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Prevent seizures b. Reduce blood pressure c. Slow the process of labor d. Increase diuresis 2. When preparing a teaching plan for a client who is to receive a rubella vaccine during the postpartum period, the midwife in charge should include which of the following? a. The vaccine prevents a future fetus from developing congenital anomalies b. Pregnancy should be avoided for 3 months after the immunization c. The client should avoid contact with children diagnosed with rubella d. The injection will provide immunity against the 7-day measles.
After administration of rubella vaccine, the client should be instructed to avoid pregnancy for at least 3 months to prevent the possibility of the vaccine’s toxic effects to the fetus.
3. A 39-year-old at 18 weeks’ gestation is admitted to the hospital with complaints of vaginal bleeding following the use of cocaine 1 hour earlier. Which complication is most likely causing the client’s complaint of vaginal bleeding? a. Placenta previa b. Abruptio placentae c. Ectopic pregnancy d. Spontaneous abortion
The major maternal adverse reactions from cocaine use in pregnancy include spontaneous abortion for the first trimester and abruption placentae in the third trimester.
4. A client makes a routine visit to the prenatal clinic. Although she’s 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Diaz diagnoses gestational trophoblastic disease and orders ultrasonography. The midwifeexpects ultrasonography to reveal: a. an empty gestational sac. b. grapelike clusters. c. a severely malformed fetus. d. an extrauterine pregnancy.
In a client with gestational trophoblastic disease, an ultrasound performed after the 3rd month shows grapelike clusters of transparent vesicles rather than a fetus. The vesicles contain a clear fluid and may involve all or part of the decidual lining of the uterus. Usually no embryo (and therefore no fetus) is present because it has been absorbed. Because there is no fetus, there can be no extrauterine pregnancy. An extrauterine pregnancy is seen with an ectopic pregnancy.
vaginal bleeding b. Which finding indicates a genetic risk factor? a. uterine contractions 8. Clients generally experience fatigue and nausea during pregnancy. The patient has a history of preterm labor at 32 weeks’ gestation 6. Proteinuria. Which of the following would the midwife Sandra most likely expect to find when assessing a pregnant client with abruption placenta? a. 7. headaches. boardlike abdomen c. A pregnant client is diagnosed with partial placenta previa. Blurred vision b. vaginal bleeding c. Excessive vaginal bleeding b. Labor induction with oxytocin . Headaches. headaches. double vision. the midwife tells the client that the usual treatment for partial placenta previa is which of the following? a. Titanic uterine contractions d.5. Immediate cesarean delivery d. usually reported as a sharp stabbing sensation high in the uterine fundus with the initial separation. The patient is 25 years old b. The midwife in charge is reviewing a patient’s prenatal history. Activity limited to bed rest b. Shortness of breath on exertion Blurred or double vision may indicate hypertension or preeclampsia and should be reported immediately. Pain. Platelet infusion c. A patient is in last trimester of pregnancy. Increased vaginal mucus d. double vision. also is common. double vision d. 9. Hemorrhoids c. Proteinuria. Urinary frequency is a common problem during pregnancy caused by increased weight pressure on the bladder from the uterus. A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms? a. The patient has a child with cystic fibrosis c. In explaining the diagnosis. Midwife Jane should instruct her to notify her primary health care provider immediately if she notices: a. Premature rupture of membranes The most common assessment finding in a client with abruption placenta is a rigid or boardlike abdomen. Proteinuria. Rigid. The patient was exposed to rubella at 36 weeks’ gestation d.
Less than 2 g protein in a 24 hour sample d. Place a pillow under the left buttock c. oxygen may be administered by face mask to prevent fetal hypoxia. which of the following assessment findings would alert the midwife to suspect hypermagnesemia. Diazepam (Vallium) b. a. The physician orders intravenous magnesium sulfate for a primigravid client at 38 weeks gestation diagnosed with severe pre-eclampsia. Phenytoin (Dilantin) 13. Hydralazine (Apresoline) c. Maintain a patent airway The priority for the pregnant client having a seizure is to maintain a patent airway to ensure adequate oxygenation to the mother and the fetus. For the client who is receiving intravenous magnesium sulfate for severe pre-eclampsia. Blood pressure of 138/94 mm Hg b. 12. Which of the following medications woult the midwife have readily available at the client’s bedside. Cool skin temperature c.10. Which of the following would the midwife in charge do first? a. A client with eclampsia begins to experience a seizure. Insert a padded tongue blade into the mouth d. High residue diet b. 11. the midwife would interpret which of the following as most indicative of the client’s diagnosis. Weight gain of 0. Decreased deep tendon reflexes b. Calcium Gluconate d. Regular diet d. Low-sodium diet c. Additionally. When teaching a multigravid client diagnosed with mild preeclampsia about nutritional needs which of the following types of diet would the midwife discuss. Rapid pulse rate d. a. When reviewing the prenatal records of a 16 year old primigravida client at 37 weeks gestation diagnosed with severe preeclampsia. Pad the side rails b. Tingling in the toes. a. . Severe blurring of vision c. a.5 pounds in 1 week. 14. High-protein diet.
the midwife teaches the client about the various factors associated with pre-eclampsia. 17. After suction and evacuation of a complete hydatidiform mole. Mild edema in hands and face. When assessing a 34 year old multigravid client at 35 weeks gestation experiencing moderate vaginal bleeding. would indicate the need for additional teaching? a. a. the 28-year-old multigravid client asks the midwife she can become pregnant again. assessment reveals that the client has gained 2 pounds in the past week and her current blood pressure is 130 mmHg. the midwife explains the need for follow-up care.15. Transverse lie c. Frequent voiding in large amounts d. Painless vaginal bleeding b. Placenta Accreta d. Age older than 35 years. Pounding headache after reading b. Which of the following assessment findings would further evidence to support the client diagnosis. Which of the following is stated by the client as an associated condition. Intermittent pain with spotting d. In response to a question from a 40 year old multigravid client diagnosed with mild pre-eclampsia about the causes of this problem. Multifetal pregnancy b. When preparing a multigravid client who has undergone evacuation of a hydatidiform mole for discharge. History of urinary tract infection c. The midwife determines that the client understands the instruction when she says that she is at risk for developing which of the following? a. Uterine Atony 18. for which of the following should the midwife assess a. 18 months . The midwife would advise the client not to become pregnant again for at least which of the following time spans? a. Multifetal Pregancies d. Abruption placentae b. Uterine Tetany c. which of the following would most likely alert the midwife that placenta previa is present. 6 months b.’ d. Fiabetes mellitus c. If a client at 36 weeks gestation with eclampsia begins to exhibit signs of labor after an eclamptic seizure. 19. 12 months c. Infertility 20. During a home visit to a 16-year-old client at 24 weeks gestation diagnosed with mild preeclampsia. Choriocarcinoma c. Dull lower back pain. a. Ectopic Pregnancy b. Iron deficiency 16.
Complete Abortion 23. The nurse notifies the physician immediately because which of the following is suspected? a. Pallor . Hemoglobin and hematocrit d. The midwife would assess for signs and symptoms of the following. Abruptio Placentae c. Hyperglycemia 22. A 36 year old client is admitted to the hospital with possible ruptured ectopic pregnancy. Ovary 24. Hypercalcemia b. Hypokalemia d. The client’s blood pressure is 70/50 mmHg and her pulse is 120 bpm. Episodes of pelvic inflammatory disease d. a. Fallopian Tube b. which of the following would the midwife assess. a. Uterine cramping b. A multigravid client though to be at 14 weeks gestation reports that she is experiencing such severe morning sickness that “she has not been able to keep anything down for a week”. which of the following would the nurse include as the most common site of implantation. a client tells the nurse that she suspects that she may be pregnant but has been having a small amount of bleeding and has severe pain in the lower abdomen. Abdominal Distention c. A multigravid client seen in the emergency department complaining of sharp abdominal pain and vaginal spotting is diagnosed with an ectopic pregnancy. In addition to monitoring client’s history. Use of estrogen-progestin contraceptives. Urinary tract infection b. Ectopic Pregnancy b. On arrival at the emergency department. Interstitial Lining d. When obtaining the client’s history. Pulse 25. Intestine c. a. 26. Gestational Trophoblastic Disease d. which of the following would be most important to identify as a predisposing factor. the nurse determines thath the client understands the instructions when she says that hyperglycemia may be manifested by which of the following: a. A multigravid client diagnosed with a probable ruptured ectopic pregnancy is scheduled for emergency surgery. a. Dehydration b. 24 months 21. Hypobilirubinemia c. Marijuana use during pregnancy c. After teaching a diabetic primigravida about symptoms of hyperglycemia. When explaining to the client and family members about ectopic pregnancy.d.
c. The midwife explains the complications of pregnancy that occur with diabetes to a primigravid client at 10 weeks gestation who has a 5 year history of insulin dependent diabetes. Nervousness 27. 28. Polyhydramnios d. Pelvic inflammatory disease (PID) b. . indicates the need for additional teaching. Presence of an IUD d. The nurse correctly responds by saying ectopic pregnancy is caused by which of the following. a. if stated by the client as a complication. Candida Albican’s Infection b. except? a. Twin to twin transfer c. Which of the following. Pre-eclampsia. Sweating d. Eclampsia 29. Endometriosis c. The client asks for information about ectopic pregnancy.