NURS 218 Lesson 2 Quiz #2

Question 1 of 50

1

A woman has just moved to the United States from Mexico. She is 3 months pregnant and has arrived for her first prenatal visit. During her assessment interview, you discover that she has not had any immunizations. Which immunizations should she receive at this point in her pregnancy (Select all that apply)?

Select one or more of the following:

  • Tetanus

  • Diptheria

  • Chickenpox

  • Rubella

  • Hepatitis B

Explanation

Question 2 of 50

1

A woman arrives at the clinic for a pregnancy test. The first day of her last menstrual period (LMP) was September 10, 2018. Her expected date of delivery (EDD) would be?

Select one of the following:

  • July 4, 2019

  • June 17, 2019

  • August 7, 2019

  • May 29, 2019

Explanation

Question 3 of 50

1

A pregnant woman experiencing nausea and vomiting should:

Select one of the following:

  • Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.

  • Eat small, frequent meals (every 2 to 3 hours).

  • Increase her intake of high-fat foods to keep the stomach full and coated.

  • Limit fluid intake throughout the day.

Explanation

Question 4 of 50

1

A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman:

Select one of the following:

  • Substitute other calcium sources for milk in her diet.

  • Lie down after each meal.

  • Reduce the amount of fiber she consumes.

  • Eat five small meals daily.

Explanation

Question 5 of 50

1

Which minerals and vitamins usually are recommended to supplement a pregnant woman’s diet?

Select one of the following:

  • Fat-soluble vitamins A and D

  • Water-soluble vitamins C and B6

  • Iron and folate

  • Calcium and zinc

Explanation

Question 6 of 50

1

Which vitamins or minerals can lead to congenital malformations of the fetus if taken in excess by the mother?

Select one of the following:

  • Zinc

  • Vitamin D

  • Folic acid

  • Vitamin A

Explanation

Question 7 of 50

1

With regard to nutritional needs during lactation, a maternity nurse should be aware that:

Select one of the following:

  • The mother’s intake of vitamin C, zinc, and protein now can be lower than during pregnancy.

  • Caffeine consumed by the mother accumulates in the infant, who may be unusually active and wakeful.

  • Critical iron and folic acid levels must be maintained.

  • Lactating women can go back to their prepregnant calorie intake.

Explanation

Question 8 of 50

1

While taking a diet history, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. This represents a nutritional problem known as:

Select one of the following:

  • Preeclampsia.

  • Pyrosis.

  • Pica.

  • Purging.

Explanation

Question 9 of 50

1

When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that:

Select one of the following:

  • Milk, coffee, and tea aid iron absorption if consumed at the same time as iron.

  • Iron absorption is inhibited by a diet rich in vitamin C.

  • Iron supplements are permissible for children in small doses.

  • Constipation is common with iron supplements.

Explanation

Question 10 of 50

1

A pregnant woman’s diet may not meet her need for folates. A good source of this nutrient is:

Select one of the following:

  • Chicken

  • Cheese

  • Potatoes

  • Green leafy vegetables

Explanation

Question 11 of 50

1

Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. The nurse should refer a client to a registered dietitian for in-depth nutritional counseling in the following situations (Select all that apply).

Select one or more of the following:

  • Preexisting or gestational illness such as diabetes

  • Ethnic or cultural food patterns

  • Obesity

  • Vegetarian diet

  • Allergy to tree nuts

Explanation

Question 12 of 50

1

A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique could be used with this pregnant woman at this time?

Select one of the following:

  • Ultrasound examination

  • Maternal serum alpha-fetoprotein (MSAFP) screening

  • Amniocentesis

  • Nonstress test (NST)

Explanation

Question 13 of 50

1

At 35 weeks of pregnancy a woman experiences preterm labor. Tocolytics are administered and she is placed on bed rest, but she continues to experience regular uterine contractions, and her cervix is beginning to dilate and efface. What would be an important test for fetal well-being at this time?

Select one of the following:

  • Percutaneous umbilical blood sampling (PUBS)

  • Ultrasound for fetal size

  • Amniocentesis for fetal lung maturity

  • Nonstress test (NST)

Explanation

Question 14 of 50

1

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

Select one of the following:

  • It is the most common medical disorder of pregnancy.

  • It can trigger reflex brachycardia.

  • The most common form of anemia is caused by folate deficiency.

  • Thalassemia is a European version of sickle cell anemia.

Explanation

Question 15 of 50

1

_____ use/abuse during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications.

Select one of the following:

  • Alcohol

  • Caffeine

  • Tobacco

  • Chocolate

Explanation

Question 16 of 50

1

In caring for an immediate postpartum client, you note petechiae and oozing from her IV site. You would monitor her closely for the clotting disorder:

Select one of the following:

  • Disseminated intravascular coagulation (DIC)

  • Amniotic fluid embolism (AFE)

  • Hemorrhage

  • HELLP syndrome

Explanation

Question 17 of 50

1

In caring for the woman with disseminated intravascular coagulation (DIC), what order should the nurse anticipate?

Select one of the following:

  • Administration of blood

  • Preparation of the client for invasive hemodynamic monitoring

  • Restriction of intravascular fluids

  • Administration of steroids

Explanation

Question 18 of 50

1

A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?

Select one of the following:

  • Blood pressure (BP) increase to 138/86 mm Hg

  • Weight gain of 0.5 kg during the past 2 weeks

  • A dipstick value of 3+ for protein in her urine

  • Pitting pedal edema at the end of the day

Explanation

Question 19 of 50

1

The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the Pitocin infusion, the nurse reviews the woman’s latest laboratory test findings, which reveal a platelet count of 90,000, an elevated aspartate transaminase (AST) level, and a falling hematocrit. The nurse notifies the physician because the laboratory results are indicative of:

Select one of the following:

  • Eclampsia.

  • Disseminated intravascular coagulation (DIC).

  • HELLP syndrome.

  • Idiopathic thrombocytopenia.

Explanation

Question 20 of 50

1

A woman with preeclampsia has a seizure. The nurse’s primary duty during the seizure is to:

Select one of the following:

  • Insert an oral airway.

  • Suction the mouth to prevent aspiration.

  • Administer oxygen by mask.

  • Stay with the client and call for help.

Explanation

Question 21 of 50

1

A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment, the nurse finds the following vital signs: temperature of 99 degrees Fahrenheit, pulse rate of 88 beats/min, respiratory rate of 10 breaths/min, blood pressure (BP) of 148/90 mm Hg, absent deep tendon reflexes, and no ankle clonus. The client complains, “I’m so thirsty and warm.” The nurse:

Select one of the following:

  • Calls for a stat magnesium sulfate level.

  • Administers oxygen.

  • Discontinues the magnesium sulfate infusion.

  • Prepares to administer hydralazine.

Explanation

Question 22 of 50

1

A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes; dark red vaginal bleeding; and a tense, painful abdomen. The nurse suspects the onset of:

Select one of the following:

  • Eclamptic seizure.

  • Rupture of the uterus.

  • Placenta previa.

  • Placental abruption.

Explanation

Question 23 of 50

1

The patient that you are caring for has severe preeclampsia and is receiving a magnesium sulfate infusion. You become concerned after assessment when the woman exhibits:

Select one of the following:

  • A sleepy, sedated affect.

  • A respiratory rate of 10 breaths/min.

  • Deep tendon reflexes of 2.

  • Absent ankle clonus.

Explanation

Question 24 of 50

1

Your patient has been receiving magnesium sulfate for 20 hours for treatment of preeclampsia. She just delivered a viable infant girl 30 minutes ago. What uterine findings would you expect to observe/assess in this client?

Select one of the following:

  • Absence of uterine bleeding in the postpartum period

  • A fundus firm below the level of the umbilicus

  • Scant lochia flow

  • A boggy uterus with heavy lochia flow

Explanation

Question 25 of 50

1

Your patient is being induced because of her worsening preeclampsia. She is also receiving magnesium sulfate. It appears that her labor has not become active despite several hours of oxytocin administration. She asks the nurse, “Why is it taking so long?” The most appropriate response by the nurse would be:

Select one of the following:

  • “The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor.”

  • “I don’t know why it is taking so long.”

  • “The length of labor varies for different women.”

  • “Your baby is just being stubborn.”

Explanation

Question 26 of 50

1

Nurses should be aware that HELLP syndrome:

Select one of the following:

  • Is a mild form of preeclampsia.

  • Can be diagnosed by a nurse alert to its symptoms.

  • Is characterized by hemolysis, elevated liver enzymes, and low platelets.

  • Is associated with preterm labor but not perinatal mortality.

Explanation

Question 27 of 50

1

In planning care for women with preeclampsia, nurses should be aware that:

Select one of the following:

  • Induction of labor is likely, as near term as possible.

  • If at home, the woman should be confined to her bed, even with mild preeclampsia.

  • A special diet low in protein and salt should be initiated.

  • Vaginal birth is still an option, even in severe cases.

Explanation

Question 28 of 50

1

Magnesium sulfate is given to women with preeclampsia and eclampsia to:

Select one of the following:

  • Improve patellar reflexes and increase respiratory efficiency.

  • Shorten the duration of labor.

  • Prevent and treat convulsions.

  • Prevent a boggy uterus and lessen lochial flow.

Explanation

Question 29 of 50

1

A woman presents to the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion?

Select one of the following:

  • Incomplete

  • Inevitable

  • Threatened

  • Septic

Explanation

Question 30 of 50

1

The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is:

Select one of the following:

  • Bleeding.

  • Intense abdominal pain.

  • Uterine activity.

  • Cramping.

Explanation

Question 31 of 50

1

A 26-year-old pregnant woman, gravida 2, para 1-0-0-1 is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what would be an expected diagnostic procedure?

Select one of the following:

  • Amniocentesis for fetal lung maturity

  • Ultrasound for placental location

  • Contraction stress test (CST)

  • Internal fetal monitoring

Explanation

Question 32 of 50

1

As related to the care of the patient with miscarriage, nurses should be aware that:

Select one of the following:

  • It is a natural pregnancy loss before labor begins.

  • It occurs in fewer than 5% of all clinically recognized pregnancies.

  • It often can be attributed to careless maternal behavior such as poor nutrition or excessive exercise.

  • If it occurs before the twelfth week of pregnancy, it may manifest only as moderate discomfort and blood loss.

Explanation

Question 33 of 50

1

Which maternal condition always necessitates delivery by cesarean section?

Select one of the following:

  • Partial abruptio placentae

  • Total placenta previa

  • Ectopic pregnancy

  • Eclampsia

Explanation

Question 34 of 50

1

A placenta previa in which the placental edge just reaches the internal os is more commonly known as:

Select one of the following:

  • Total

  • Partial

  • Complete

  • Marginal

Explanation

Question 35 of 50

1

What condition indicates concealed hemorrhage when the patient experiences an abruptio placentae?

Select one of the following:

  • Decrease in abdominal pain

  • Bradycardia

  • Hard, boardlike abdomen

  • Decrease in fundal height

Explanation

Question 36 of 50

1

The priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to:

Select one of the following:

  • Assess fetal heart rate (FHR) and maternal vital signs

  • Perform a venipuncture for hemoglobin and hematocrit levels

  • Place clean disposable pads to collect any drainage

  • Monitor uterine contractions

Explanation

Question 37 of 50

1

A patient with pregnancy-induced hypertension is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs are an indication of:

Select one of the following:

  • Anxiety due to hospitalization.

  • Worsening disease and impending convulsion.

  • Effects of magnesium sulfate.

  • Gastrointestinal upset.

Explanation

Question 38 of 50

1

The nurse providing care for a woman with preterm labor who is receiving terbutaline would include which intervention to identify side effects of the drug?

Select one of the following:

  • Assessing deep tendon reflexes (DTRs)

  • Assessing for chest discomfort and palpitations

  • Assessing for bradycardia

  • Assessing for hypoglycemia

Explanation

Question 39 of 50

1

In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, what finding would alert the nurse to possible side effects?

Select one of the following:

  • Urine output of 160 mL in 4 hours

  • Deep tendon reflexes 2+ and no clonus

  • Respiratory rate of 16 breaths/min

  • Serum magnesium level of 10 mg/dL

Explanation

Question 40 of 50

1

The nurse is caring for a client whose labor is being augmented with oxytocin. He or she recognizes that the oxytocin should be discontinued immediately if there is evidence of:

Select one of the following:

  • Uterine contractions occurring every 8 to 10 minutes.

  • A fetal heart rate (FHR) of 180 with absence of variability.

  • The client’s needing to void.

  • Rupture of the client’s amniotic membranes.

Explanation

Question 41 of 50

1

With regard to the process of augmentation of labor, the nurse should be aware that it:

Select one of the following:

  • Is part of the active management of labor that is instituted when the labor process is unsatisfactory.

  • Relies on more invasive methods when oxytocin and amniotomy have failed.

  • Is a modern management term to cover up the negative connotations of forceps-assisted birth.

  • Uses vacuum cups.

Explanation

Question 42 of 50

1

The nurse practicing in a labor setting knows that the woman most at risk for uterine rupture is:

Select one of the following:

  • A gravida 3 who has had two low-segment transverse cesarean births.

  • A gravida 2 who had a low-segment vertical incision for delivery of a 10-pound infant.

  • A gravida 5 who had two vaginal births and two cesarean births.

  • A gravida 4 who has had all cesarean births.

Explanation

Question 43 of 50

1

The priority nursing care associated with an oxytocin (Pitocin) infusion is:

Select one of the following:

  • Measuring urinary output.

  • Increasing infusion rate every 30 minutes.

  • Monitoring uterine response.

  • Evaluating cervical dilation.

Explanation

Question 44 of 50

1

The nurse recognizes that uterine hyperstimulation with oxytocin requires emergency interventions. What clinical cues would alert the nurse that the woman is experiencing uterine hyperstimulation (Select all that apply)?

Select one or more of the following:

  • Uterine contractions lasting <90 seconds and occurring >2 minutes in frequency

  • Uterine contractions lasting >90 seconds and occurring <2 minutes in frequency

  • Uterine tone <20 mm Hg

  • Uterine tone >20 mm Hg

  • Increased uterine activity accompanied by a nonreassuring fetal heart rate (FHR) and pattern

Explanation

Question 45 of 50

1

When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal:

Select one of the following:

  • Lie.

  • Presentation.

  • Attitude.

  • Position.

Explanation

Question 46 of 50

1

The nurse has received report regarding her patient in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and ?2-2. The nurse’s interpretation of this assessment is that:

Select one of the following:

  • The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines.

  • The cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.

  • The cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines.

  • The cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines.

Explanation

Question 47 of 50

1

To care for a laboring woman adequately, the nurse understands that the __________ stage of labor varies the most in length?

Select one of the following:

  • First

  • Second

  • Third

  • Fourth

Explanation

Question 48 of 50

1

The factors that affect the process of labor and birth, known commonly as the five Ps, include all except:

Select one of the following:

  • Passenger.

  • Passageway.

  • Powers.

  • Pressure.

Explanation

Question 49 of 50

1

Which basic type of pelvis includes the correct description and percentage of occurrence in women?

Select one of the following:

  • Gynecoid: classic female; heart shaped; 75%

  • Android: resembling the male; wider oval; 15%

  • Anthropoid: resembling the ape; narrower; 10%

  • Platypelloid: flattened, wide, shallow; 3%

Explanation

Question 50 of 50

1

To teach patients about the process of labor adequately, the nurse knows that which event is the best indicator of true labor?

Select one of the following:

  • Bloody show

  • Cervical dilation and effacement

  • Fetal descent into the pelvic inlet

  • Uterine contractions every 7 minutes

Explanation