Quiz
NURS 218 Lesson 2 Quiz #2
Questions in this quiz (50)
1A 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)?
- ATetanus
- BDiptheria
- CChickenpox
- DRubella
- EHepatitis B
2A 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?
- AJuly 4, 2019
- BJune 17, 2019
- CAugust 7, 2019
- DMay 29, 2019
3A pregnant woman experiencing nausea and vomiting should:
- ADrink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.
- BEat small, frequent meals (every 2 to 3 hours).
- CIncrease her intake of high-fat foods to keep the stomach full and coated.
- DLimit fluid intake throughout the day.
4A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman:
- ASubstitute other calcium sources for milk in her diet.
- BLie down after each meal.
- CReduce the amount of fiber she consumes.
- DEat five small meals daily.
5Which minerals and vitamins usually are recommended to supplement a pregnant woman’s diet?
- AFat-soluble vitamins A and D
- BWater-soluble vitamins C and B6
- CIron and folate
- DCalcium and zinc
6Which vitamins or minerals can lead to congenital malformations of the fetus if taken in excess by the mother?
- AZinc
- BVitamin D
- CFolic acid
- DVitamin A
7With regard to nutritional needs during lactation, a maternity nurse should be aware that:
- AThe mother’s intake of vitamin C, zinc, and protein now can be lower than during pregnancy.
- BCaffeine consumed by the mother accumulates in the infant, who may be unusually active and wakeful.
- CCritical iron and folic acid levels must be maintained.
- DLactating women can go back to their prepregnant calorie intake.
8While 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:
- APreeclampsia.
- BPyrosis.
- CPica.
- DPurging.
9When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that:
- AMilk, coffee, and tea aid iron absorption if consumed at the same time as iron.
- BIron absorption is inhibited by a diet rich in vitamin C.
- CIron supplements are permissible for children in small doses.
- DConstipation is common with iron supplements.
10A pregnant woman’s diet may not meet her need for folates. A good source of this nutrient is:
- AChicken
- BCheese
- CPotatoes
- DGreen leafy vegetables
11Most 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).
- APreexisting or gestational illness such as diabetes
- BEthnic or cultural food patterns
- CObesity
- DVegetarian diet
- EAllergy to tree nuts
12A 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?
- AUltrasound examination
- BMaternal serum alpha-fetoprotein (MSAFP) screening
- CAmniocentesis
- DNonstress test (NST)
13At 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?
- APercutaneous umbilical blood sampling (PUBS)
- BUltrasound for fetal size
- CAmniocentesis for fetal lung maturity
- DNonstress test (NST)
14As related to the care of the patient with anemia, the nurse should be aware that:
- AIt is the most common medical disorder of pregnancy.
- BIt can trigger reflex brachycardia.
- CThe most common form of anemia is caused by folate deficiency.
- DThalassemia is a European version of sickle cell anemia.
15_____ use/abuse during pregnancy causes vasoconstriction and decreased placental perfusion, resulting in maternal and neonatal complications.
- AAlcohol
- BCaffeine
- CTobacco
- DChocolate
16In caring for an immediate postpartum client, you note petechiae and oozing from her IV site. You would monitor her closely for the clotting disorder:
- ADisseminated intravascular coagulation (DIC)
- BAmniotic fluid embolism (AFE)
- CHemorrhage
- DHELLP syndrome
17In caring for the woman with disseminated intravascular coagulation (DIC), what order should the nurse anticipate?
- AAdministration of blood
- BPreparation of the client for invasive hemodynamic monitoring
- CRestriction of intravascular fluids
- DAdministration of steroids
18A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?
- ABlood pressure (BP) increase to 138/86 mm Hg
- BWeight gain of 0.5 kg during the past 2 weeks
- CA dipstick value of 3+ for protein in her urine
- DPitting pedal edema at the end of the day
19The 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:
- AEclampsia.
- BDisseminated intravascular coagulation (DIC).
- CHELLP syndrome.
- DIdiopathic thrombocytopenia.
20A woman with preeclampsia has a seizure. The nurse’s primary duty during the seizure is to:
- AInsert an oral airway.
- BSuction the mouth to prevent aspiration.
- CAdminister oxygen by mask.
- DStay with the client and call for help.
21A 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:
- ACalls for a stat magnesium sulfate level.
- BAdministers oxygen.
- CDiscontinues the magnesium sulfate infusion.
- DPrepares to administer hydralazine.
22A 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:
- AEclamptic seizure.
- BRupture of the uterus.
- CPlacenta previa.
- DPlacental abruption.
23The 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:
- AA sleepy, sedated affect.
- BA respiratory rate of 10 breaths/min.
- CDeep tendon reflexes of 2.
- DAbsent ankle clonus.
24Your 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?
- AAbsence of uterine bleeding in the postpartum period
- BA fundus firm below the level of the umbilicus
- CScant lochia flow
- DA boggy uterus with heavy lochia flow
25Your 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:
- A“The magnesium is relaxing your uterus and competing with the oxytocin. It may increase the duration of your labor.”
- B“I don’t know why it is taking so long.”
- C“The length of labor varies for different women.”
- D“Your baby is just being stubborn.”
26Nurses should be aware that HELLP syndrome:
- AIs a mild form of preeclampsia.
- BCan be diagnosed by a nurse alert to its symptoms.
- CIs characterized by hemolysis, elevated liver enzymes, and low platelets.
- DIs associated with preterm labor but not perinatal mortality.
27 In planning care for women with preeclampsia, nurses should be aware that:
- AInduction of labor is likely, as near term as possible.
- BIf at home, the woman should be confined to her bed, even with mild preeclampsia.
- CA special diet low in protein and salt should be initiated.
- DVaginal birth is still an option, even in severe cases.
28Magnesium sulfate is given to women with preeclampsia and eclampsia to:
- AImprove patellar reflexes and increase respiratory efficiency.
- BShorten the duration of labor.
- CPrevent and treat convulsions.
- DPrevent a boggy uterus and lessen lochial flow.
29A 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?
- AIncomplete
- BInevitable
- CThreatened
- DSeptic
30The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is:
- ABleeding.
- BIntense abdominal pain.
- CUterine activity.
- DCramping.
31A 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?
- AAmniocentesis for fetal lung maturity
- BUltrasound for placental location
- CContraction stress test (CST)
- DInternal fetal monitoring
32As related to the care of the patient with miscarriage, nurses should be aware that:
- AIt is a natural pregnancy loss before labor begins.
- BIt occurs in fewer than 5% of all clinically recognized pregnancies.
- CIt often can be attributed to careless maternal behavior such as poor nutrition or excessive exercise.
- DIf it occurs before the twelfth week of pregnancy, it may manifest only as moderate discomfort and blood loss.
33Which maternal condition always necessitates delivery by cesarean section?
- APartial abruptio placentae
- BTotal placenta previa
- CEctopic pregnancy
- DEclampsia
34A placenta previa in which the placental edge just reaches the internal os is more commonly known as:
- ATotal
- BPartial
- CComplete
- DMarginal
35What condition indicates concealed hemorrhage when the patient experiences an abruptio placentae?
- ADecrease in abdominal pain
- BBradycardia
- CHard, boardlike abdomen
- DDecrease in fundal height
36The priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy is to:
- AAssess fetal heart rate (FHR) and maternal vital signs
- BPerform a venipuncture for hemoglobin and hematocrit levels
- CPlace clean disposable pads to collect any drainage
- DMonitor uterine contractions
37A 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:
- AAnxiety due to hospitalization.
- BWorsening disease and impending convulsion.
- CEffects of magnesium sulfate.
- DGastrointestinal upset.
38The nurse providing care for a woman with preterm labor who is receiving terbutaline would include which intervention to identify side effects of the drug?
- AAssessing deep tendon reflexes (DTRs)
- BAssessing for chest discomfort and palpitations
- CAssessing for bradycardia
- DAssessing for hypoglycemia
39In evaluating the effectiveness of magnesium sulfate for the treatment of preterm labor, what finding would alert the nurse to possible side effects?
- AUrine output of 160 mL in 4 hours
- BDeep tendon reflexes 2+ and no clonus
- CRespiratory rate of 16 breaths/min
- DSerum magnesium level of 10 mg/dL
40The 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:
- AUterine contractions occurring every 8 to 10 minutes.
- BA fetal heart rate (FHR) of 180 with absence of variability.
- CThe client’s needing to void.
- DRupture of the client’s amniotic membranes.
41With regard to the process of augmentation of labor, the nurse should be aware that it:
- AIs part of the active management of labor that is instituted when the labor process is unsatisfactory.
- BRelies on more invasive methods when oxytocin and amniotomy have failed.
- CIs a modern management term to cover up the negative connotations of forceps-assisted birth.
- DUses vacuum cups.
42The nurse practicing in a labor setting knows that the woman most at risk for uterine rupture is:
- AA gravida 3 who has had two low-segment transverse cesarean births.
- BA gravida 2 who had a low-segment vertical incision for delivery of a 10-pound infant.
- CA gravida 5 who had two vaginal births and two cesarean births.
- DA gravida 4 who has had all cesarean births.
43The priority nursing care associated with an oxytocin (Pitocin) infusion is:
- AMeasuring urinary output.
- BIncreasing infusion rate every 30 minutes.
- CMonitoring uterine response.
- DEvaluating cervical dilation.
44The 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)?
- AUterine contractions lasting <90 seconds and occurring >2 minutes in frequency
- BUterine contractions lasting >90 seconds and occurring <2 minutes in frequency
- CUterine tone <20 mm Hg
- DUterine tone >20 mm Hg
- EIncreased uterine activity accompanied by a nonreassuring fetal heart rate (FHR) and pattern
45When assessing a woman in labor, the nurse is aware that the relationship of the fetal body parts to one another is called fetal:
- ALie.
- BPresentation.
- CAttitude.
- DPosition.
46The 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:
- AThe cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm above the ischial spines.
- BThe cervix is 3 cm dilated, it is effaced 30%, and the presenting part is 2 cm above the ischial spines.
- CThe cervix is effaced 3 cm, it is dilated 30%, and the presenting part is 2 cm below the ischial spines.
- DThe cervix is dilated 3 cm, it is effaced 30%, and the presenting part is 2 cm below the ischial spines.
47To care for a laboring woman adequately, the nurse understands that the __________ stage of labor varies the most in length?
- AFirst
- BSecond
- CThird
- DFourth
48The factors that affect the process of labor and birth, known commonly as the five Ps, include all except:
- APassenger.
- BPassageway.
- CPowers.
- DPressure.
49Which basic type of pelvis includes the correct description and percentage of occurrence in women?
- AGynecoid: classic female; heart shaped; 75%
- BAndroid: resembling the male; wider oval; 15%
- CAnthropoid: resembling the ape; narrower; 10%
- DPlatypelloid: flattened, wide, shallow; 3%
50To teach patients about the process of labor adequately, the nurse knows that which event is the best indicator of true labor?
- ABloody show
- BCervical dilation and effacement
- CFetal descent into the pelvic inlet
- DUterine contractions every 7 minutes
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