6
.his is an a""urate statement. -human "horioni" gonadotropin )h4=, levels will be drawn for 1
year to ensure that the mole is "ompletely gone. .here is an in"reased "han"e of developing
"horio"ar"inoma after the development of a hydatidiform mole. .he goal is to a"hieve a E2eroF h4=
level. 1f the woman were to be"ome pregnant, it may obs"ure the presen"e of the potentially
"ar"inogeni" "ells. $omen should be instru"ted to use birth "ontrol for 1 year after treatment for a
hydatidiform mole. .he rationale for avoiding pregnan"y for 1 year is to ensure that "ar"inogeni"
"ells are not present. Any "ontra"eptive method e!"ept an intrauterine devi"e is a""eptable.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; 379
B6P; 4lient -eeds; +hysiologi" 1ntegrity
.B+; -ursing +ro"ess; +lanning, 1mplementation
78. A-; 4
(ethotre!ate is an effe"tive, nonsurgi"al treatment option for a hemodynami"ally stable woman
whose e"topi" pregnan"y is unruptured and less than 5 "m in diameter. (ethotre!ate is not indi"ated
or re"ommended as a treatment option for "omplete hydatidiform mole, missed abortion, and
abruptio pla"entae.
+.; 1 31*; 4ognitive >evel; Dnowledge 9A*; 37<
B6P; 4lient -eeds; +hysiologi" 1ntegrity .B+; -ursing +ro"ess; +lanning
7<. A-; 6
.he presen"e of painless bleeding should always alert the health "are team to the possibility of
pla"enta previa. .his "an be "onfirmed through ultrasonography. Amnio"entesis would not be
performed on a woman who is e!perien"ing bleeding. 1n the event of an imminent delivery, the fetus
would be presumed to have immature lungs at this gestational age, and the mother would be given
"orti"osteroids to aid in fetal lung maturity. A 4. would not be performed at a preterm gestational
age. *urthermore, bleeding would be a "ontraindi"ation to this test. 1nternal fetal monitoring would
be "ontraindi"ated in the presen"e of bleeding.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; 383
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
MULTIPLE RESP!"SE
78. A-; A, 6
mall amounts of protein in the urine are a""eptable during pregnan"y. .he presen"e of protein in
greater amounts may indi"ate renal problems. A dipsti"k assessment of L/ and O300 mg:/5 hours are
e!"essive amounts of protein in the urine and should be evaluated further.
+.; 1 31*; 4ognitive >evel; Appli"ation 9A*; //3
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; Assessment
79. A-; A, 6, A
1mmuni2ation with live or attenuated live viruses is "ontraindi"ated during pregnan"y be"ause of its
potential teratogeni"ity. Ca""ines "onsisting of killed viruses may be used. .hose that may be
administered during pregnan"y in"lude tetanus, diphtheria, re"ombinant hepatitis 6, and rabies
va""ines.
>ive-virus va""ines in"lude those for measles )rubeola and rubella,, "hi"kenpo!, and mumps.
+.; 1 31*; 4ognitive >evel; Analysis 9A*; /7/
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e .B+; -ursing +ro"ess; 1mplementation
C!MPLETI!"
80. A-; Augly"emia
+.; 1 31*; 4ognitive >evel; 4omprehension 9A*; /99
B6P; 4lient -eeds; #ealth +romotion and (aintenan"e
.B+y; -ursing +ro"ess; +lanning, 1mplementation