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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
CARE OF MOTHER AND CHILD AT RISK OR WITH PROBLEMS (ACUTE AND CHRONIC)
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Information
Patient Scenario: Nursing Care of a Pregnant Family With Special Needs
A WOMEN WITH SUBSTANCE DEPENDENCY DURING PREGNANCY
Andrea Drew is an 18-year-old, G3P2, 36-week pregnant woman admitted to the maternity service because of vaginal bleeding. She broke
her leg in a fall last month so uses a wheelchair for ambulation.
CHIEF CONCERN:
“I’ve had sharp pain in my stomach for over an hour.”
HISTORY OF CHIEF CONCERN:
The client states an hour ago, she and her boyfriend were smoking “crack.” Suddenly, she felt hard fundal pain followed by dark red
vaginal bleeding. Her boyfriend immediately transported her to the hospital.
FAMILY PROFILE:
She lives with her boyfriend and one other couple in two-bedroom apartment; the client does not work outside home; her boyfriend works
as a delivery man for local drugstore. She states finances are, “all right, you know.” She smokes 1 pack of cigarettes daily; she had no
alcohol since pregnancy began. She admits to using cocaine at least weekly and marijuana daily.
HISTORY OF PAST ILLNESSES:
She had chickenpox at age 6 years and scarlet fever at age 9 years. She had viral pneumonia treated on an ambulatory basis 2 years ago.
She was “tripped” over throw rug 1 month ago; she was seen in ER for broken tibia.
HISTORY OF FAMILY ILLNESSES:
The client does not know father’s family history. Maternal grandmother has severe osteoporosis.
GYNECOLOGIC HISTORY:
Menarche was at age 10 years; cycle duration: 30 days; menstrual flow duration: 7 days. She had severe premenstrual symptoms for 2
days prior to menstrual flow.
OBSTETRIC HISTORY:
She had two previous pregnancies: boy, 5 lb 13 oz, born 4 years ago, alive and well; girl, 6 lb 0 oz, born 2 years ago, “is okay; just behind in
things she should do.” This pregnancy was planned and wanted. Client signed up for prenatal care at hospital clinic but only kept two
appointments.
DAY HISTORY:
Nutrition: 24-hour recall:
Breakfast: 1 cup coffee; 1 bowl Cheerios with milk and sugar
Lunch: 1 cup strawberry yogurt; 1 glass cola beverage
Dinner: 1 serving chicken with Chinese vegetables (take-out); 1 glass milk
Snack: Chocolate candy; 1 dish ice cream
Sleep: Sleeps 6 hours nightly
Recreation: Does not participate in any structured recreation program
REVIEW OF SYSTEMS:
Essentially negative
PHYSICAL EXAMINATION:
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
General appearance: Pale-appearing, young adult, pregnant woman with swollen face
and hands and ankles sitting in wheelchair; height: 6 ft 6 in.; weight: 145 lb; BP: 160/100
mmHg
HEENT: Edema present on face; otherwise negative
Chest: Faint systolic heart murmur heard at left sternal border; heart rate: 82 beats/min
Lungs: Clear to auscultation
Abdomen: Fundal height: 34 cm and rigid; very tender to touch; abdominal contractions present on external monitor about every 6
minutes; fetus palpated to be in breech position at −1 station; no fetal heart rate discernible by Doppler
Pelvic examination: Cervix thick and dilated 2 cm; dark red blood observed flowing from cervix
Extremities: 3+ edema present in both hands and ankles; needle injection marks on arms and behind knees
LABORATORY RESULTS:
Hemoglobin: 9 g/dl
Hematocrit: 33.5%
Urinalysis: Negative for glucose; 2+ for protein; positive for blood
Question 1
Correct
Mark 1.00 out of 1.00
Pregnancy is a difficult time for adolescents like Andrea because they still have developmental tasks of adolescence to complete. Which
of the following is a typical adolescent developmental task?
a. Gaining emancipation from his or her parents

b. Learning to operate a motor vehicle safely
c.
Choosing a spiritual belief system
d. Solving financial challenges
Your answer is correct.
Adolescents need to learn to separate from their parents. This task supersedes driving, solving financial problems, or addressing
spiritual matters.
The correct answer is:
Gaining emancipation from his or her parents
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 2
Correct
Mark 1.00 out of 1.00
Pregnant adolescents like Andrea are considered to be emancipated minors. What is an implication of this status that the nurse should
be aware of when planning care?
a. Andrea is financially dependent on her parents.
b. Andrea can sign permission for her own health care.
c.

Andrea must report to a probation officer during pregnancy.
d. Consent is not necessary when caring for Andrea.
Your answer is correct.
An emancipated minor is an underage person who provides for the majority of her own care or who is the mother of a child.
The correct answer is:
Andrea can sign permission for her own health care.
Question 3
Correct
Mark 1.00 out of 1.00
When assessing Andrea, you should be aware of what complication of pregnancy that frequently occurs in adolescents?
a. Increased gestational weight
b. Multiple pregnancy
c.
Gestational diabetes
d. Iron-deficiency anemia

Your answer is correct.
Iron-deficiency anemia occurs at an increased rate during adolescence because of typical teenage diets, which are deficient in iron.
Teenagers can have cephalopelvic disproportion, but the problem is usually that their pelvis is too small, not that the baby is too big.
The correct answer is:
Iron-deficiency anemia
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 4
Correct
Mark 1.00 out of 1.00
The only physical activity Andrea participates in is swimming. She asks you if she could continue swimming during pregnancy. How
should you advise her?
a. Yes, provided it is not in a public swimming pool.
b. Yes, swimming is a healthy pregnancy exercise activity.
c.

The answer depends on what type of swimming stroke she uses.
d. No. Adolescents need to conserve energy for fetal growth.
Your answer is correct.
Women are actually more buoyant during pregnancy than usual so swimming is an enjoyable activity during pregnancy. She should stop
short of becoming fatigued and discontinue this after membranes rupture. Swimming in public pools is not contraindicated.
The correct answer is:
Yes, swimming is a healthy pregnancy exercise activity.
Question 5
Correct
Mark 1.00 out of 1.00
You are planning your health assessments based on Andrea’s health history. Based on her history of cocaine abuse, Andrea is at high risk
for which of the following?
a. Placenta abruption

b. Electrolyte imbalances
c.
Delayed cervical dilatation
d. Placenta previa
Your answer is correct.
Because of vasoconstriction, cocaine use is associated with dislodgement of the placenta.
The correct answer is:
Placenta abruption
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 6
Correct
Mark 1.00 out of 1.00
Andrea attended an inpatient drug treatment clinic last year. What is the main benefit of substance dependency treatment programs for
pregnant women like Andrea?
a. They are a safe place to stay for the night for known drug abusers.
b. They are a drug-free place where the woman may safely deliver her baby.
c.
They are a place for maintenance of drug-free status and psychosocial support.

d. They are an alternate place for her to continue her prenatal care.
Your answer is correct.
Treatment programs combine a drug-free environment and psychosocial support. They are not normally a site for prenatal care or labor
and delivery.
The correct answer is:
They are a place for maintenance of drug-free status and psychosocial support.
Question 7
Correct
Mark 1.00 out of 1.00
Adolescents need to be encouraged to be as responsible as possible for their own care during pregnancy. Thinking of the QSEN
competency of patient-centered care, what would be the best action to take at a prenatal visit to encourage this?
a. Emphasize the need to eat vegetables, even though she doesn’t like them.
b. Compliment her on her clothes or the way she has recently styled her hair.
c.
Point out what a great growth experience pregnancy can be.
d. Encourage her to weigh herself and report her findings to you.

Your answer is correct.
Small actions such as testing urine or weighing herself can foster independence, insisting on actions defeat personal responsibility.
Personal compliments may be superficial.
The correct answer is:
Encourage her to weigh herself and report her findings to you.
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 8
Correct
Mark 1.00 out of 1.00
A second age group that is having an increasing number of pregnancies is women over age 40 years. What is the developmental task of
middle age, according to Erikson, that could interfere with the work of pregnancy in this group?
a. Sense of intimacy
b. Sense of integrity
c.
Sense of generativity

d. Sense of identity
Your answer is correct.
A sense of generativity means people are interested in reaching out to the community. It can be difficult for a woman to do this when she
also has to “reach inward” to concentrate on a pregnancy.
The correct answer is:
Sense of generativity
Question 9
Correct
Mark 1.00 out of 1.00
Most women over age 40 years have a chromosomal analysis done during pregnancy. This is because there is a higher than usual
incidence of which condition?
a. Heart defects
b. Down syndrome
c.

Renault syndrome
d. Hypoglycemia
Your answer is correct.
Down syndrome occurs at a higher frequency in women over age 40 years than in younger women.
The correct answer is:
Down syndrome
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 10
Correct
Mark 1.00 out of 1.00
Which of the following complications occurs more frequently in women over age 40 years than in younger women such as Andrea?
a. Disturbing dreams at night
b. Ankle edema with standing
c.
Skin rashes with pruritus
d. Failure to progress in labor

Your answer is correct.
Labor in the woman over age 40 years may be prolonged because cervical dilatation may not occur as spontaneously as in younger
women.
The correct answer is:
Failure to progress in labor
Question 11
Correct
Mark 1.00 out of 1.00
You learn that a local public prenatal clinic refused to see Andrea for a first prenatal visit because the clinic was not wheelchair
accessible. You would advise Andrea of which of the following?
a. She likely would not have received good care at the site.
b. She has a right to wheelchair access to all public buildings.
c.

As a mother, she will need to make more flexible choices.
d. There are wheelchair accessible sites where she can receive prenatal care.
Your answer is correct.
By federal law, health care facilities should be in compliance with full access rights of persons who are physically challenged.
The correct answer is:
She has a right to wheelchair access to all public buildings.
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 12
Correct
Mark 1.00 out of 1.00
What is a common reason that women who are physically challenged, such as Andrea, may have difficulty obtaining adequate prenatal
care?
a. They may not have easy access to transportation to a care site.

b. They may not believe they need special care during pregnancy.
c.
They may want to have a “special” pregnancy, not an average one.
d. They may try to take advantage of the system.
Your answer is correct.
Many women who are physically challenged have to rely on family or friends for transportation.
The correct answer is:
They may not have easy access to transportation to a care site.
Question 13
Correct
Mark 1.00 out of 1.00
You are planning care for Andrea based on the nursing diagnosis of Risk for Impaired Skin Integrity because she is temporarily using a
wheelchair. Women who are wheelchair challenged may need to perform which exercise to help prevent pressure ulcers?
a.
Lift their buttocks off the chair seat every hour.

b. Push up against a pretend ceiling every hour.
c.
Perform Kegel exercises several times daily.
d. Perform leg extension and flexion three to four times daily.
Your answer is correct.
Pressing on the arm rests and lifting their buttocks off the chair seat helps relieve pressure on their buttocks and posterior thighs,
preventing pressure ulcers. The other listed exercises are not effective against skin breakdown.
The correct answer is:
Lift their buttocks off the chair seat every hour.
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 14
Incorrect
Mark 0.00 out of 1.00
Women who are vision challenged may need some suggestions on baby care. Which of the following would you advise a vision challenged
woman to do?
a. Introduce the child to Braille by one year.

b. Teach the child early on to not be afraid of the dark.
c.
Hire a full-time nanny to provide the baby’s care.
d. Look at her newborn when she feeds or talks to him.
Your answer is incorrect.
Eye contact or assuming an en face position is thought to be important for parent–child bonding. A visually impaired woman will need an
active support person to help her but needs to think of herself as the primary care person.
The correct answer is:
Look at her newborn when she feeds or talks to him.
Question 15
Incorrect
Mark 0.00 out of 1.00
Andrea admits to using cocaine almost daily. The pathologic effects of cocaine on fetal growth are related to what effect of the drug?
a. A decrease in the size of the pancreas
b. Extreme vasoconstriction in the mother
c.
“Locked” fetal knee and elbow joints

d. Atrophy of the fetal lungs
Your answer is incorrect.
The vasoconstriction caused by cocaine can decrease the blood supply to the fetus or cause the placenta to separate from the uterus
(abruptio placenta).
The correct answer is:
Extreme vasoconstriction in the mother
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 16
Correct
Mark 1.00 out of 1.00
In addition to using cocaine, Andrea also uses marijuana on a near-daily basis. Following the birth of her baby, your plan of care should
include which of the following?
a. She should try to limit her marijuana use to twice weekly.
b. She should eat the drug instead of smoking it for the baby’s safety.
c.
She should not breastfeed because marijuana is present in breast milk.

d. She should have weekly drug tests at an outpatient clinic.
Your answer is correct.
Marijuana both decreases breast milk production and found in the milk itself. Drug testing is not normally performed in relation to
marijuana use.
The correct answer is:
She should not breastfeed because marijuana is present in breast milk.
Question 17
Incorrect
Mark 0.00 out of 1.00
What would be important to remember when supporting a woman who is hearing impaired during a pelvic examination?
a. She may have an accompanying cognitive deficit.
b. She has likely been the victim of abuse in the past.
c.
She cannot lip-read if she cannot see the examiner’s face.
d. She may need simpler instructions than a woman with intact hearing.

Your answer is incorrect.
Must women who are hearing challenged rely on lip reading to improve understanding. Difficulty hearing is not an indication of decreased
cognition. There is no noted to be an increased incidence of abuse in women who have hearing impairments.
The correct answer is:
She cannot lip-read if she cannot see the examiner’s face.
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 18
Incorrect
Mark 0.00 out of 1.00
As a general rule, an expected outcome for labor you would want to establish with a vision challenged woman would be:
a. She will need a seeing support person with her in labor and birth.

b. She will begin breathing exercises as early as 2 months of pregnancy.
c.
She will not ask for an anesthetic in labor because this causes blurred vision.
d. She will enroll in a preparation for labor course to be well informed.
Your answer is incorrect.
Women who are physically challenged need preparation for labor and parenthood as do all women. Breathing exercises for labor are
started during the second half of pregnancy so the knowledge is fresh at the time of labor.
The correct answer is:
She will enroll in a preparation for labor course to be well informed.
Question 19
Incorrect
Mark 0.00 out of 1.00
Because Andrea has a broken leg, which of the following would you anticipate is most likely to be true?
a. You need to discuss what analgesia she wants for labor.
b. She may have difficulty pushing effectively during labor.
c.

Her baby is high risk for caudal regression syndrome.
d. She will need a cesarean birth because of her cast.
Your answer is incorrect.
You need to discuss what analgesia all women want in labor. Pushing should not be a problem; a cesarean birth would not be indicated.
The correct answer is:
You need to discuss what analgesia she wants for labor.
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 20
Correct
Mark 1.00 out of 1.00
Based on Andrea’s health history, what is the most appropriate nursing diagnosis for her?
a. Risk for fetal and maternal injury related to drug dependency

b. Fear related to lack of education because she had to quit school
c.
Anxiety related to lack of support for her during pregnancy
d. Impaired thought processes related to substance dependency
Your answer is correct.
Andrea doesn’t show distorted thought processes; she has a support person. Drug use can lead to both maternal and fetal harm.
The correct answer is:
Risk for fetal and maternal injury related to drug dependency
Question 21
Correct
Mark 1.00 out of 1.00
A woman who is severely hearing impaired is concerned that she will not wake at night when her newborn cries. Which of the following
would you suggest?
a. Sleeping with her arm or leg on the crib so she feels the vibration of her infant’s crying or buying a sound-sensitive device

that will flash a bright light when a loud noise is detected
b. Feeding her baby cereal at bedtime so he or she will not wake at night
c.
Telling her that if the newborn wakes and cries but is not fed, the newborn will not continue to wake at night
d. Sleeping with the newborn in bed with her so she can hear him
Your answer is correct.
Sleeping with an arm or leg placed on the crib will allow the thrashing of a crying infant to be felt. As a more expensive alternative,
devices are available that will flash a bright light when a loud sound such as crying is detected.
The correct answer is:
Sleeping with her arm or leg on the crib so she feels the vibration of her infant’s crying or buying a sound-sensitive device that will flash a
bright light when a loud noise is detected
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 22
Correct
Mark 1.00 out of 1.00
A 15-year-old girl is 6 months pregnant when she first comes for prenatal care. She states that she had no idea she was pregnant. What is
the most probable rationale for her statement?
a. Low intelligence level
b. Ignorance of the signs of pregnancy
c.
Lack of visible pregnancy signs
d. Denial of the pregnancy

Your answer is correct.
Although ignorance of the signs of pregnancy is possible, the most likely reason is denial. Adolescents often feel that they are invincible
and that nothing bad can happen to them, thus putting into motion psychological mechanisms that allow them to deny the signs and
symptoms of pregnancy for extended periods of time.
The correct answer is:
Denial of the pregnancy
Question 23
Correct
Mark 1.00 out of 1.00
You met a 42-year-old woman in a prenatal clinic who is in her second trimester. Which of the following would be the top priority in your
planning of her care?
a. Scheduling her for a triple or quad screen fetal evaluation

b. Evaluating the woman’s daily responsibilities
c.
Helping the woman decide on what career clothing to wear during her pregnancy
d. Evaluating her tolerance for pain during labor
Your answer is correct.
Although evaluation of the pregnant woman’s daily responsibilities is important, screening for fetal anomalies is vital because it impacts
planning for the future if a fetal abnormality is found.
The correct answer is:
Scheduling her for a triple or quad screen fetal evaluation
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 24
Incorrect
Mark 0.00 out of 1.00
The most important reason that all pregnant women should be assessed for the possibility of substance abuse is that:
a. There is a major increase in the incidence of fetal chromosomal abnormalities.

b. Illicit drug use may result in a postterm pregnancy.
c.
Appropriate care may be rendered to the infant after delivery.
d. The infant may need to be breastfed more frequently to negate the effects of the drugs.
Your answer is incorrect.
Depending on the drug and its last dose, infants of women who use illicit drugs during pregnancy need to be closely monitored for signs
and symptoms of drug withdrawal. Because illicit drugs do cross the placenta, the major fetal risk is drug dependence and withdrawal.
Because illicit drugs cross into the breast milk, breastfeeding is usually contraindicated. Use of illicit drugs may result in preterm labor or
placental abruption.
The correct answer is:
Appropriate care may be rendered to the infant after delivery.
Question 25
Incorrect
Mark 0.00 out of 1.00
The body system to assess first in a pregnant woman who has suffered trauma is the
integumentary
 system.
The correct answer is: respiratory
Question 26
Correct
Mark 1.00 out of 1.00
To help prevent spinal cord defects in their fetus, pregnant adolescents need to ingest an adequate level of
folic acid
 .
The correct answer is: folic acid
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 27
Incorrect
Mark 0.00 out of 1.00
Vital signs
 is a key area of concern for a pregnant woman who is physically or cognitively challenged.
The correct answer is: Safety
Question 28
Incorrect
Mark 0.00 out of 1.00
During pregnancy, leukocytosis is not a reliable sign of
postpartum bacterial infection  due to changes in the body.
The correct answer is: Infection
Question 29
Not answered
Marked out of 1.00
Implementations in emergency situations must be done quickly while remembering a woman’s primary health condition is
 .
The correct answer is: Pregnancy
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 30
Incorrect
Mark 0.00 out of 3.00
You are planning the prenatal care of younger mothers. Common complications of adolescent pregnancy are which of the following?
(Select all that apply.)
a. Perineal and cervical tears
b. Hyperthermia or hypothermia

c.

Increased bleeding postpartally

d. Cephalopelvic disproportion
Your answer is incorrect.
The correct answers are:
Increased bleeding postpartally,
Cephalopelvic disproportion,
Perineal and cervical tears
Question 31
Correct
Mark 3.00 out of 3.00
What is the correct order for cardiopulmonary resuscitation for a pregnant woman?
a. Assess airway and administer two quick breaths.
b. Begin rapid chest compressions at 100 beats/min.
c. Assess the woman is unconscious and not breathing.
a. c,a,b
b. c,b,a
c.

a,c,b
b,a,c
d. b,c,a
e.
a,b,c
Your answer is correct.
The new order for CPR after realizing a woman is not breathing is no longer A, B, C, but C (compression), A (airway), and then B (breaths):
CAB.
The correct answer is:
c,b,a
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 32
Correct
Mark 1.00 out of 1.00
Many adolescents do not seek prenatal care until late in their pregnancies.
Select one:
True 
False
The correct answer is 'True'.
Question 33
Incorrect
Mark 0.00 out of 1.00
Adolescents have a decreased risk for developing gestational hypertension.
Select one:
True 
False
Adolescents have higher risk for developing gestational hypertension.
The correct answer is 'False'.
Question 34
Correct
Mark 1.00 out of 1.00
The risk for Down syndrome is higher in older women.
Select one:
True 
False
The correct answer is 'True'.
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
Question 35
Correct
Mark 1.00 out of 1.00
Women over the age of 30 years are at a higher risk for postpartum hemorrhage.
Select one:
True
False 
Women over the age of 35 years are at a higher risk for postpartum hemorrhage.
The correct answer is 'False'.
Question 36
Correct
Mark 1.00 out of 1.00
Women with physical challenges should not be encouraged to get pregnant.
Select one:
True
False 
Women with physical challenges have special needs when pregnant, and requires special attention, but they are not prohibited/
discouraged to get pregnant.
The correct answer is 'False'.
◄ Formative Test #4: Chapter 21 Quiz (2022)
Jump to...
Individual Activity #5: Chapter Study Questions ►
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
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Formative Test #5: Chapter 22 Quiz (2022): Attempt review
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4/5/22, 11:54 AM
Formative Test #5: Chapter 22 Quiz (2022): Attempt review
https://online.msuiit.edu.ph/moodle/mod/quiz/review.php?attempt=191286&cmid=113354
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