Quiz 5 Test Bank

Chapter 7: High-Risk Antepartum Nursing Care
Multiple Choice
1. A client on 2 gm/hr of magnesium sulfate has decreased deep tendon reflexes. Identify the
priority nursing assessment to ensure client safety.a. Assess uterine contractions continuously.b.
Assess fetal heart rate continuously.c. Assess urinary output.d. Assess respiratory rate.
ANS: d
Feedback
a. Monitoring contractions does not indicate
magnesium toxicity.
b. Magnesium sulfate will decrease fetal
variability and not provide an accurate
assessment of magnesium toxicity.
c. Urinary output does not correlate to decreased
deep tendon reflexes.
d. Correct. Respiratory effort and deep tendon
reflexes (DTRs) are involuntary, and a
decrease in DTRs could indicate the risk of
magnesium sulfate toxicity and the risk for
decreased respiratory effort.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Analysis | Content Area:
Maternity | Client Need: Pharmacological/Parenteral Therapies | Difficulty Level: Moderate
2. A pregnant client with a history of multiple sexual partners is at highest risk for which of the
following complications:a. Premature rupture of membranesb. Gestational diabetesc. Ectopic
pregnancyd. Pregnancy-induced hypertension
ANS: c
Feedback
a. Multiple partners do not increase a woman’s
risk of premature rupture of membranes.
b. Genetics and client diet and weight are
contributing factors to gestational diabetes.
c. Correct. A history of multiple sexual partners
places the client at a higher risk of having
contracted a sexually transmitted disease that
could have ascended the uterus to the
fallopian tubes and caused fallopian tube
blockage, placing the client at high risk for an
ectopic pregnancy.
d. Multiple sexual partners are not a risk factor
for pregnancy-induced hypertension.
3. Identify the hallmark of placenta previa that differentiates it from abruptio placenta.a. Sudden
onset of painless vaginal bleedingb. Board-like abdomen with severe painc. Sudden onset of
bright red vaginal bleedingd. Severe vaginal pain with bright red bleeding
ANS: a
Feedback
a. Correct. When the placenta attaches to the
lower uterine segment near or over the
cervical os, bleeding may occur without the
onset of contractions or pain.
b. The hallmark for abruptio placenta is pain
and a board-like abdomen.
c. Bright red bleeding could be related to
abruptio placenta, placenta previa, or other
complications of pregnancy.
d. Pain is not a hallmark of placenta previa.
Maternity | Client Need: Physiological Adaptation | Difficulty Level: Moderate
4. Which of the following assessments would indicate instability in the client hospitalized for
placenta previa?a. BP <90/60 mm/Hg, Pulse <60 BPM or >120 BPMb. FHR moderate variability
without accelerationsc. Dark brown vaginal discharge when voidingd. Oral temperature of 99.9F
ANS: a
Feedback
a. A decrease in BP accompanied by
bradycardia or tachycardia is an indication of
hypovolemic shock.
b. FHR with moderate variability can be absent
of accelerations during fetal sleep cycles or
after maternal sedation.
c. Bright red vaginal bleeding is an indication of
current bleeding.
d. Oral temperature may fluctuate based on the
client’s hydration status. It should be
reassessed. Cause for concern is a
temperature of 100.4F or more.
5. During pregnancy, poorly controlled asthma can place the fetus at risk for:a. Hyperglycemiab.
IUGRc. Hypoglycemiad. Macrosomia
ANS: b
Feedback
a. Maternal asthma does not place the fetus at
risk for hyperglycemia.
b. Compromised pulmonary function can lead to
decompensation and hypoxia that decrease
oxygen flow to the fetus and can cause
intrauterine growth restriction (IUGR).
c. Asthma does not directly affect glycemic
control.
d. A fetus experiencing hypoxia would be small
for gestational age, not large for gestational
age.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: AnalysisContent Area:
6. Which of the following nursing diagnoses is of highest priority for a client with an ectopic
pregnancy who has developed disseminated intravascular coagulation (DIC)?a. Risk for deficient
fluid volumeb. Risk for family process interruptedc. Risk for disturbed identityd. High risk for
injury
ANS: a
Feedback
a. Correct. The client is at high risk for
hypovolemia which is life threatening and
takes precedence over any psychosocial or
less pressing diagnoses.
b. This is a psychosocial diagnosis and is not
life threatening.
c. This is a psychosocial diagnosis and is not
life threatening.
d. The client is at risk for injury; however, the
diagnosis of deficient fluid volume is more
descriptive and has clearly defined goals and
interventions.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Comprehension | Content
Area: Maternity | Client Need: Physiological Adaptation | Difficulty Level: Difficult
7. Which of the following laboratory values is most concerning in a client with pregnancy-
induced hypertension?a. Total urine protein of 200 mg/dLb. Total platelet count of 40,000 mm c.
Uric acid level of 8 mg/dLd. Blood urea nitrogen 24 mg/dL
ANS: b
Feedback
a. The client’s urine protein is elevated. A urine
protein of ≥300 mg/dL in a 24-hour collection
is considered concerning.
b. Correct. A platelet count of 50,000 is a critical
value and should be reported to the health-
care provider immediately. This client is at
increased risk of hemorrhage.
c. The uric acid level is only slightly elevated.
d. The BUN is only slightly elevated.
Area: Maternity | Client Need: Physiological Adaptation | Difficulty Level: Difficult
8. Which of the following medications administered to the pregnant client with GDM and
experiencing preterm labor requires close monitoring of the client’s blood glucose levels?a.
Nifedipineb. Betamethasone c. Magnesium sulfated. Indomethacin
ANS: b
Feedback
a. Nifedipine does not affect maternal blood
glucose levels.
b. Beta-sympathomimetics may stimulate
hyperglycemia which will require an
increased need for insulin.
c. Magnesium sulfate does not affect blood
glucose levels.
d. Indomethacin does not affect blood glucose
levels.
Area: Maternity | Client Need: Pharmacological/Parenteral Therapies | Difficulty Level: Difficult
9. While educating the client with class II cardiac disease, at 28 weeks’ gestation, the nurse
instructs the client to notify the physician if she experiences which of the following conditions?
a. Emotional stress at workb. Increased dyspnea while restingc. Mild pedal and ankle edemad.
Weight gain of 1 pound in 1 week
ANS: b
Feedback
a. Emotional stress increases cardiac workload;
however, without symptoms of cardiac
decompensation, this is not immediately
concerning.
b. Increasing dyspnea, at rest, can be a sign of
cardiac decompensation leading to increased
congestive heart failure.
c. Mild edema during the third trimester is
normal. However, increasing edema and
pitting edema should be reported as they can
be a sign of increasing CHF.
d. A weight gain of 1 pound per week is
expected during the third trimester.
KEY: Integrated Process: Teaching and Learning | Cognitive Level: Application | Content Area:
Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate
10. The nurse working in a prenatal clinic is providing care to three primigravida patients. Which
of the patient findings would the nurse highlight for the physician?
a. 15 weeks, denies feeling fetal movement
b. 20 weeks, fundal height at the umbilicus
c. 25 weeks, complains of excess salivation
d. 30 weeks, states that her vision is blurry
ANS: d
Feedback
a. This finding is normal. Quickening is usually
felt between 16 and 20 weeks’ gestation.
b. This finding is normal. The fundal height at
20 weeks’ gestation is usually at the level of
the umbilicus.
c. Excess salivation is a normal, albeit
annoying, finding.
d. Blurred vision is a sign of pregnancy-induced
hypertension (PIH). This finding should be
reported to the woman’s health-care
practitioner.
KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Application |

Content Area: Antepartum Care; Reduction of Risk Potential: Potential for Alterations in Body
Systems | Client Need: Health Promotion and Maintenance; Physiological Integrity: Reduction of
Risk Potential | Difficulty Level: Difficult
11. The perinatal nurse is assessing a woman in triage who is 34 + 3 weeks’ gestation in her first
pregnancy. She is worried about having her baby “too soon,” and she is experiencing uterine
contractions every 10 to 15 minutes. The fetal heart rate is 136 beats per minute. A vaginal
examination performed by the health-care provider reveals that the cervix is closed, long, and
posterior. The most likely diagnosis would be:
a. Preterm labor
b. Term labor
c. Back labor
d. Braxton-Hicks contractions
ANS: d
Feedback
a. Preterm labor (PTL) is defined as regular
uterine contractions and cervical dilation
before the end of the 36th week of gestation.
Many patients present with preterm
contractions, but only those who demonstrate
changes in the cervix are diagnosed with
preterm labor.
b. Term labor occurs after 37 weeks’ gestation.
c. There is no indication in this scenario that this
is back labor.
d. Braxton-Hicks contractions are regular
contractions occurring after the third month
of pregnancy. They may be mistaken for
regular labor, but unlike true labor, the
contractions do not grow consistently longer,
stronger, and closer together, and the cervix is
not dilated. Some patients present with
preterm contractions, but only those who
demonstrate changes in the cervix are
diagnosed with preterm labor.
Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Difficult
12. The perinatal nurse knows that the term to describe a woman at 26 weeks’ gestation with a
history of elevated blood pressure who presents with a urine showing 2+ protein (by dipstick) is:
a. Preeclampsia
b. Chronic hypertension
c. Gestational hypertension
d. Chronic hypertension with superimposed preeclampsia
ANS: d
Feedback
a. Preeclampsia is a multisystem, vasopressive
disease process that targets the
cardiovascular, hematologic, hepatic, and
renal and central nervous systems.
b. Chronic hypertension is hypertension that is
present and observable prior to pregnancy or
hypertension that is diagnosed before the 20th
week of gestation.
c. Gestational hypertension is a nonspecific term
used to describe the woman who has a blood
pressure elevation detected for the first time
during pregnancy, without proteinuria.
d. The following criteria are necessary to
establish a diagnosis of superimposed
preeclampsia: hypertension and no
proteinuria early in pregnancy (prior to 20
weeks’ gestation) and new-onset proteinuria,
a sudden increase in protein—urinary
excretion of 0.3 g protein or more in a 24-
hour specimen, or two dipstick test results of
2+ (100 mg/dL), with the values recorded at
least 4 hours apart, with no evidence of
urinary tract infection; a sudden increase in
blood pressure in a woman whose blood
pressure has been well controlled;
thrombocytopenia (platelet count lower than
100,000/mmC); and an increase in the liver
enzymes alanine transaminase (ALT) or
aspartate transaminase (AST) to abnormal
levels.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application | Content
Area: Peds/Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level:
Moderate
13. A patient is receiving magnesium sulfate for severe preeclampsia. The nurse must notify the
attending physician immediately of which of the following findings?
a. Patellar and biceps reflexes of +4
b. Urinary output of 50 mL/hr
c. Respiratory rate of 10 rpm
d. Serum magnesium level of 5 mg/dL
ANS: c
Feedback
a. The magnesium sulfate has been ordered
because the patient has severe pregnancy-
induced hypertension. Patellar and biceps
reflexes of +4 are symptoms of the disease.
b. The urinary output must be above 25 mL/hr.
c. The drop in respiratory rate may indicate that
the patient is suffering from magnesium
toxicity. The nurse should report the finding
to the physician.
d. The therapeutic range of magnesium is 4 to 7
mg/dL.
KEY: Integrated Process: Nursing Process: Analysis; Nursing Process: Implementation |
Cognitive Level: Application | Content Area: Adverse Effects/Contraindications; Antepartum
Care; Potential for Alterations in Body Systems; Reduction of Risk Potential: Diagnostic Tests |
Client Need: Health Promotion and Maintenance; Pharmacological and Parenteral Therapies;
Physiological Integrity: Reduction of Risk Potential | Difficulty Level: Difficult
14. A woman in labor and delivery is being given subcutaneous terbutaline for preterm labor.
Which of the following common medication effects would the nurse expect to see in the mother?
a. Serum potassium level increases
b. Diarrhea
c. Urticaria
d. Complaints of nervousness
ANS: d
Feedback
a. The nurse would not expect to see a rise in
the mother’s serum potassium levels.
b. The beta agonists are not associated with
diarrhea.
c. The beta agonists are not associated with
urticaria.
d. Complaints of nervousness are commonly
made by women receiving subcutaneous beta
agonists.
KEY: Integrated Process: Nursing Process: Analysis | Cognitive Level: Application | Content
Area: Intrapartum Care; Pharmacological and Parenteral Therapies: Adverse Effects/
Contraindications and Side Effects | Client Need: Health Promotion and Maintenance;
Physiological Integrity: Pharmacological and Parenteral Therapies | Difficulty Level: Moderate
15. Which of the following signs or symptoms would the nurse expect to see in a woman with
concealed abruptio placentae?
a. Increasing abdominal girth measurements
b. Profuse vaginal bleeding
c. Bradycardia with an aortic thrill
d. Hypothermia with chills
ANS: a
Feedback
a. The nurse would expect to see increasing
abdominal girth measurements.
b. Profuse vaginal bleeding is rarely seen in
placental abruption and is never seen when
the abruption is concealed.
c. With excessive blood loss, the nurse would
expect to see tachycardia.
d. The nurse would expect to see a stable
temperature.
KEY: Integrated Process: Nursing Process: Assessment | Cognitive Level: Application | Content
Area: Antepartum Care; Reduction of Risk Potential: Potential for Alterations in Body Systems |
Client Need: Health Promotion and Maintenance; Physiological Integrity: Reduction of Risk
Potential | Difficulty Level: Moderate
16. A woman who has had no prenatal care was assessed and found to have hydramnios on
admission to the labor unit and has since delivered a baby weighing 4500 grams. Which of the
following complications of pregnancy likely contributed to these findings?
a. Pyelonephritis
b. Pregnancy-induced hypertension
c. Gestational diabetes
d. Abruptio placentae
ANS: c
Feedback
a. Pyelonephritis does not lead to the
development of hydramnios or macrosomia.
b. Pregnancy-induced hypertension does not
lead to the development of hydramnios or
macrosomia.
c. Untreated gestational diabetics often have
hydramnios and often deliver macrosomic
babies.
d. Abruptio placentae does not lead to the
development of hydramnios or macrosomia.
Area: Antepartum Care; Physiological Adaptation: Alterations in Body Systems | Client Need:
Health Promotion and Maintenance; Physiological Integrity: Physiological Adaptation |
Difficulty Level: Difficult
17. For the patient with which of the following medical problems should the nurse question a
physician’s order for beta agonist tocolytics?
a. Type 1 diabetes mellitus
b. Cerebral palsy
c. Myelomeningocele
d. Positive group B streptococci culture
ANS: a
Feedback
a. Beta agonists often elevate serum glucose
levels. The nurse should question the order.
b. Beta agonists are not contraindicated for
patients with cerebral palsy.
c. Beta agonists are not contraindicated for
patients with myelomeningocele.
d. Beta agonists are not contraindicated for
patients with group B streptococci.

Cognitive Level: Application | Content Area: Intrapartum Care; Reduction of Risk Potential:
Potential for Alterations in Body Systems | Client Need: Health Promotion and Maintenance;
18. The nurse is caring for two laboring women. Which of the patients should be monitored most
carefully for signs of placental abruption?
a. The patient with placenta previa
b. The patient whose vagina is colonized with group B streptococci
c. The patient who is hepatitis B surface antigen positive
d. The patient with eclampsia
ANS: d
Feedback
a. Patients with placenta previa are not
especially high risk for placental abruption.
b. Patients colonized with group B streptococci
are not especially high risk for placental
abruption.
c. Patients who are hepatitis B surface antigen
positive are not especially high risk for
placental abruption.
d. Patients with eclampsia are high risk for
placental abruption.
Content Area: Intrapartum Care; Reduction of Risk Potential: Potential for Complications |
Potential | Difficulty Level: Difficult
19. The nurse is caring for a woman at 28 weeks’ gestation with a history of preterm delivery.
Which of the following laboratory data should the nurse carefully assess in relation to this
diagnosis?
a. Human relaxin levels
b. Amniotic fluid levels
c. Alpha-fetoprotein levels
d. Fetal fibronectin levels
ANS: d
Feedback
a. Relaxin levels are rarely assessed. In addition,
they are unrelated to the incidence of preterm
labor.
b. Amniotic fluid levels are not directly related
to the incidence of preterm labor.
c. Alpha-fetoprotein levels are not related to the
incidence of preterm labor.
d. A rise in the fetal fibronectin levels in cervical
secretions has been associated with preterm
labor.
Area: Antepartum Care; Reduction of Risk Potential: Laboratory Values | Client Need: Health
Promotion and Maintenance; Physiological Integrity: Reduction of Risk Potential | Difficulty
Level: Moderate
20. Which of the following statements is most appropriate for the nurse to say to a patient with a
complete placenta previa?
a. “During the second stage of labor you will need to bear down.”
b. “You should ambulate in the halls at least twice each day.”
c. “The doctor will likely induce your labor with oxytocin.”
d. “Please promptly report if you experience any bleeding or feel any back discomfort.”
ANS: d
Feedback
a. This response is inappropriate. This patient
will be delivered by cesarean section.
b. This response is inappropriate. Patients with
placenta previa are usually on bed rest.
c. This response is inappropriate. This patient
will be delivered by cesarean section.
d. Labor often begins with back pain. Labor is
contraindicated for a patient with complete
placenta previa.

Content Area: Antepartum Care | Client Need: Health Promotion and Maintenance | Difficulty
Level: Easy
21. A woman at 32 weeks’ gestation is diagnosed with severe preeclampsia with HELLP
syndrome. The nurse will identify which of the following as a positive patient care outcome?
a. Rise in serum creatinine
b. Drop in serum protein
c. Resolution of thrombocytopenia
d. Resolution of polycythemia
ANS: c
Feedback
a. A rise in serum creatinine indicates that the
kidneys are not effectively excreting
creatinine. It is a negative outcome.
b. A drop in serum protein indicates that the
kidneys are allowing protein to be excreted.
This is a negative outcome.
c. Resolution of thrombocytopenia is a positive
sign. It indicates that the platelet count is
returning to normal.
d. Polycythemia is not related to HELLP
syndrome. Rather one sees a drop in red cell
and platelet counts with HELLP. A positive
sign, therefore, would be a rise in the RBC
count.
KEY: Integrated Process: Nursing Process: Evaluation | Cognitive Level: Application | Content
Area: Antepartum Care; Physiological Adaptation: Illness Management | Client Need: Health
Promotion and Maintenance; Physiological Integrity: Physiological Adaptation | Difficulty Level:
Difficult
22. A 16-year-old patient is admitted to the hospital with a diagnosis of severe preeclampsia. The
nurse must closely monitor the woman for which of the following?
a. High leukocyte count
b. Explosive diarrhea
c. Fractured pelvis
d. Low platelet count
ANS: d
Feedback
a. High leukocyte count is not associated with
severe pregnancy-induced hypertension (PIH)
or HELLP (hemolysis, elevated liver
enzymes, and low platelets) syndrome.
b. Explosive diarrhea is not associated with
severe PIH or HELLP syndrome.
c. A fractured pelvis is not associated with
severe PIH or HELLP syndrome.
d. Low platelet count is one of the signs
associated with HELLP (hemolysis, elevated
liver enzymes, and low platelets) syndrome.
Area: Antepartum Care; Diagnostic Tests; Reduction of Risk Potential: Laboratory Data | Client
Need: Health Promotion and Maintenance; Physiological Integrity: Reduction of Risk Potential |
23. A woman at 10 weeks’ gestation is diagnosed with gestational trophoblastic disease

(hydatiform mole). Which of the following findings would the nurse expect to see?
a. Platelet count of 550,000/ mm3
b. Dark brown vaginal bleeding
c. White blood cell count 17,000/ mm3
d. Macular papular rash
ANS: b
Feedback
a. The nurse would not expect to see an elevated
platelet count.
b. The nurse would expect to see dark brown
vaginal discharge
c. The nurse would not expect to see an elevated
white blood cell count.
d. The nurse would not expect to see a rash.
24. After an education class, the nurse overhears an adolescent woman discussing safe sex
practices. Which of the following comments by the young woman indicates that additional
teaching about sexually transmitted infection (STI) control issues is needed?
a. “I could get an STI even if I just have oral sex.”
b. “Girls over 16 are less likely to get STDs than younger girls.”
c. “The best way to prevent an STI is to use a diaphragm.”
d. “Girls get human immunodeficiency virus (HIV) easier than boys do.”
ANS: c
Feedback
a. This statement is true. Organisms that cause
sexually transmitted infections can invade the
respiratory and gastrointestinal tracts.
b. This statement is true. Young women are
especially high risk for becoming infected
with sexually transmitted diseases.
c. This statement is untrue. The young woman
needs further teaching. Condoms protect
against STDs and pregnancy. In addition,
condoms can be kept in readiness for
whenever sex may occur spontaneously.
Using condoms does not require the teen to
plan to have sex. A diaphragm is not an
effective infection-control method. Plus, it
would require the teen to plan for intercourse.
d. This statement is true. Young women are
higher risk for becoming infected with HIV
than are young men.
KEY: Integrated Process: Nursing Process: Evaluation; Teaching and Learning | Cognitive Level:
Application | Content Area: Disease Prevention; High Risk Behaviors; Human Sexuality | Client
Need: Health Promotion and Maintenance: High Risk Behaviors; Human Sexuality | Difficulty
Level: Moderate
25. A woman who is admitted to labor and delivery at 30 weeks’ gestation, is 1 cm dilated, and is
contracting q 5 minutes. She is receiving magnesium sulfate IV piggyback. Which of the
following maternal vital signs is most important for the nurse to assess each hour?
a. Temperature
b. Pulse
c. Respiratory rate
d. Blood pressure
ANS: c
Feedback
a. The temperature should be monitored, but it
is not the most important vital sign.
b. The pulse rate should be monitored, but it is
not the most important vital sign.
c. The respiratory rate is the most important
vital sign. Respiratory depression is a sign of
magnesium toxicity.
d. The blood pressure should be monitored, but
it is not the most important vital sign.
Area: Intrapartum Care; Potential for Complications from Pharmacological Therapies: Adverse
Effects/Contraindications | Client Need: Health Promotion and Maintenance; Physiological
Integrity: Pharmacological and Parenteral Therapies | Difficulty Level: Moderate
26. You are caring for a patient who was admitted to labor and delivery at 32 weeks’ gestation
and diagnosed with preterm labor. She is currently on magnesium sulfate, 2 gm per hour. Upon
your initial assessment you note that she has a respiratory rate of 8 with absent deep tendon
reflexes. What will be your first nursing intervention?
a. Elevate head of the bed
b. Notify the MD
c. Discontinue magnesium sulfate
d. Draw a serum magnesium level
ANS: c
Initial nursing intervention needs to be discontinuing magnesium sulfate because the patient is
exhibiting signs of magnesium toxicity with absent deep tendon reflexes and decreased
respiratory rate.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Application and
Comprehension | Content Area: Maternity | Client Need: Safe and Effective Care Environment |
Difficulty Level: Hard
27. A 34-weeks’ gestation multigravida, G3 P1 is admitted to the labor suite. She is contracting
every 7 minutes and 40 seconds. The woman has several medical problems. Which of the
following of her comorbidities is most consistent with the clinical picture?
a. Kyphosis
b. Urinary tract infection
c. Congestive heart failure
d. Cerebral palsy
ANS: b
Feedback
a. Kyphosis is unrelated to preterm labor.
b. Urinary tract infections often precipitate
preterm labor.
c. It is unlikely that the congestive heart failure
precipitated the preterm labor.
d. Cerebral palsy is unrelated to preterm labor.
Health Promotion and Maintenance: Antepartum Care; Physiological Integrity: Physiological
Adaptation | Difficulty Level: Difficult
28. A primiparous woman has been admitted at 35 weeks’ gestation and diagnosed with HELLP
syndrome. Which of the following laboratory changes is consistent with this diagnosis?
a. Hematocrit dropped to 28%.
b. Platelets increased to 300,000 cells/mm3.
c. Red blood cells increased to 5.1 million cells/mm3.
d. Sodium dropped to 132 mEq/dL.
ANS: a
Feedback
a. The nurse would expect to see a drop in the
hematocrit: The H in HELLP stands for
hemolysis.
b. The nurse would expect to see low platelets.
c. The nurse would expect to see hemolysis.
d. The sodium is usually unaffected in HELLP
syndrome.
Area: Intrapartum Care; Physiological Adaptation: Alterations in Body Systems | Client Need:
Difficulty Level: Moderate
29. A labor nurse is caring for a patient, 39 weeks’ gestation, who has been diagnosed with
placenta previa. Which of the following physician orders should the nurse question?
a. Type and cross-match her blood.
b. Insert an internal fetal monitor electrode.
c. Administer an oral stool softener.
d. Assess her complete blood count.
ANS: b
Feedback
a. It would be appropriate to type and cross-
match the patient for a blood transfusion.
b. This action is inappropriate. When a patient
has a placenta previa, nothing should be
inserted into the vagina.
c. To prevent constipation, it is appropriate for a
patient to take a stool softener.
d. It is appropriate to monitor the patient for
signs of anemia.

Content Area: Antepartum Care; Patient Advocacy; Potential for Alterations in Body Systems |
Potential; Safe and Effective Care Environment: Management of Care | Difficulty Level:
Moderate
30. A type 1 diabetic patient has repeatedly experienced elevated serum glucose levels
throughout her pregnancy. Which of the following complications of pregnancy would the nurse
expect to see?
a. Postpartum hemorrhage
b. Neonatal hyperglycemia
c. Postpartum oliguria
d. Neonatal macrosomia
ANS: d
Feedback
a. The patient is not especially high risk for a
postpartum hemorrhage.
b. The nurse would expect to see neonatal
hypoglycemia, not hyperglycemia.
c. The nurse would expect to see postpartum
polyuria.
d. The nurse would expect to see neonatal
macrosomia.
31. According to agency policy, the perinatal nurse provides the following intrapartal nursing
care for the patient with preeclampsia:
a. Take the patient’s blood pressure every 6 hours
b. Encourage the patient to rest on her back
c. Notify the physician of a urine output greater than 30 mL/hr
d. Administer magnesium sulfate according to agency policy
ANS: d
Feedback
a. The nurse is the manager of care for the
woman with preeclampsia during the
intrapartal period. Careful assessments are
critical. The blood pressure is taken every 1
hour or more frequently according to
physician orders or institutional protocol.
b. The nurse is the manager of care for the
critical. The patient should be encouraged to
assume a side-lying position to enhance
uterine perfusion.
c. The nurse is the manager of care for the
critical. A urine output less than 30 mL/hr is
indicative of oliguria and the physician must
be notified.
d. The nurse is the manager of care for the
critical. The nurse administers medications as
ordered and should adhere to hospital
protocol for a magnesium sulfate infusion.
Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate
32. The perinatal nurse is providing care to Marilyn, a 25-year-old G1 TPAL 0000 woman
hospitalized with severe hypertension at 33 weeks’ gestation. The nurse is preparing to
administer the second dose of beta-methasone prescribed by the physician. Marilyn asks: “What
is this injection for again?” The nurse’s best response is:
a. “This is to help your baby’s lungs to mature.”
b. “This is to prepare your body to begin the labor process.”
c. “This is to help stabilize your blood pressure.”
d. “This is to help your baby grow and develop in preparation for birth.”
ANS: a
Feedback
a. Antenatal glucocorticoids such as beta-
methasone may be given (12 mg IM 24 hours
apart) to promote fetal lung maturity if the
gestational age is less than 34 weeks and
childbirth can be delayed for 48 hours.
b. Antenatal glucocorticoids such as beta-
c. Antenatal glucocorticoids such as beta-
d. Antenatal glucocorticoids such as beta-
33. A woman who is 36 weeks pregnant presents to the labor and delivery unit with a history of
congestive heart disease. Which of the following findings should the nurse report to the primary
health-care practitioner?
a. Presence of chloasma
b. Presence of severe heartburn
c. 10-pound weight gain in a month
d. Patellar reflexes +1
ANS: c
Feedback
a. Chloasma is a normal pregnancy finding.
b. Heartburn is an expected finding during the
third trimester.
c. The weight gain may be due to fluid
retention. Fluid retention may occur in
patients with pregnancy-induced hypertension
and in patients with congestive heart failure.
The physician should be notified.
d. Although slightly hyporeflexic, patellar
reflexes of +1 are within normal limits.

Cognitive Level: Application | Content Area: Antepartum Care; Reduction of Risk Potential:
Potential for Alterations in Body Systems | Client Need: Health Promotion and Maintenance;
34. The single most important risk factor for preterm birth includes:
a. Uterine and cervical anomalies
b. Infection
c. Increased BMI
d. Prior preterm birth
ANS: d
The single most important factor is prior preterm birth with a reoccurrence rate of up to 40%.
KEY: Integrated Process: Nursing Process: Analysis | Cognitive Level: Knowledge | Content
Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level:
Moderate
35. Your antepartal patient is 38 weeks’ gestation, has a history of thrombosis, and has been on
strict bed rest for the last 12 hours. She is now experiencing shortness of breath. What about the
patient may be a contributing factor for her shortness of breath?
a. Physiologic changes in pregnancy result in vasodilation, which increases the tendency to form
blood clots.
b. Physiologic changes in pregnancy result in vasoconstriction, which increases the tendency to
form blood clots.
c. Physiologic changes in pregnancy result in anemia, which increases the tendency to form
blood clots.
d. Physiologic changes in pregnancy result in decreased perfusion to the lungs, which increases
the tendency to form blood clots.
ANS: a
The patient’s shortness of breath, bed rest, and history of thrombosis indicate possible pulmonary
embolism. Her pregnant state also increases the potential for thrombosis resulting from increased
levels of coagulation factors and decreased fibrinolysis, venous dilation, and obstruction of the
venous system by the gravid uterus. Thromboembolitic diseases occurring most frequently in
pregnancy include deep vein thrombosis and pulmonary embolism.
KEY: Integrated Process: Critical Thinking | Cognitive Level: Complication | Content Area:
Physiologic Adaptation: Alteration in Body Systems | Client Need: Physiologic Adaptation |
Difficulty Level: Hard
36. Metabolic changes during pregnancy __________ glucose tolerance.

a. lower
b. increase
c. maintain
d. alter
ANS: a
Metabolic changes during pregnancy lower glucose tolerance.
KEY: Integrated Process: Knowledge | Cognitive Level: Synthesis | Content Area: Maternity
| Client Need: Physiologic Adaptation | Difficulty Level: Hard
True/False
37. Immediately postpartum, the insulin needs in diabetic women increase dramatically.
ANS: FalseThere is a significant decrease in the need for insulin immediately after delivery
related to the loss of antagonistic placental hormones and suppression of the anterior pituitary
growth hormone.
KEY: Integrated Process: Clinical Problem Solving | Cognitive Level: Knowledge | Content
Area: Maternity | Client Need: Physiological Adaptation | Difficulty Level: Easy
38. The perinatal nurse observes the placental inspection by the health-care provider after birth.
This examination may help to determine whether an abruption has occurred prior to or during
labor.
ANS: True
Fifty percent of abruptions occur before labor and after the 30th week, 15% occur during labor,
and 30% are identified only upon inspection of the placenta after delivery.
Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate
39. It is critical for the perinatal nurse to learn, as part of the facility’s policies and procedures, to
immediately perform a vaginal examination on a woman who presents with vaginal bleeding
after 24 weeks’ gestation.
ANS: False
Placenta previa should be suspected in all patients who present with bleeding after 24 completed
weeks of gestation. Because of the risk of placental perforation, vaginal examinations are not
performed.
Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Moderate
40. The perinatal nurse knows that the survival rate for infants born at or greater than 28 to 29
gestational weeks is greater than 90%.
ANS: True
With appropriate medical care, neonatal survival dramatically improves as the gestational age
increases, with over 50% of neonates surviving at 25 weeks’ gestation, and over 90% surviving
at 28 to 29 weeks of gestation.
Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Easy
41. A patient with hypertension who is receiving intravenous magnesium sulfate therapy has
requested an epidural anesthetic. The perinatal nurse should first review the patient’s complete
blood count results for evidence of a decreased platelet count.
ANS: True
Baseline information, including complete blood count (CBC), clotting studies, serum
electrolytes, and renal function tests, is used to alert the care providers to changes in the patient’s
condition as additional laboratory tests are obtained.
Maternity | Client Need: Physiological Integrity | Difficulty Level: Difficult
42. The perinatal nurse knows that the laboring diabetic patient’s blood glucose level should
always be less than 120 mg/dL.
ANS: True
Blood glucose levels are assessed every hour, and fluid/insulin adjustments are made as needed
to maintain maternal blood glucose levels between 80 and 120 mg/dL.
Area: Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Easy
Multiple Response
43. The perinatal nurse describes risk factors for placenta previa to the student nurse. Placenta
previa risk factors include (select all that apply):
a. Cocaine use
b. Tobacco use
c. Previous caesarean birth
d. Previous use of medroxyprogesterone (Depo-Provera)
ANS: a, b, c
Feedback
a. Placenta previa may be associated with risk
factors including smoking, cocaine use, a
prior history of placenta previa, closely
spaced pregnancies, African or Asian
ethnicity, and maternal age greater than 35
years.
b. Placenta previa may be associated with risk
factors including smoking, cocaine use, a
prior history of placenta previa, closely
spaced pregnancies, African or Asian
ethnicity, and maternal age greater than 35
years.
c. Placenta previa may be associated with
conditions that cause scarring of the uterus
such as a prior cesarean section, multiparity,
or increased maternal age.
d. Previous use of medroxyprogesterone (Depo-
Provera) is not a risk factor for placenta
previa.
KEY: Integrated Process: Teaching and Learning | Cognitive Level: Knowledge | Content Area:
Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Easy
44. Kerry, a 30-year-old G3 TPAL 0110 woman presents to the labor unit triage with complaints
of lower abdominal cramping and urinary frequency at 30 weeks’ gestation. An appropriate
nursing action would be to (select all that apply):
a. Assess the fetal heart rate
b. Obtain urine for culture and sensitivity
c. Assess Kerry’s blood pressure and pulse
d. Palpate Kerry’s abdomen for contractions
ANS: a, b, d
Feedback
a. Women experiencing preterm labor may
complain of backache, pelvic aching,
menstrual-like cramps, increased vaginal
discharge, pelvic pressure, urinary frequency,
and intestinal cramping with or without
diarrhea. The patient’s abdomen should be
palpated to assess for contractions, and the
fetus’s heart rate should be monitored.
b. Women experiencing preterm labor may
diarrhea. A urinalysis and urine culture and
sensitivity (C & S) should be obtained on all
patients who present with signs of preterm
labor, and the nurse must remember that signs
of UTI often mimic normal pregnancy
complaints (i.e., urgency, frequency). The
patient’s abdomen should be palpated to
assess for contractions, and the fetus’s heart
rate should be monitored.
c. Assessment of blood pressure and pulse is not
an important nursing action in this scenario.
d. Women experiencing preterm labor may
diarrhea. The patient’s abdomen should be
palpated to assess for contractions and the
fetus’s heart rate should be monitored.
45. The perinatal nurse knows that tocolytic agents are most often used to (select all that apply):
a. Prevent maternal infection
b. Prolong pregnancy to 40 weeks’ gestation
c. Prolong pregnancy to facilitate administration of antenatal corticosteroids
d. Allow for transport of the woman to a tertiary care facility
ANS: c, d
Feedback
a. Tocolytics are not used to treat maternal
infection.
b. Tocolytics are generally only effective in
delaying delivery for several days.
c. Presently, it is believed that the best reason to
use tocolytic drugs is to allow an opportunity
to begin the administration of antenatal
corticosteroids to accelerate fetal lung
maturity.
d. Delaying the birth provides time for maternal
transport to a facility equipped with a
neonatal intensive care unit.
Area: Peds/Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level:
Easy
46. The perinatal nurse provides a hospital tour for couples and families preparing for labor and
birth in the future. Teaching is an important component of the tour. Information provided about
preterm labor and birth prevention includes (select all that apply):
a. Encouraging regular, ongoing prenatal care
b. Reporting symptoms of urinary frequency and burning to the health-care provider
c. Coming to the labor triage unit if back pain or cramping persist or become regular
d. Lying on the right side, withholding fluids, and counting fetal movements if contractions occur
every 5 minutes
ANS: a, b, c
Feedback
a. The nurse should encourage all pregnant
women to obtain prenatal care and screen for
vaginal and urogenital infections and treat
appropriately, and remind pregnant women to
call their provider repeatedly if symptoms of
preterm labor occur.
b. Educating all women of childbearing age
about preterm labor is a crucial component of
prevention. The nurse should encourage all
pregnant women to obtain prenatal care and
screen for vaginal and urogenital infections
and treat appropriately, and remind pregnant
women to call their provider repeatedly if
symptoms of preterm labor occur.
c. Educating all women of childbearing age
about preterm labor is a crucial component of
prevention. The nurse should encourage all
pregnant women to obtain prenatal care and
screen for vaginal and urogenital infections
and treat appropriately, and remind pregnant
women to call their provider if symptoms of
preterm labor occur.
d. Lying on the right side; drinking fluids, not
withholding fluids; and counting fetal
movements if contractions occur every 5
minutes are recommended if a woman thinks
she is contracting.
Maternity | Client Need: Safe and Effective Care Environment | Difficulty Level: Moderate
47. The perinatal nurse describes for the new nurse the various risks associated with prolonged
premature preterm rupture of membranes. These risks include (select all that apply):
a. Chorioamnionitis
b. Abruptio placentae
c. Operative birth
d. Cord prolapse
ANS: a, b, d
Even though maintaining the pregnancy to gain further fetal maturity can be beneficial,
prolonged PPROM has been correlated with an increased risk of chorioamnionitis, placental
abruption, and cord prolapse.
48. Betamethasone is a steroid that is given to a pregnant woman with signs of preterm labor.
The purpose of giving steroids is to (select all that apply):
a. Stimulate the production of surfactant in the preterm infant
b. Be given between 24 and 34 weeks’ gestation
c. Increase the severity of respiratory distress
d. Accelerate fetal lung maturity
ANS: a, b, d
Betamethasone is a steroid that is given to pregnant women with signs of preterm labor between
24 and 34 weeks’ gestation. It stimulates the production of surfactant in the preterm infant and
accelerates fetal lung maturity.
KEY: Integrated Process: Knowledge | Cognitive Level: Comprehension | Content Area:

Pharmacological and Parenteral Therapies: Expected Effects/Outcomes | Client Need:
Pharmacologic and Parenteral Therapies | Difficulty Level: Hard
49. Marked hemodynamic changes in pregnancy can impact the pregnant woman with cardiac
disease. Signs and symptoms of deteriorating cardiac status include (select all that apply):
a. Orthopnea
b. Nocturnal dyspnea
c. Palpitations
d. Irritation
ANS: a, b, c
Signs and symptoms of deteriorating cardiac status with cardiac disease include orthopnea,
nocturnal dyspnea, and palpitations, but do not include irritation.
KEY: Integrated Process: Nursing Process: Assessment | Cognitive Level: Synthesis | Content
Area: Reduction of Risk Potential-Potential for Complications | Client Need: Physiologic
Adaptation | Difficulty Level: Hard
Short Answer
50. A condition where the placenta attaches to the lower uterine segment of the uterus
ANS: Placenta previa

Refer To: Maternity Nursing Terms and Definitions; Ref. 7
KEY: Integrated Process: Teaching/Learning | Cognitive Level: Knowledge | Content Area:

Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Easy
51. A pregnancy that ends before 20 weeks’ gestation
ANS: Miscarriage
52. Birth prior to 37 completed weeks of pregnancy
ANS: Preterm birth

Refer To: Glossary; Perinatal Nursing Terms and Definitions
53. Specks or spots in the vision where the patient cannot see; “blind spots”
ANS: Scotoma
54. A disease characterized by an abnormal placental development that results in the production
of fluid-filled grapelike clusters and a vast proliferation of trophoblastic tissue
ANS: Hydatidiform mole/Gestational trophoblastic disease

Refer To: Perinatal Nursing Terms and Definitions; Ref. 7
Peds/Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Easy
55. No expulsion of the products of conception, but bleeding and dilation of the cervix such that
a pregnancy is unlikely
ANS: Inevitable abortion

KEY: Integrated Processes: Teaching and Learning | Cognitive Level: Knowledge | Content Area:
56. Placement of suture to mechanically close a weak cervix

ANS: Cervical cerclage
KEY: Integrated Process: Teaching and Learning | | Cognitive Level: Knowledge | Content Area:
Fill-in-the-Blank
57. The perinatal nurse knows that an early pregnancy loss occurs before __________ weeks,
and a late pregnancy loss is one that occurs between 12 and __________ weeks.
ANS: 12; 20
Not all conceptions result in a live-born infant. Of all clinically recognized pregnancies, 10% to
20% are lost, and approximately 22% of pregnancies detected on the basis of hCG assays are lost
before the appearance of any clinical signs or symptoms. By definition, an early pregnancy loss
occurs before 12 weeks of gestation; a late pregnancy loss is one that occurs between 12 and 20
weeks.
58. Mary, a G3 TPAL 0020 woman at 20 weeks’ gestation, has had a transvaginal ultrasound.
Mary has been informed that she has cervical incompetence. The perinatal nurse explains that
this diagnosis means that her cervix has __________ without __________ contractions.
ANS: dilated; regular

Patients with cervical incompetence usually present with painless dilation and effacement of the
cervix, often during the second trimester of pregnancy. The patient frequently gives a history of
repeated second trimester losses with no apparent etiology. Incompetent cervix is estimated to
cause approximately 15% of all second trimester losses.
59. The perinatal nurse knows that nausea and vomiting are common in pregnancy and usually
resolve by __________ weeks’ gestation. The severe form of this condition is __________.
ANS: 16; hyperemesis gravidarum
Feedback 1: Nausea and vomiting are a common condition of pregnancy which affect 70% to
85% of pregnant women and usually resolve by the 16th week of gestation.
Feedback 2: Hyperemesis gravidarum represents the extreme end of the nausea/vomiting
spectrum in terms of severity. Criteria for the diagnosis of hyperemesis gravidarum include
persistent vomiting unrelated to other causes, a measure of acute starvation (usually large
ketonuria), and some discrete weight loss, most often 5% of the prepregnancy weight.
Area: Maternity | Client Need: Health Promotion and Maintenance | Difficulty Level: Easy
60. The perinatal nurse explains to the student nurse who is assessing the abdomen of a 32-week
pregnant woman with placenta previa that it would not be unusual to find the fetus in a
__________ or __________ position.
ANS: breech; transverse

Placenta previa is an implantation of the placenta in the lower uterine segment, near or over the
internal cervical os. This condition accounts for 20% of all antepartal hemorrhages. Leopold
maneuvers often reveal the fetus to be in a breech or oblique position or transverse lie because of
the abnormal location of the placenta.
61. The perinatal nurse knows that a __________ hemorrhage is limited to the uterus, and a
__________ hemorrhage moves blood toward and through the cervix.
ANS: concealed; revealed

Feedback 1: A concealed hemorrhage occurs in 20% of cases and describes an abruption in
which the bleeding is confined within the uterine cavity. The most common abruption is
associated with a revealed or external hemorrhage, where the blood dissects downward toward
the cervix.
Feedback 2: The most common abruption is associated with a revealed or external hemorrhage,
where the blood dissects downward toward the cervix.
62. The perinatal nurse encourages Colleen, who has just been discharged from the hospital for
intravenous therapy for severe nausea and vomiting, to ensure that she __________ often, eats
frequent, __________ meals and avoids __________ odors.
ANS: rests; small; cooking

The nurse should counsel the woman with nausea and vomiting to avoid foods and sensory
stimuli that provoke symptoms (i.e., some women become nauseous when they smell certain
foods being prepared) and also to eat small, frequent meals of dry, bland foods and include high-
protein snacks in their diet.
____ 1. The nurse in a prenatal clinic is reviewing the files of four patients scheduled for
visits. Which patient does the nurse identify as having the highest-risk pregnancy?
1. The patient who is 16 years of age just diagnosed with gestational diabetes
2. The patient with preexisting hypertension who is currently pregnant with twins
3. The patient who is 37 years of age, obese, and experiencing pregnancy-induced
hypertension
4. The patient who is 28 years of age who delivered a premature neonate 3 years prior
____ 2. The nurse is interviewing a new patient who is in the first trimester of her second
pregnancy. The patient shares that her first child was born at 36 weeks gestation. Which
information does the patient share that places the patient at risk for a second premature birth?
1. The first labor was induced due to unresponsive management of hypertension.
2. The health care provider induced labor at the patient’s request to avoid holiday
interruptions.
3. Labor was induced when the fetus moved from a posterior to an anterior position.
4. The premature labor and birth was unexpected and followed a normal pregnancy.
____ 3. The nurse educator is preparing a presentation on preterm labor (PTL) and birth
(PTB). Which information does the nurse recognize as being inaccurate?
1. PTB is the leading cause of neonatal mortality and for antenatal hospitalization.
2. PTL is defined as regular uterine contractions resulting in cervical changes before
40 weeks gestation.
3. PTBs result in increased numbers of neonatal and infant deaths and long-term
neurological impairment.
4. Average costs for premature/low birthweight infants are more than 10 times as high
than for other newborns.
____ 4. When performing a physical assessment on a patient during the initial prenatal
visit, the nurse notes spongy gums prone to bleeding during the oral exam. Which comment by
the nurse is appropriate?
1. “Oral bleeding can contribute to anemia.”
2. “Dental problems can interfere with nutrition.”
3. “Periodontal disease is a risk factor for preterm labor”
4. “You need dental care because pregnancy causes dental problems.”
____ 5. A patient at 36 weeks gestation reports a constant dull backache, regular frequent
contractions that are painless, and lower abdominal pressure. Physical examination reveals intact
membranes and cervical dilation of 3 cm. Which order by the health care provider is unexpected
by the nurse?
1. Administer antenatal steroids
2. Obtain fetal fibronectin levels
3. Beta-adrenergic agonist therapy
4. Monitor blood glucose levels
____ 6. A patient at 30 weeks gestation is exhibiting signs of preterm labor and delivery.
The health care provider (HCP) informs the patient that nothing can be done to disrupt this
process. The patient is in distress and states, “Why can’t something be done to save my baby?”
The nurse understands the HCP’s decision is likely based on which finding?
1. Ruptured membranes caused an infection.
2. The patient is unstable due to hemorrhage.
3. Fetal age is incompatible with survival.
4. A fetal heartbeat could not be obtained.
____ 7. A patient undergoes chorionic villa sampling to rule out the presence of a genetic
disorder. Following the procedure, the patient experiences iatrogenic PPROM. Which
explanation does the nurse provide to promote patient understanding?
1. The rupture of the membranes is from a bacterial infection.
2. The membranes ruptured because the test caused fetal death.
3. premature rupture of the membranes is a known risk to the test.
4. The The membranes ruptured due to the presence of a genetic disorder.
____ 8. The nurse in a prenatal unit is providing care for a patient who experienced
PPROM at 32 weeks gestation. Which assessment does the nurse consider unnecessary?
1. Check for cervical dilation
2. Monitor for signs of infection
3. Assess for vaginal bleeding
4. Watch for fetal compromise
____ 9. The nurse in a prenatal clinic is assessing a patient who is at 37 weeks gestation
for twins. The patient reports increased discomfort and increased lower pelvic pressure. Which
action does the nurse take with this patient?
1. After examination, assures the patient of the absence of contractions
2. Explains to the patient that increased discomfort is expected with twins
3. Performs a digital cervical examination to determine if dilation is occurring
4. Sends the patient to the hospital to be checked for possible signs of labor
____ 10. The nurse is providing care to a postpartum patient after an emergency cesarean
due to eclampsia. The patient received spinal anesthesia prior to delivery. Magnesium sulfate is
infusing 2 g/hr in 100 mL of IV fluid. Which assessment finding will cause the nurse to
administer calcium gluconate to the patient via IV push?
1. Serum magnesium level is 10 mg/dL.
2. Patella reflexes are rated at zero.
3. Respiratory rate is 18 breaths/min.
4. Urinary output remains at 30 mL/hr.
____ 11. A patient who is in the third trimester of pregnancy is informed that she will need
a cesarean hysterectomy and bladder reconstruction due to a placenta defect. Which medical
condition does the nurse explain to the patient?
1. Placenta accreta. Invasion of trophoblast is beyond normal boundary
2. Placenta increta: extends into myometrium
3. Placenta percreta: extends into uterine musculature adhere to pelvis organs
4. Placenta previa
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 12. A patient just learns that her unborn fetus has a life-threatening condition and is
not expected to survive long term. Which does the nurse include in a plan of care to meet
psychological needs of the patient and her partner? Select all that apply.
1. Provide time for the patient to talk about her feelings.
2. Encourage the patient’s partner to be emotionally strong.
3. Facilitate referrals related to the fetal condition.
4. Monitor patient’s condition and adjust visitors accordingly.
5. Ascertain if the patient and partner have previous crisis skills.
____ 13. A patient with pregestational diabetes mellitus delivers a neonate who is
diagnosed with macrosomia. The nurse is aware that the neonate is at risk for additional long-
term conditions related to maternal diabetes mellitus. Which long-term effects may occur? Select
all that apply.
1. Shoulder injury related to birth size
2. Development of metabolic syndrome
3. Impaired intellectual development
4. Changes in genetic expression
5. Increased risk for chronic illnesses
____ 14. The nurse is assessing a patient at 26 weeks gestation. The patient has chronic
hypertension and exhibited hypertension and proteinuria prior to 20 weeks gestation. Previous
blood pressure (BP) readings have been in the range of 130 to 140/88 to 90 mm Hg. Due to
superimposed preeclampsia, for which additional manifestations will the nurse immediately
contact the health care provider? Select all that apply.
1. Laboratory report that shows an elevation of liver enzymes
2. Current blood pressure reading of 162/102 mm Hg
3. Evident pulmonary edema noted with auscultation.
4. Subjective report of severe headache and photophobia
5. Lack of response to verbal and tactile stimulation
____ 15. The nurse is conducting a staff education session about preeclampsia and
eclampsia complications. Which statements by the nurse are accurate about HELLP syndrome?
Select all that apply.
1. This syndrome destroys red blood cells.
2. This syndrome impacts the amount of platelets.
3. This syndrome decreases a patient’s white blood cell (WBC) count.
4. This syndrome decreases a patient’s blood urea nitrogen (BUN).
5. This syndrome increases liver enzymes.
____ 16. The nursing staff in a labor and delivery unit has noticed an increase in the
number of patients experiencing placental abruption. The nurses begin to review demographics
for the patients involved. Which risk factors will the nurses expect? Select all that apply.
1. Hypertensive disorders
2. Uterine fibroids
3. Cigarette smoking
4. Methamphetamine use
5. Abdominal trauma
____ 17. A patient at 35 weeks gestation arrives at the prenatal clinic in physical distress.
Assessment reveals hypotension, thready pulse, shallow respirations, pallor, cold and clammy
skin, and anxiety. The nurse does not find evidence of vaginal bleeding but suspects placental
abruption. For which reason does the nurse call for emergency transport to the hospital? Select
all that apply.
1. The patient has all the symptoms of hypovolemia.
2. The patient reports a recent bout with nausea and vomiting.
3. The absence of blood can indicate a concealed hemorrhage.
4. The patient and fetus are at risk of death from hypovolemic shock.
5. The patient states a sudden onset of severe symptoms.
Completion
Complete each statement.
18. Premature rupture of membranes is defined as rupture of the

chorioamniotic____________________ membranes before the onset of labor but at term.
19. A patient is threatening spontaneous abortion at 18 weeks gestation. The patient’s

two previous pregnancies aborted in the same time frame. The patient states, “They want to sew
my cervix shut.” The nurse shares the terminology for surgical treatment of incompetent cervix,
which is _cerclage___________________.
20. When a patient is diagnosed with preeclampsia, one sign that the fetus is at risk
for hypoxia is a change in amniotic fluid called _______oligohydraminos_____________.
Chapter 7: High-Risk Antepartum Nursing Care
Answer Section
MULTIPLE CHOICE

Quiz 5 Test Bank

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Quiz 5 Test Bank

Uploaded by

Copyright:

Available Formats

Chapter 7: High-Risk Antepartum Nursing Care

KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Application |

KEY: Integrated Process: Nursing Process: Analysis; Nursing Process: Implementation |

KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Application |

23. A woman at 10 weeks’ gestation is diagnosed with gestational trophoblastic disease

KEY: Integrated Process: Nursing Process: Implementation | Cognitive Level: Application |

KEY: Integrated Process: Nursing Process: Analysis; Nursing Process: Implementation |

36. Metabolic changes during pregnancy __________ glucose tolerance.

KEY: Integrated Process: Knowledge | Cognitive Level: Comprehension | Content Area:

ANS: Placenta previa

KEY: Integrated Process: Teaching/Learning | Cognitive Level: Knowledge | Content Area:

51. A pregnancy that ends before 20 weeks’ gestation

ANS: Preterm birth

ANS: Hydatidiform mole/Gestational trophoblastic disease

ANS: Inevitable abortion

56. Placement of suture to mechanically close a weak cervix

ANS: dilated; regular

ANS: breech; transverse

ANS: concealed; revealed

ANS: rests; small; cooking

18. Premature rupture of membranes is defined as rupture of the

19. A patient is threatening spontaneous abortion at 18 weeks gestation. The patient’s

You might also like