Ricci Chapter 20 - Test Bank - 4th Edition
1. 1. The nurse is teaching a pregnant woman with
type 1 diabetes about her diet during pregnancy.
Which client statement indicates that the nurse's
teaching was successful?
A. "I'll basically follow the same diet that I was following
before I became
4. Assessment of a pregnant woman and her fetus
reveals tachycardia and hypertension. There is also
evidence suggesting vasoconstriction. The nurse would
question the woman about use of which substance?
A. marijuana
B. alcohol
C. heroin
pregnant."
D. cocaine:
B. "Because I need extra protein, I'll have to increase my
intake of milk and
5. When teaching a class of pregnant women about the
effects of substance use duringpregnancy, the nurse
would include which effect?
meat."
C. "Pregnancy affects insulin production, so I'll need to
make adjustments
A. low-birthweight infants
B. excessive weight gain
in my diet."
C. higher pain tolerance
D. "I'll adjust my diet and insulin based on the results of
my urine tests for
D. longer gestational periods: Answer: A
glucose
2. A pregnant woman with diabetes at 10 weeks'
gestation has a glycosylated hemoglobin
(HbA1c) level of 13%. At this time the nurse should be
most concerned about which possiblefetal outcome?
A. congenital anomalies
B. incompetent cervix
C. placenta previa
D. placental abruption (abruptio placentae):
3. A nurse is conducting a review class for a group of
perinatal nurses working at the local clinic.The clinic
sees a high population of women who are HIV positive.
After discussing the recommendations for
antiretroviral therapy with the group, the nurse
determines that the teaching was successful when the
group identifies which rationale as the underlying
principle for the therapy?
A. reduction in viral loads in the blood
2 / 18
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Rationale: Substance use during pregnancy is associated
with low birth weight
infants, preterm
labor, abortion, intrauterine growth restriction, abruptio
placentae, neurobehavioral
abnormalities, and long-term childhood developmental
consequences. Excessive
weight gain,
higher pain tolerance, and longer gestational periods
are not associated with
substance use.
6. 6. A client who is HIV-positive is in her second
trimester and remains
asymptomatic. She voices
B. treatment of opportunistic infections
concern about her newborn's risk for the infection.
Which statement by the
C. adjunct therapy to radiation and chemotherapy
nurse would be most
D. can cure acute HIV/AIDS infections:
appropriate?
A. "You'll probably have a cesarean birth to prevent
exposing your newborn."
weeks until 28 weeks' gestation and then weekly to
allow for frequent maternal and
B. "Antibodies cross the placenta and provide immunity
to the newborn."
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C. "Wait until after the infant is born, and then
something can be done."
D. "Antiretroviral medications are available to help
reduce the risk of transmission.": Answer: D
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fetal
surveillance.
Rationale: Drug therapy is the mainstay of treatment for
pregnant women infected
8. 8. A woman with a history of asthma comes to the
clinic for evaluation for
with HIV. The
pregnancy. The
goal of therapy is to reduce the viral load as much as
possible; this reduces the
woman's pregnancy test is positive. When reviewing the
woman's medication therapy regimen
risk of
for asthma, which medication would the nurse identify
as problematic for the
transmission to the fetus. Decisions about the method
of birth should be based on
woman now that
the woman's
she is pregnant?
viral load, duration of ruptured membranes, progress of
labor, and other pertinent
A. ipratropium
clinical factors.
B. albuterol
C. salmeterol
The newborn is at risk for HIV because of potential
perinatal transmission. Waiting
D. Prednisone: Answer: D
until after
Rationale: Oral corticosteroids such as prednisone are
not preferred for the
the infant is born may be too late.
7. 7. When preparing a schedule of follow-up visits for a
pregnant woman
with chronic
hypertension, which schedule would be most
appropriate?
A. monthly visits until 32 weeks, then bi-monthly visits
long-term treatment
of asthma during pregnancy. Inhaled steroids are the
choice for maintenance
medications to
reduce inflammation that leads to bronchospasm.
Common ones prescribed include
B. bi-monthly visits until 28 weeks, then weekly visits
beclomethasone and salmeterol. Rescue agents such as
albuterol or ipratropium
C. monthly visits until 20 weeks, then bi-monthly visits
provide
D. bi-monthly visits until 36 weeks, then weekly visits:
Answer: B
immediate symptomatic relief by reducing acute
bronchospasm.
Rationale: For the woman with chronic hypertension,
antepartum visits typically
9. 9. A pregnant woman is diagnosed with irondeficiency anemia and is
occur every 2
prescribed an iron
abusing alcohol. Which
supplement. After teaching her about her prescribed
iron supplement, which
newborn finding would provide additional evidence to
support this suspicion?
statement indicates
A. wide, large eyes
successful teaching?
B. thin upper lip
A. "I should take my iron with milk."
C. protruding jaw
B. "I should avoid drinking orange juice."
D. elongated nose: Answer: B
C. "I need to eat foods high in fiber."
Rationale: Newborn characteristics suggesting fetal
alcohol spectrum disorder
D. "I'll call the primary care provider if my stool is black
and tarry.": Answer:
C
Rationale: Iron supplements can lead to constipation, so
the woman needs to
increase her intake
of fluids and high-fiber foods. Milk inhibits absorption
and should be discouraged.
include thin upper
lip, small head circumference, small eyes, receding jaw,
and short nose. Other
features include a
low nasal bridge, short palpebral fissures, flat midface,
epicanthal folds, and minor
ear
Vitamin Ccontaining
abnormalities.
fluids such as orange juice are encouraged because they
promote absorption.
11. 11. After teaching a group of nurses working at the
women's health clinic
Ideally
about the impact of
the woman should take the iron on an empty stomach
to improve absorption, but
pregnancy on the older woman, which statement by the
group indicates that
4 / 18
the teaching was
Ricci Chapter 20 - Test Bank - 4th Edition
successful?
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A. "The majority of women who become pregnant over
age 35 experience
many women
cannot tolerate the gastrointestinal discomfort it causes.
In such cases, the woman
should take it
with meals. Iron typically causes the stool to become
black and tarry; there is no
need for the
complications."
B. "Women over the age of 35 who become pregnant
require a specialized
type of assessment."
C. "Women over age 35 and are pregnant have an
increased risk for spontaneous abortions."
woman to notify her primary care provider.
D. "Women over age 35 are more likely to have a
substance use disorder.": -
10. 10. The nurse is assessing a newborn of a woman
who is suspected of
Answer: C
Rationale: Whether childbearing is delayed by choice or
by chance, women starting
successful when the group identifies which infection as
being responsible
a family at
for ophthalmia
age 35 or older are not doing so without risk. Women in
this age group may already
neonatorum?
have chronic health conditions that can put the
pregnancy at risk. In addition,
numerous studies have shown
5 / 18
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that increasing maternal age is a risk factor for infertility
and spontaneous abortions, gestational
A. syphilis
B. gonorrhea
C. chlamydia
D. HPV: Answer: B
Rationale: Infection with gonorrhea during pregnancy
can cause ophthalmia
neonatorum in the
newborn from birth through an infected birth canal.
Infection with syphilis can cause
diabetes, chronic hypertension, postpartum
hemorrhage, preeclampsia, preterm
congenital
labor and birth,
syphilis in the neonate. Infection with chlamydia can
lead to conjunctivitis or
multiple pregnancy, genetic disorders and chromosomal
abnormalities, placenta
pneumonia in the
previa, fetal
newborn. Exposure to HPV during birth is associated
with laryngeal papillomas.
growth restriction, low Apgar scores, and surgical births
(Dillion et al. 2019).
However, even
though increased age implies increased complications,
most women today who
become pregnant
after age 34, have healthy pregnancies and healthy
newborns. Nursing assessment of the
pregnant woman over age 35 is the same as that for any
pregnant woman. Women
of this age
have the same risk for a substance use disorder as any
other age group.
12. 12. A nurse is conducting an in-service presentation
to a group of perinatal nurses about sexually
13. 13. A nurse is preparing a presentation for a group of
young adult pregnant women about
common infections and their effect on pregnancy. When
describing the
infections, which
infection would the nurse include as the most common
congenital and
perinatal viral infection in
6 / 18
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the world?
A. rubella
B. hepatitis B
transmitted infections and their effect on pregnancy.
The nurse determines
C. cytomegalovirus
that the teaching was
D. parvovirus B19: Answer: C
Rationale: Although rubella, hepatitis B, and parovirus
B19 can affect pregnant
have not been linked to caffeine consumption, but
maternal coffee consumption
women and their
decreases iron
fetuses, cytomegalovirus (CMV) is the most common
congenital and perinatal viral
absorption and may increase the risk of anemia during
pregnancy. It is not known
infection in
if there is a
the world. CMV is the leading cause of congenital
infection, with morbidity and
correlation between high caffeine intake and
miscarriage due to lack of sufficient
mortality at
studies.
birth and sequelae. Each year approximately 1% to 7%
of pregnant women acquire
15. 15. A neonate born to a mother who was abusing
heroin is exhibiting
a primary
signs and symptoms of
CMV infection. Of these, about 30% to 40% transmits
infection to their fetuses.
withdrawal. Which signs would the nurse assess? Select
all that apply.
14. 14. A pregnant woman asks the nurse, "I'm a big
coffee drinker. Will the
A. low whimpering cry
caffeine in my coffee
hurt my baby?" Which response by the nurse would be
most appropriate?
A. "The caffeine in coffee has been linked to birth
defects."
B. "Caffeine has been shown to restrict growth in the
fetus."
B. hypertonicity
7 / 18
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C. lethargy
D. excessive sneezing
E. overly vigorous sucking
C. "Caffeine is a stimulant and needs to be avoided
completely."
F. tremors: Answer: B, D, F
D. "If you keep your intake to less than 200 mg/day, you
should be okay.": -
Rationale: Signs and symptoms of withdrawal, or
neonatal abstinence syndrome,
Answer: D
include:
Rationale: The effect of caffeine intake during pregnancy
on fetal growth and
irritability, hypertonicity, excessive and often highpitched crying, vomiting, diarrhea, feeding
development is
disturbances, respiratory distress, disturbed sleeping,
excessive sneezing and
still unclear. A recent study found that caffeine intake of
no more than 200 mg/day
yawning, nasal
during
stuffiness, diaphoresis, fever, poor sucking, tremors, and
seizures.
pregnancy does not affect pregnancy duration and the
condition of the newborn.
Birth defects
16. 16. A nurse has been invited to speak at a local high
school about
adolescent pregnancy. When
Ricci Chapter 20 - Test Bank - 4th Edition
developing the presentation, the nurse would
incorporate information related to which aspects?
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Select all that apply.
having sexual intercourse. About one in four teen
mothers under age 18 have a
A. peer pressure to become sexually active
second baby
B. rise in teen birth rates over the years.
within 2 years after the birth of the first baby.
C. Asian Americans as having the highest teen birth rate
17. 17. A nurse is counseling a pregnant woman with
rheumatoid arthritis
D. loss of self-esteem as a major impact
E. about half occurring within a year of first sexual
intercourse: Answer: A, D
Rationale: Adolescent pregnancy has emerged as one of
the most significant
about medications that can
be used during pregnancy. The nurse would emphasize
the need to avoid
which medication at
social problems
this time?
facing our society. Early pregnancies among adolescents
have major health consequences for
A. hydroxychloroquine
mothers and their infants. The latest estimates show
that approximately 1 million
teenagers
become pregnant each year in the United States,
accounting for 13% of all U.S.
births, but the
rates have been declining in the last several years. Teen
birth rates in the United
B. nonsteroidal anti-inflammatory drugs
C. glucocorticoid
D. methotrexate: Answer: D
Rationale: Methotrexate is contraindicated during
pregnancy. For rheumatoid
arthritis,
medications are limited to hydroxychloroquine,
glucocorticoids, and NSAIDS.
States have
18. 18. A nurse is preparing a teaching program for a
group of pregnant
declined but remain high,especially among African
American and Hispanic
women about preventing
teenagers and
infections during pregnancy. When describing measures
for preventing cytomegalovirus
adolescents in southern states. The most important
impact lies in the psychosocial
area as it
contributes to a loss of self-esteem, a destruction of life
projects, and the maintenance of the
circle of poverty. Moreover, about half of all teen
pregnancies occur within 6 months
of first
8 / 18
infection, which measure would the nurse include as a
priority?
A. frequent handwashing
B. immunization
C. prenatal screening
D. antibody titer screening: Answer: A
Rationale: Most women are asymptomatic and do not
know they have been
exposed to CMV.
Prenatal screening for CMV infection is not routinely
performed. Since there is no
therapy that
prevents or treats CMV infections, nurses are
responsible for educating and
20. 20. After teaching a pregnant woman with iron
deficiency anemia about
nutrition, the nurse
determines that the teaching was successful when the
woman identifies
which foods as being
supporting
good sources of iron in her diet? Select all that apply.
childbearing-age women at risk for CMV infection.
Stressing the importance of
A. dried fruits
good
handwashing and use of sound hygiene practices can
help to reduce transmission
of the virus.
There is no immunization for CMV. Antibody titer levels
would be useful for identifying women
at risk for rubella.
9 / 18
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19. 19. A pregnant woman comes to the clinic for her
first evaluation. The
woman is screened for
hepatitis B (HBV) and tests positive. The nurse would
anticipate administering which agent?
A. HBV immune globulin
B. HBV vaccine
C. acylcovir
D. valacyclovir: Answer: A
Rationale: If a woman tests positive for HBV, expect to
administer HBV immune
globulin. The
newborn will also receive HBV vaccine within 12 hours
of birth. Acyclovir or
valacyclovir
would be used to treat herpes simplex virus infection.
B. peanut butter
C. meats
D. milk
E. white bread: Answer: A, B, C
Rationale: Foods high in iron include meats, green leafy
vegetables, legumes, dried
fruits, whole
grains, peanut butter, bean dip, whole-wheat fortified
breads, and cereals.
21. 21. A pregnant woman with gestational diabetes
comes to the clinic for a
fasting blood glucose
level. When reviewing the results, the nurse determines
that the woman is
achieving good
glucose control based on which result?
A. 88 mg/dL
B. 100 mg/dL
C. 110 mg/dL
D. 120 mg/dL: Answer: A
Rationale: For a pregnant woman with diabetes, the
ADA and ACOG recommend
maintaining a
fasting blood glucose level below 95 mg/dL, with
postprandial levels below 140
10 / 18
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mg/dL at 1
hour, below 120 mg/dL at 2 hours.
22. 22. A nurse is conducting a program for pregnant
women with gestational
nurse would expect to screen for group B streptococcus
infection in the
client who is at:
A. 16 weeks' gestation.
B. 28 weeks' gestation.
diabetes about
C. 32 weeks' gestation.
reducing complications. The nurse determines that the
teaching was successful when the group
D. 36 weeks' gestation.: Answer: D
identifies which factor as being most important in
helping to reduce complications associated
with pregnancy and diabetes?
A. stability of the woman's emotional and psychological
status
B. degree of blood glucose control achieved during the
pregnancy
C. reduction in retinopathy risk by frequent
ophthalmologic evaluations
Rationale: Pregnant women between 36 and 37 weeks'
gestation should be
universally screened
for GBS infection during a prenatal visit and if positive,
receive appropriate intrapartum
antibiotic prophylaxis.
11 / 18
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D. control of blood urea nitrogen (BUN) levels for
optimal kidney function: -
24. 24. A woman with a history of systemic lupus
erythematosus comes to
Answer: B
the clinic for evaluation.
Rationale: Therapeutic management for the woman
with diabetes focuses on tight
The woman tells the nurse that she and her partner
would like to have a baby
glucose
but that they are
control, thereby minimizing the risks to the mother,
fetus, and neonate. The
afraid her lupus will be a problem. Which response
would be most appropriate for the nurse to
woman's emotional
make?
and psychological status is highly variable and may or
may not affect the pregnancy. Evaluating
A. "It's probably not a good idea for you to get pregnant
since you have
for long-term diabetic complications such as retinopathy
or nephropathy, as evidenced by
lupus."
laboratory testing such as BUN levels, is an important
aspect of preconception
care to ensure that
B. "Be sure that your lupus is stable or in remission for 6
months before
getting pregnant."
the mother enters the pregnancy in an optimal state.
C. "Your lupus will not have any effect on your
pregnancy whatsoever."
23. 23. A nurse is providing care to several pregnant
women at different
D. "If you get pregnant, we'll have to add quite a few
medications to your
weeks of gestation. The
normal treatment plan.: Answer: B
Rationale: The time at which the nurse comes in contact
with the woman in her
antimalarial agent, hydroxychloroquine. During
pregnancy in the woman with SLE,
12 / 18
childbearing life
Ricci Chapter 20 - Test Bank - 4th Edition
cycle will determine the focus of the assessment. If the
woman is considering
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pregnancy, it is
recommended that she postpone conception until the
disease has been stable or
in remission for 6
months. Active disease at time of conception and
history of renal disease increase
the likelihood
of a poor pregnancy outcome (Cunningham et al.,
2018). In particular, if pregnancy
is planned
during periods of inactive or stable disease, the result is
often giving birth to healthy
full-term
babies without increased risks of pregnancy
complications. Nonetheless, pregnancies with most
autoimmune diseases are still classified as high risk
because of the potential for
major
complications. Preconception counseling should include
the medical and obstetric
risks of
spontaneous abortion, stillbirth, fetal death, fetal
growth restriction, preeclampsia,
the goal is to
keep drug therapy to a minimum.
25. 25. A nurse is conducting a presentation for a group
of pregnant women
about measures to
prevent toxoplasmosis. The nurse determines that
additional teaching is
needed when the group
identifies which measure as preventive?
A. washing raw fruits and vegetables before eating them
B. cooking all meat to an internal temperature of 125° F
(52° C)
C. wearing gardening gloves when working in the soil
D. avoiding contact with a cat's litter box: Answer: B
Rationale: Meats should be cooked to an internal
temperature of 160° F (71° C).
Other measures
to prevent toxoplasmosis include peeling or thoroughly
washing all raw fruits and
vegetables
before eating them, wearing gardening gloves when in
contact with outdoor soil,
and avoiding
preterm labor,
the emptying or cleaning of a cat's litter box.
and neonatal death and the need for more frequent
visits for monitoring the
26. 26. A pregnant client with iron-deficiency anemia is
prescribed an iron
condition. Treatment
supplement. After
of SLE in pregnancy is generally limited to NSAIDs (e.g.,
ibuprofen), prednisone,
teaching the woman about using the supplement, the
nurse determines that
and an
more teaching is
needed based on which client statement?
A. "Taking the iron supplement with food will help with
the side effects."
27. 27. A client in her first trimester comes to the clinic
for an evaluation.
Assessment reveals
B. "I will need to avoid coffee and tea when I take this
supplement."
reports of fatigue, anorexia, and frequent upper
respiratory infections. The
C. "I will take the iron with milk instead of orange or
grapefruit juice."
client's skin is pale
D. "If I happen to miss a dose, I will take it as soon as I
remember.": Answer:
C
Rationale: The pregnant client should take the iron
supplement with vitamin C-containing fluids
such as orange juice, which will promote absorption,
rather than milk, which can
inhibit iron
absorption. Taking iron on an empty stomach improves
its absorption, but many
and the client is slightly tachycardic. The client also
reports drinking about
6 cups of coffee on
average each day. A diagnosis of iron-deficiency anemia
is suspected. The
client is scheduled for
laboratory testing and the results are as follows:
• Hemoglobin 11.5 g/dL (115 g/L)
• Hematocrit 35% (0.35)
• Serum iron 32 ¼g/dL (5.73 ¼mol/L)
women cannot
• Serum ferritin 90 ng/dL (90 ¼g/L)
tolerate the gastrointestinal discomfort it causes. In such
cases, the woman is
Which laboratory finding would the nurse correlate with
the suspected diagnosis?
advised to take it
A. Hemoglobin
with meals. The woman also needs instruction about
adverse effects, which are
B. Hematocrit
predominantly
gastrointestinal and include gastric discomfort, nausea,
vomiting, anorexia, diar13 / 18
Ricci Chapter 20 - Test Bank - 4th Edition
C. Serum iron level
D. Serum ferritin level: Answer: D
Rationale: Laboratory tests for iron-deficiency anemia
usually reveal low hemoglobin (less than
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11 g/dL or 110 g/L), low hematocrit (less than 35% or
0.35), low serum iron (less
rhea, metallic
than 30 ¼g/dL
taste, and constipation. Taking the iron supplement with
meals and increasing
or 5.37 ¼mol/L), microcytic and hypochromic cells, and
low serum ferritin (less than
intake of fiber and
100 ng/dL
fluids helps overcome the most common side effects. If
the woman misses a dose,
or 100 ¼g/L). The client's hemoglobin, hematocrit, and
serum iron levels are borderline low
she should
normal, but the client's serum ferritin is below 100
ng/dL (100 ¼g/L), helping to
take a dose as soon as she remembers.
support the
diagnosis.
28. 28. A young adult woman comes to the clinic for a
routine check-up.
During the visit, the woman
who works in a day care facility tells the nurse that she
and her partner are
14 / 18
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considering having a
baby. "We are concerned that I might be exposed to
common childhood
illnesses." The woman
undergoes testing and finds out that she is not immune
from chickenpox.
Based on this
information, which information would the nurse give to
the client?
the cornerstone of prevention. The vaccine is
administered if needed. Varicella
vaccine is a live
attenuated viral vaccine. It should be administered to all
adolescents and adults 13
years of age
and older who do not have evidence of varicella
immunity. Therefore, the woman
should be
vaccinated now before she becomes pregnant and then
wait at least 1 month
before getting
pregnant. The varicella vaccine is contraindicated for
pregnant women because
the effects of the
vaccine on the fetus are unknown. There is no need for
the woman to quit her job
once she is
immunized nor does she need to take a leave of
abscence during the winter and
A. "You will need to be vaccinated now and wait at least
1 month before
spring months
getting pregnant."
when the incidence is highest. Chickenpox does occur
and is highly contagious.
B. "It is very likely that you will need to quit your job if
you do get pregnant."
Maternal varicella can be transmitted to the fetus
through the placenta, leading to
C. "Because chickenpox is so rare nowadays, there is
nothing to worry
congenital varicella
about."
syndrome if the mother is infected during the first half
of pregnancy via an ascending aorta.
D. "You will need to take a leave of absence during
winter and spring
months.": Answer: A
Rationale: Preconception counseling is important for
preventing chickenpox (varicella). A major
component of counseling involves determining the
woman's varicella immunity.
Vaccination is
29. 29. A nurse is obtaining a medication history from a
pregnant client with
a history of systemic
lupus erythematosus (SLE). Which medication(s) would
the nurse expect the
15 / 18
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woman to report to
pregnant."
be currently using? Select all that apply.
C. "Your heart disease would put too much strain on
your heart if you were
A. Ibuprofen
B. Hydroxychloroquine
C. Methotrexate
D. Leflunomide
E. Prednisone: Answer: A, B, E
Rationale: Treatment of SLE in pregnancy is generally
limited to NSAIDs like
ibuprofen,
prednisone, and an antimalarial agent,
hydroxychloroquine. Methotrexate and
leflunomide are
used to treat rheumatoid arthritis but are
contraindicated for use in pregnancy
because of the
potential for fetal toxicity.
30. 30. The nurse reviews the medical record of a
woman who has come to
the clinic for an
evaluation. The client has a history of mitral valve
prolapse and is listed as
risk class II. During
the visit, the woman states, "We want to have a baby,
but I know I am at higher
risk. But what is
my risk, really?" Which response by the nurse would be
appropriate?
A. "If you do get pregnant, you will need to be seen by a
cardiologist every
other month for
monitoring."
B. "Your risk during pregnancy is small, but you should
see your cardiologist
first before getting
to get pregnant."
D. "Your pregnancy would be uneventful, but you would
need specialized
care for labor and
birth.": Answer: B
Rationale: Typically, a woman with class I or II cardiac
disease can go through a
pregnancy
without major complications. For class I disease, there is
no detectable increased
risk of maternal
mortality and no increase or a mild increase in
morbidity. For class II disease, there
is a small
increased risk of maternal mortality or moderate
increase in morbidity and cardiac
16 / 18
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consultation
should occur every trimester. It is best to have the
woman see her cardiologist
before becoming
pregnant. A woman with class III disease needs frequent
visits with the cardiac
care team
throughout pregnancy. There is a significantly increased
risk of maternal mortality
or severe
morbidity and cardiologist consult should occur every
other month with prenatal
care and
delivery occurring at an appropriate level hospital. A
woman with class IV disease
for any signs of preeclampsia. At approximately 24
weeks' gestation, the woman
is typically
will be
advised to avoid pregnancy.
instructed to document fetal movement. At this same
time, serial ultrasounds will
31. 31. A pregnant woman with chronic hypertension is
entering her second
trimester. The nurse is
providing anticipatory guidance to the woman about
measures to promote a
be prescribed
to monitor fetal growth and amniotic fluid volume. The
woman should also have
17 / 18
healthy outcome.
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The nurse determines that the teaching was successful
based on which
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client statement(s)? Select
all that apply.
A. "I will need to schedule follow-up appointments
every 2 weeks until I reach
daily periods of
rest (1 hour) in the left lateral recumbent position to
maximize placental perfusion
and use home
32 weeks'
blood pressure monitoring devices frequently (daily
checks would be preferred),
gestation."
reporting any
B. "I should try to lie down and rest on my left side for
about an hour each
elevations.
day."
C. "I will start doing daily counts of my baby's activity at
about 24 weeks'
gestation."
D. "I will need to have an ultrasound at each visit
beginning at 28 weeks'
gestation."
E. "I should take my blood pressure frequently at home
and report any high
readings.": Answer: B, C, E
Rationale: The woman with chronic hypertension will be
seen more frequently
(every 2 weeks
until 28 weeks' gestation and then weekly until birth) to
monitor her blood pressure
and to assess
18 / 18
1. ": Answer: C
Rationale: In pregnancy, placental hormones cause
insulin resistance at a level that tends toparallel growth
of the fetoplacental unit. Nutritional management
focuses on main taining balanced glucose levels. Thus,
the woman will probably need to make adjustments in
her diet. Protein needs increase during pregnancy, but
this is unrelated to diabetes. Blood Glucose monitoring
results typically guide therapy
2. Answer: A
Rationale: A HbA1c level of 13% indicates poor glucose
control. This, in conjunction with thewoman being in the
first trimester, increases the risk for congenital
anomalies in the fetus. Elevated glucose levels are not
associated with incompetent cervix, placenta previa, or
placental abruption (abruptio placentae).
3.Answer: A
Rationale: Drug therapy is the mainstay of treatment
and is important in reducing
the viral load as much as possible. Antiretroviral agents
do not treat opportunistic infections and are not
adjunctive therapy. There is no cure for HIV/AIDS.
4.Answer: D
Rationale: Cocaine use produces vasoconstriction,
tachycardia, and hypertension in both the
mother and fetus. The effects of marijuana are not yet
fully understood. Alcohol
ingestion would lead to cognitive and behavioral
problems in the newborn. Heroin is a central nervous
systemdepressant.