NCM109A QUIZ BEE MIDTERM 2022

NCM109A

QUIZ BEE

MIDTERM 2022

TRIBE BRAIN WAR​

Maternal Antenatal Complications Class Participation

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1. Join the quizziz app: LASTNAME/SECTION (1 ACCOUNT ONLY)

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2. 10 SECONDS PER QUESTION

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3. Top 10 in the OVERALL count will have +2 in the TERM EXAM

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4. Top 10 - the highest number of STUDENTS per Section = +1 Term EXAM  ALL CLASSMATES5. All scores after the MCN Quiz bee will be part of the Midterm Class Participation

Multiple Choice

   A homecare nurse visits a pregnant client who has a diagnosis of mild Preeclampsia and who is being monitored for pregnancy induced hypertension (PIH). Which assessment finding indicates a worsening of the preeclampsia and the need to notify the physician?

• Blood pressure reading is at the prenatal baseline.

• Urinary output has increased.

• The client complains of a headache and blurred vision.

• Dependent edema has resolved.

    A homecare nurse visits a pregnant client who has a diagnosis of mild Preeclampsia and who is being monitored for pregnancy induced hypertension (PIH). Which assessment finding indicates a worsening of the preeclampsia and the need to notify the physician?

Blood pressure reading is at the prenatal baseline.

Urinary output has increased.

The client complains of a headache and blurred vision.

Dependent edema has resolved.

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Correct Answer: C. The client complains of a headache and blurred vision.

If the client complains of a headache and blurred vision, the physician should be notified because these are signs of worsening preeclampsia.

Multiple Choice

Human immunodeficiency virus is not transmitted through:

• Sexual contact

• Kissing

• Blood transfusion

• Breastfeeding

Human immunodeficiency virus is not transmitted through:

Sexual contact

Kissing

Blood transfusion

Breastfeeding

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Correct Answer:: B

□ Human immunodeficiency virus which is the causative agent of AIDS is transmitted by sexual contract, blood transfusion and breastfeeding. Holding hands, embracing, kissing and sharing of eating utensils do not transmit HIV.

Multiple Choice

In which of the following conditions can the causative agent pass through the placenta and affect the fetus in utero?

• Gonorrhea

• Rubella

• Candidiasis

• Moniliasis

In which of the following conditions can the causative agent pass through the placenta and affect the fetus in utero?

Gonorrhea

Rubella

Candidiasis

Moniliasis

Correct Answer: B. Rubella

Rubella is caused by a virus and viruses have low molecular weight thus can pass through the placental barrier. Relatively few pathogens are capable of placental and fetal infections in humans and even for these, maternal infection does not guarantee placental or fetal infection.

Multiple Choice

The Human Immunodeficiency Virus (HIV) mainly attacks what type of cells in the human body?

• Red Blood Cells

• CD4 positive cells

• Stem Cells

• Platelets

The Human Immunodeficiency Virus (HIV) mainly attacks what type of cells in the human body? 

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Red Blood Cells

CD4 positive cells

Stem Cells

Platelets

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The answer is B. The HIV virus attacks the human body’s immune system, specifically the CD4 positive cells…mainly the helper t cells. These cells are white blood cells that help the immune system fight infection.

Multiple Choice

Which of the following physical findings would lead the nurse to suspect that a client with severe pre-eclampsia has developed HELLP syndrome?

• +3 pitting edema.

• Petechiae and Jaundice

• +4 deep tendon reflexes

• 1.      Elevated specific gravity.

1.     Which of the following physical findings would lead the nurse to suspect that a client with severe pre-eclampsia has developed HELLP syndrome?

 +3 pitting edema.  

Petechiae. and Jaundice.

+4 deep tendon reflexes.  

Elevated specific gravity.

​Correct Answer: Petechiae. and Jaundice.

1. A client with severe pre-eclampsia could exhibit symptoms of +3 pitting edema without the addition of HELLP syndrome. 

2. Petechiae may develop when a client is thrombocytopenic, one of the signs of HELLP syndrome. 

3.Hyperbilirubinemia develops when red blood cells hemolyze, one of the changes that may develop as a result of liver necrosis. Jaundice is a symptom of hyperbilirubinemia. Also, elevated liver function tests (EL) are a manifestation of HELLP syndrome. 

4. +4 refl exes are consistent with a diagnosis of severe pre-eclampsia and may be present without the addition of HELLP syndrome. 

5. Elevated specific gravity is consistent with a diagnosis of severe pre-eclampsia and may be present without the addition of HELLP syndrome. 

Some text here about the topic of discussion

Multiple Choice

A patient is currently 34 weeks pregnant with her first baby. Which findings below could indicate the development of preeclampsia in this patient that would need to be reported to the physician?

• blood pressure 144/100, 1700: blood pressure 120/80 

•  3+ dipstick urine protein  & blood pressure 142/92, 1230: blood pressure: 144/98

• 1 hour glucose tolerance test 90 mg/dL

• <300 mg/dL 24-hour urine protein 

 A patient is currently 34 weeks pregnant with her first baby. Which findings below could indicate the development of preeclampsia in this patient that would need to be reported to the physician? Select all that apply:

blood pressure 144/100, 1700: blood pressure 120/80 

 3+ dipstick urine protein & blood pressure 142/92, 1230: blood pressure: 144/98 

1 hour glucose tolerance test 90 mg/dL

​<300 mg/dL 24-hour urine protein

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The answers 3+ dipstick urine protein & blood pressure 142/92, 1230: blood pressure: 144/98 . Signs and symptoms of preeclampsia include: proteinuria (>1+ dipstick urine protein or >300 mg/dL 24 hour urine protein, hypertension >140/90...two reading at least 4-6 hours apart), swelling in face, eyes, extremities, headaches, vision changes, etc.

Multiple Choice

  What is the common reason for oligohydramnios?

• A bladder or renal disorder in the fetus that interferes with voiding

• Decrease production of amniotic fluid

• A small uterine capacity to hold the amniotic fluid

• Perforation of the amniotic sac

What is the common reason for oligohydramnios?

A bladder or renal disorder in the fetus that interferes with voiding

Decrease production of amniotic fluid

A small uterine capacity to hold the amniotic fluid

Perforation of the amniotic sac

Answer: A. A bladder or renal disorder in the fetus that interferes with voiding

·        The fetus may have difficulty in voiding as it swallows the amniotic fluid leading to a decrease in the amount of amniotic fluid.

·        Option B: The production of the amniotic fluid is normal.

·        Option C: The uterine capacity does not affect the amount of amniotic fluid produced.

·        Option D: There is no perforation of the amniotic sac in oligohydramnios.​

Multiple Choice

   What is the first sign of hydramnios in a pregnant woman?

• Shortness of breath

• Varicosities and hemorrhoids

• Difficulty in auscultating the fetal heart rate

•  Rapid growth of the uterus

What is the first sign of hydramnios in a pregnant woman?

Shortness of breath  

Varicosities and hemorrhoids  

Difficulty in auscultating the fetal heart rate

 Rapid growth of the uterus

 

Answer: D. Rapid growth of the uterus

·        Rapid growth of the uterus is the first noticeable sign of hydramnios.

·        Option A: This symptom occurs later in the development of the disease.

·        Option B: Varicosities and hemorrhoids are symptoms yet they do not appear first.

Option C: Difficulty in auscultating the heart rate is also a symptom yet develops later in the progress of the disease

Multiple Choice

  A client is being treated for DVT. The nurse understands that the client’s response to treatment will be evaluated by regularly assessing the client for:

• Dysuria, ecchymosis, and vertigo

• Epistaxis, hematuria, and dysuria

• Hematuria, ecchymosis, and epistaxis

• Hematuria, ecchymosis, and vertigo

   A postpartum (PP) client is being treated for DVT. The nurse understands that the client’s response to treatment will be evaluated by regularly assessing the client for:

Dysuria, ecchymosis, and vertigo

Epistaxis, hematuria, and dysuria

Hematuria, ecchymosis, and epistaxis

Hematuria, ecchymosis, and vertigo

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Correct Answer: C. Hematuria, ecchymosis, and epistaxis.

The treatment for DVT is anticoagulant therapy. The nurse assesses for bleeding, which is an adverse effect of anticoagulants. This includes hematuria, ecchymosis, and epistaxis. Dysuria and vertigo are not associated specifically with bleeding. The cornerstone of treatment is anticoagulation. NICE guidelines only recommend treating proximal DVT (not distal) and those with pulmonary emboli. In each patient, the risks of anticoagulation need to be weighed against the benefits.

Multiple Choice

   An ultrasound is performed on a client at term gestation that is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on these findings, the nurse would prepare the client for:

• Complete bed rest for the remainder of the pregnancy.

• Delivery of the fetus.

• Strict monitoring of intake and output.

• The need for weekly monitoring of coagulation studies until the time of delivery.

   An ultrasound is performed on a client at term gestation that is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on these findings, the nurse would prepare the client for:

Complete bed rest for the remainder of the pregnancy.

Delivery of the fetus.

Strict monitoring of intake and output.

The need for weekly monitoring of coagulation studies until the time of delivery.

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Correct Answer: B. Delivery of the fetus.

The goal of management in abruptio placentae is to control the hemorrhage and deliver the fetus as soon as possible. Delivery is the treatment of choice if the fetus is at term gestation or if the bleeding is moderate to severe and the mother or fetus is in jeopardy.

Multiple Choice

 

   A maternity nurse is preparing for the admission of a client in the 3rd trimester of pregnancy that is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the physician’s orders and would question which order?

• Prepare the client for an ultrasound.

• Obtain equipment for external electronic fetal heart monitoring.

• Obtain equipment for a manual pelvic examination.

• Prepare to draw a Hgb and Hct blood sample.

A maternity nurse is preparing for the admission of a client in the 3rd trimester of pregnancy that is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the physician’s orders and would question which order?

Prepare the client for an ultrasound.

Obtain equipment for external electronic fetal heart monitoring.

Obtain equipment for a manual pelvic examination.

Prepare to draw a Hgb and Hct blood sample.

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Correct Answer: C. Obtain equipment for a manual pelvic examination.

Manual pelvic examinations are contraindicated when vaginal bleeding is apparent in the 3rd trimester until a diagnosis is made and placenta previa is ruled out. Digital examination of the cervix can lead to maternal and fetal hemorrhage

Multiple Choice

A client with eclampsia begins to experience a seizure. Which of the following would the nurse in charge do first?

• Pad the side rails.

• Place a pillow under the left buttock.

• Insert a padded tongue blade into the mouth.

• Maintain a patent airway.

A client with eclampsia begins to experience a seizure. Which of the following would the nurse in charge do first?

•  A. Pad the side rails.

•  B. Place a pillow under the left buttock.

•  C. Insert a padded tongue blade into the mouth.

•  D. Maintain a patent airway.

Correct Answer: D. 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. Additionally, oxygen may be administered by face mask to prevent fetal hypoxia.

Multiple Choice

   Which of the following is the most common kind of placental adherence seen in pregnant women?

• Accreta

• Placenta previa

• Percreta

• Increta

    Which of the following is the most common kind of placental adherence seen in pregnant women?

 Accreta

 Placenta previa

 Percreta

 Increta

Correct Answer: A. Accreta

Placenta accreta is the most common kind of placental adherence seen in pregnant women and is characterized by slight penetration of myometrium.

·        Option B: In placenta previa, the placenta does not embed correctly and results in what is known as a low-lying placenta. It can be marginal, partial, or complete in how it covers the cervical os, and it increases the patient’s risk for painless vaginal bleeding during the pregnancy and/or delivery process.

·        Option C: Placenta percreta leads to perforation of the uterus and is the most serious and invasive of all types of accrete.

·        Option D: Placenta increta leads to deep penetration of the myometrium.​

Multiple Choice

When evaluating a client’s knowledge of symptoms to report during her pregnancy, which statement would indicate to the nurse in charge that the client understands the information given to her?

•  “I’ll report increased frequency of urination.”

•  “If I have blurred or double vision, I should call the clinic immediately.”

•  “If I feel tired after resting, I should report it immediately.”

•  “Nausea should be reported immediately.”

  When evaluating a client’s knowledge of symptoms to report during her pregnancy, which statement would indicate to the nurse in charge that the client understands the information given to her?

 “I’ll report increased frequency of urination.”

 “If I have blurred or double vision, I should call the clinic immediately.”

 “If I feel tired after resting, I should report it immediately.”

 “Nausea should be reported immediately.”

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Correct Answer: B. “If I have blurred or double vision, I should call the clinic immediately.”

Blurred or double vision may indicate hypertension or preeclampsia and should be reported immediately. It can affect the visual pathways, from the anterior segment to the visual cortex.

Multiple Choice

   A client makes a routine visit to the prenatal clinic. Although she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Charles diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal:

• An empty gestational sac.

• Grapelike clusters.

• A severely malformed fetus.

• An extrauterine pregnancy.

   A client makes a routine visit to the prenatal clinic. Although she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Charles diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal:

 An empty gestational sac.

Grapelike clusters.

 A severely malformed fetus.

 An extrauterine pregnancy.

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Correct Answer: B. Grapelike clusters.

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.

Multiple Choice

     A patient is in her last trimester of pregnancy. Nurse Vickie should instruct her to notify her primary health care provider immediately if she notices:

• Blurred vision

• Hemorrhoids

• Increased vaginal mucus

• Shortness of breath on exertion

A patient is in her last trimester of pregnancy. Nurse Vickie should instruct her to notify her primary health care provider immediately if she notices:

Blurred vision

Hemorrhoids

Increased vaginal mucus

Shortness of breath on exertion

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Correct Answer: A. Blurred vision

Blurred vision or other visual disturbance, excessive weight gain, edema, and increased blood pressure may signal severe preeclampsia. This condition may lead to eclampsia, which has potentially serious consequences for both the patient and fetus.

Multiple Choice

  A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms?

• Proteinuria, headaches, vaginal bleeding

• Headaches, double vision, vaginal bleeding

•  Proteinuria, headaches, double vision

•  Proteinuria, double vision, uterine contractions

   A patient with pregnancy-induced hypertension probably exhibits . Which of the following symptoms?

Proteinuria, headaches, vaginal bleeding

Headaches, double vision, vaginal bleeding

 Proteinuria, headaches, double vision

 Proteinuria, double vision, uterine contractions

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Correct Answer: C. Proteinuria, headaches, double vision

A patient with pregnancy-induced hypertension complains of a headache, double vision, and sudden weight gain. A urine specimen reveals proteinuria.

Multiple Choice

    A patient in her 14th week of pregnancy has presented with abdominal cramping and vaginal bleeding for the past 8 hours. She has passed several clots. What is the primary nursing diagnosis for this patient?

• Knowledge deficit

• Fluid volume deficit

• Anticipatory grieving

• Pain

1.     A patient in her 14th week of pregnancy has presented with abdominal cramping and vaginal bleeding for the past 8 hours. She has passed several clots. What is the primary nursing diagnosis for this patient?

 Knowledge deficit

 Fluid volume deficit

 Anticipatory grieving

Pain

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Correct Answer: B. Fluid volume deficit

If bleeding and clots are excessive, this patient may become hypovolemic. Pad count should be instituted. Blood volume expands during pregnancy, and a considerable portion of the weight of a pregnant woman is retained water.

Some text here about the topic of discussion

Multiple Choice

   Which of the following would the nurse most likely expect to find when assessing a pregnant client with abruption placenta?

• Excessive vaginal bleeding

• Rigid, board-like abdomen

• Tetanic uterine contractions

• Premature rupture of membranes

1.     Which of the following would the nurse most likely expect to find when assessing a pregnant client with abruption placenta?

Excessive vaginal bleeding

Rigid, board-like abdomen

Tetanic uterine contractions

Premature rupture of membranes

​Correct Answer: B. Rigid, board-like abdomen

The most common assessment finding in a client with abruption placenta is a rigid or boardlike abdomen. Pain, usually reported as a sharp stabbing sensation high in the uterine fundus with the initial separation, also is common.

·        Option A: It’s possible for the blood to become trapped inside the uterus, so even with a severe placental abruption, there might be no visible bleeding.

·        Option C: Uterine contractions are a common finding with placental abruption. Contractions progress as the abruption expands, and uterine hypertonus may be noted. Contractions are painful and palpable.

·        Option D: Increased frequency of placental abruption was found in patients with early rupture of membranes. The incidence was 50% and 44% when rupture of the membranes occurred before 20 weeks or between 20-24 weeks of pregnancy, respectively.

Multiple Choice

   A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following?

• Activity limited to bed rest.

• Platelet infusion.

• Immediate cesarean delivery.

• Labor induction with oxytocin.

A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following?

Activity limited to bed rest.

Platelet infusion.

Immediate cesarean delivery.

Labor induction with oxytocin.

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Correct Answer: A. Activity limited to bed rest

Treatment of partial placenta previa includes bed rest, hydration, and careful monitoring of the client’s bleeding.

Multiple Choice

   When developing a plan of care for a client newly diagnosed with gestational diabetes, which of the following instructions would be the priority?

• Medication

• Exercise

• Glucose monitoring

• Dietary intake

When developing a plan of care for a client newly diagnosed with gestational diabetes, which of the following instructions would be the priority?

Dietary intake

Medication

​Exercise

Glucose monitoring

​Correct Answer: A. Dietary intake

Although all of the choices are important in the management of diabetes, diet therapy is the mainstay of the treatment plan and should always be the priority. The goal of dietary therapy is to avoid single large meals and foods with a large percentage of simple carbohydrates.

·        Option B: Women diagnosed with gestational diabetes generally need only diet therapy without medication to control their blood sugar levels. A total of 6 feedings per day is preferred, with 3 major meals and 3 snacks to limit the amount of energy intake presented to the bloodstream at any interval.

·        Option C: Exercise, is important for all pregnant women and especially for diabetic women, because it burns up glucose, thus decreasing blood sugar. However, dietary intake, not exercise, is the priority. The diet should include foods with complex carbohydrates and cellulose, such as whole-grain bread and legumes.

·        Option D: All pregnant women with diabetes should have periodic monitoring of serum glucose. However, those with gestational diabetes generally do not need daily glucose monitoring. The standard of care recommends a fasting and 2-hour postprandial blood sugar level every 2 weeks.

Multiple Choice

    A client with severe preeclampsia is admitted with BP 160/110, proteinuria, and severe pitting edema. Which of the following would be most important to include in the client’s plan of care?

• Daily weights

• Seizure precautions

• Right lateral positioning

• Stress reduction

Client with severe preeclampsia is admitted with BP 160/110, proteinuria, and severe pitting edema. Which of the following would be most important to include in the client’s plan of care?

Daily weights

Seizure precautions

Right lateral positioning

Stress reduction

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Correct Answer: B. Seizure precautions

Women hospitalized with severe preeclampsia need decreased CNS stimulation to prevent a seizure. Seizure precautions provide environmental safety should a seizure occur.

·        Option A: Because of edema, daily weight is important but not the priority. High pregnancy weight gain was more strongly associated with term preeclampsia than early preterm preeclampsia (eg, 64% versus 43% increased odds per 1 z score difference in weight gain in normal-weight women, and 30% versus 0% in obese women, respectively).

·        Option C: Preeclampsia causes vasospasm and therefore can reduce uteroplacental perfusion. The client should be placed on her left side to maximize blood flow, reduce blood pressure, and promote diuresis.

·        Option D: Interventions to reduce stress and anxiety are very important to facilitate coping and a sense of control, but seizure precautions are the priority.

Multiple Choice

   The preferred manner of delivering the baby in a gravido-cardiac is vaginal delivery assisted by forceps under epidural anesthesia. The main rationale for this is:

• To allow atraumatic delivery of the baby.

• To allow a gradual shifting of the blood into the maternal circulation.

• To make the delivery effort-free and the mother does not need to push with contractions.

• To prevent perineal laceration with the expulsion of the fetal head.

  The preferred manner of delivering the baby in a gravido-cardiac is vaginal delivery assisted by forceps under epidural anesthesia. The main rationale for this is:

To allow atraumatic delivery of the baby.

To allow a gradual shifting of the blood into the maternal circulation.

To make the delivery effort-free and the mother does not need to push with contractions.

To prevent perineal laceration with the expulsion of the fetal head.

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Correct Answer: C. To make the delivery effort-free and the mother does not need to push with contractions.

Forceps delivery under epidural anesthesia will make the delivery process less painful and require less effort to push for the mother. Pushing requires more effort which a compromised heart may not be able to endure.

Multiple Choice

  Which of the following are the most commonly assessed findings in cystitis?

• Frequency, urgency, dehydration, nausea, chills, and flank pain

• Nocturia, frequency, urgency dysuria, hematuria, fever, and suprapubic pain

• Dehydration, hypertension, dysuria, suprapubic pain, chills, and fever

• High fever, chills, flank pain nausea, vomiting, dysuria, and frequency

.Which of the following are the most commonly assessed findings in cystitis?

Frequency, urgency, dehydration, nausea, chills, and flank pain

 Nocturia, frequency, urgency dysuria, hematuria, fever, and suprapubic pain

Dehydration, hypertension, dysuria, suprapubic pain, chills, and fever

 High fever, chills, flank pain nausea, vomiting, dysuria, and frequency

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Correct Answer: B. Manifestations of cystitis include, frequency, urgency, dysuria, hematuria nocturia, fever, and suprapubic pain.

Dehydration, hypertension, and chills are not typically associated with cystitis. High fever chills, flank pain, nausea, vomiting, dysuria, and frequency are associated with pyelonephritis.

Multiple Choice

   Which of the following is TRUE in Rh incompatibility?

• The condition can occur if the mother is Rh(+) and the fetus is Rh(-).

• Every pregnancy of an Rh(-) mother will result in erythroblastosis fetalis

• On the first pregnancy of the Rh(-) mother, the fetus will not be affected

• RhoGam is given only during the first pregnancy to prevent incompatibility.

  Which of the following is TRUE in Rh incompatibility?

The condition can occur if the mother is Rh(+) and the fetus is Rh(-).

Every pregnancy of an Rh(-) mother will result in erythroblastosis fetalis.

On the first pregnancy of the Rh(-) mother, the fetus will not be affected.

RhoGam is given only during the first pregnancy to prevent incompatibility.

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Correct Answer: C. On the first pregnancy of the Rh(-) mother, the fetus will not be affected

On the first pregnancy, the mother still has no contact with Rh(+) blood thus it has not antibodies against Rh(+). After the first pregnancy, even if terminated into an abortion, there is already the possibility of mixing of maternal and fetal blood so this can trigger the maternal blood to produce antibodies against Rh(+) blood. The fetus takes its blood type usually from the father.

Multiple Choice

Before giving a repeat dose of magnesium sulfate to a pre-eclamptic patient, the nurse should assess the patient’s condition. Which of the following conditions will require the nurse to temporarily suspend a repeat dose of magnesium sulfate?

• 100 cc. urine output in 4 hours

•  Knee jerk reflex is (+)2

• Serum magnesium level is 10mEg/L.

• Respiratory rate of 16/min

   Before giving a repeat dose of magnesium sulfate to a pre-eclamptic patient, the nurse should assess the patient’s condition. Which of the following conditions will require the nurse to temporarily suspend a repeat dose of magnesium sulfate?

100 cc. urine output in 4 hours

 Knee jerk reflex is (+)2

Serum magnesium level is 10mEg/L.

Respiratory rate of 16/min

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Correct Answer: A. 100 cc. urine output in 4 hours

The minimum urine output expected for a repeat dose of MgSO4 is 30 cc/hr. If in 4 hours the urine output is only 100 cc this is low and can lead to poor excretion of Magnesium with a possible cumulative effect, which can be dangerous to the mother.

Multiple Choice

  In placenta previa marginalis, the placenta is found at the:

• Internal cervical os partly covering the opening.

• External cervical os slightly covering the opening.

• Lower segment of the uterus with the edges near the internal cervical os.

• Lower portion of the uterus completely covering the cervix.

   In placenta previa marginalis, the placenta is found at the:

Internal cervical os partly covering the opening.

External cervical os slightly covering the opening.

Lower segment of the uterus with the edges near the internal cervical os.

Lower portion of the uterus completely covering the cervix.

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Correct Answer: C. Lower segment of the uterus with the edges near the internal cervical os

Placenta marginalis is a type of placenta previa wherein the placenta is implanted at the lower segment of the uterus thus the edges of the placenta are touching the internal cervical opening/os. The normal site of placental implantation is the upper portion of the uterus.

Multiple Choice

The nursing measure to relieve fetal distress due to maternal supine hypotension is:

• Place the mother in semi-Fowler's position.

• Put the mother on the left side-lying position.

• Place mother on a knee-chest position.

• Any of the above.

 The nursing measure to relieve fetal distress due to maternal supine hypotension is:

Place the mother in semi-Fowler's position.

Put the mother on the left side-lying position.

Place mother on a knee-chest position.

Any of the above.

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Correct Answer: B. Put the mother on left side-lying position.

When a pregnant woman lies in a supine position, the weight of the gravid uterus would be compressing on the vena cava against the vertebrae obstructing blood flow from the lower extremities. This causes a decrease in blood return to the heart and consequently immediate decreased cardiac output and hypotension. Hence, putting the mother on side-lying will relieve the pressure exerted by the gravid uterus on the vena cava.

Multiple Choice

   Which of the following signs will distinguish threatened abortion from imminent abortion?

• Severity of bleeding.

• Dilation of the cervix.

• Nature and location of pain.

• Presence of uterine contraction.

   Which of the following signs will distinguish threatened abortion from imminent abortion?

Severity of bleeding.

Dilation of the cervix.

Nature and location of pain.

Presence of uterine contraction.

Correct Answer: B. Dilation of the cervix

In imminent abortion, the pregnancy will definitely be terminated because the cervix is already open unlike in threatened abortion where the cervix is still closed.

Multiple Choice

   A gravidocardiac mother is advised to observe bed rest primarily to:

• Allow the fetus to achieve normal intrauterine growth.

• Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother.

• Prevent perinatal infection.

• Reduce incidence of premature labor.

A gravidocardiac mother is advised to observe bed rest primarily to:

Allow the fetus to achieve normal intrauterine growth.

Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother.

Prevent perinatal infection.

Reduce incidence of premature labor.

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Correct Answer: B. Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother.

The activity of the mother will require more oxygen consumption. Since the heart of a gravido-cardiac is compromised, there is a need to put a mother on bedrest to reduce the need for oxygen.

Some text here about the topic of discussion

Multiple Choice

   When a pregnant woman goes into a convulsive seizure, the MOST immediate action of the nurse to ensure the safety of the patient is:

• Apply restraint so that the patient will not fall out of bed.

• Put a mouth gag so that the patient will not bite her tongue and the tongue will not fall back.

• Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration.

• Check if the woman is also having precipitate labor.

   When a pregnant woman goes into a convulsive seizure, the MOST immediate action of the nurse to ensure the safety of the patient is:

Apply restraint so that the patient will not fall out of bed.

Put a mouth gag so that the patient will not bite her tongue and the tongue will not fall back.

Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration.

Check if the woman is also having precipitate labor.

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Correct Answer: C. Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration.

Positioning the mother on her side will allow the secretions that may accumulate in her mouth to drain by gravity thus preventing aspiration pneumonia.

Multiple Choice

     Chicky who has a history of repeated trichomonas infection was advised to have a Pap smear by her physician. She asked you what the test is for. Your appropriate response is:

•      It is a screening test for cervical cancer

•   It is a screening test for cancer of the female reproductive tract

•      It is a diagnostic test for the presence of trichomonas infection.

•      It is a test that will show if she has cervical cancer or not

Chinky who has a history of repeated trichomonas infection was advised to have a Pap smear by her physician. She asked you what the test is for. Your appropriate response is:

a.      It is a screening test for cervical cancer

b.      It is a screening test for cancer of the female reproductive tract

c.      It is a diagnostic test for the presence of trichomonas infection.

d.      It is a test that will show if she has cervical cancer or not

.          Answer: A

□ Pap smear is cytologic examination of the cervix. It is a screening test to determine if a woman has signs of cervical cancer. Even if it shows that a woman has signs of malignancy of the cervix, the result is not yet conclusive. Further testing of cervical tissue should be conducted to be able to have an accurate diagnosis. Cervical biopsy is the diagnostic test for cervical cancer.

Multiple Choice

The result of the Pap test is class I. This means that:

•     Presence of malignant cells

•   Presence of infections

•    Normal findings

•      Presence of atypical but not malignant cells

1.      The result of the Pap test is class I. This means that:

Presence of malignant cells

Presence of infections

Normal findings

Presence of atypical but not malignant cells      

Answer: A

□ Class I means normal findings, the patient has no signs of cervical cancer

□ Class II means presence of atypical cells which is often due inflammatory condition such as infection of the cervix.

□ Class III means presence of benign and possibly malignant cells.

□ Class VI means presence of malignant signs and symptoms

□ Class V means presence malignant cells.

Multiple Choice

     You should be aware that a major difficulty in preventing the spread of gonorrhea is that many women who have the disease:

• Are unaware that they  have it

• Have a milder form of the disease that most men

• Are more reluctant to seek health care than men

• Acquire the disease without having sexual intercourse

     You should be aware that a major difficulty in preventing the spread of gonorrhea is that many women who have the disease:

Are unaware that they  have it

Have a milder form of the disease that most men

Are more reluctant to seek health care than men

Acquire the disease without having sexual intercourse         

Answer: A

□ Majority of woman infected with gonorrhea does not experience any signs and symptoms and may unknowingly transmit the disease to their sexual partners. Most common means of transmission of the disease in adult women is by sexual intercourse. Gonorrhea is transmitted by direct contract of the infected mucous membranes of the mouth, anus, and genitals of a person to another person . Newborns acquire the infection when microorganisms in the birth canal enter their eyes resulting in opthalmia neonatorum.

Multiple Choice

  Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy?

• Large for gestational age (LGA) fetus

• Hemorrhage

• Small for gestational age (SGA) baby

• Erythroblastosis fetalis

Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy?

Large for gestational age (LGA) fetus

Hemorrhage

Small for gestational age (SGA) baby

Erythroblastosis fetalis

​

Correct Answer: C. Small for gestational age (SGA) baby

Anemia is a condition where there is a reduced amount of hemoglobin. Hemoglobin is needed to supply the fetus with adequate oxygen. Oxygen is needed for normal growth and development of the fetus.

Multiple Choice

   Smoking is contraindicated in pregnancy because:

• Nicotine causes vasodilation of the mother’s blood vessels.

• Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the fetus.

• The smoke will make the fetus, and the mother feels dizzy.

• Nicotine will cause vasoconstriction of the fetal blood vessels.

   Smoking is contraindicated in pregnancy because:

Nicotine causes vasodilation of the mother’s blood vessels.

Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the fetus.

The smoke will make the fetus, and the mother feels dizzy.

Nicotine will cause vasoconstriction of the fetal blood vessels.

​

Correct Answer: B. Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the fetus.

Carbon monoxide is one of the substances found in cigarette smoke. This substance diminishes the ability of the hemoglobin to bind with oxygen thus reducing the amount of oxygenated blood reaching the fetus.

·        Option A: There is blood flow restriction to the placenta due to the vasoconstrictive effects of catecholamines released from the adrenals and nerve cells after nicotine activation.

·        Option C: Nicotine is rapidly absorbed when the tobacco smoke reaches the small airways and alveoli of the lung. This causes a quick rise in blood nicotine concentrations, but due to the eventual burnout of the cigarette, these levels also peak early and thereafter drop to lower levels.

·        Option D: Direct effects on nicotinic acetylcholine receptors (nAChRs), which are present and functional very early in the fetal brain [5] are also likely to contribute.

Multiple Choice

   The main reason for an expected increased need for iron in pregnancy is:

• The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about 350-400 mg of iron to grow.

• The mother may suffer anemia because of poor appetite.

• The fetus has an increased need for RBC which the mother must supply.

• The mother may have a problem with digestion because of pica.

The main reason for an expected increased need for iron in pregnancy is:

The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about 350-400 mg of iron to grow.

The mother may suffer anemia because of poor appetite.

The fetus has an increased need for RBC which the mother must supply.

The mother may have a problem with digestion because of pica.

​

Correct Answer: A. The mother may have physiologic anemia due to the increased need for red blood cell mass, as well as the fetal, requires about 350-400 mg of iron to grow.

About 400 mg of iron is needed by the mother in order to produce more RBC mass to be able to provide the needed increase in blood supply for the fetus. Also, about 350-400 mg of iron is needed for the normal growth of the fetus. Thus, about 750-800 mg iron supplementation is needed by the mother to meet this additional requirement.

Multiple Choice

   Which of the following signs will require a mother to seek immediate medical attention?

• When the first fetal movement is felt.

• No fetal movement is felt on the 6th month.

• Mild uterine contraction.

• Slight dyspnea on the last month of gestation.

  Which of the following signs will require a mother to seek immediate medical attention?

When the first fetal movement is felt.

No fetal movement is felt on the 6th month.

Mild uterine contraction.

Slight dyspnea on the last month of gestation.

​

Correct Answer: B. No fetal movement is felt on the 6th month.

Fetal movement is usually felt by the mother during 4.5 – 5 months. If the pregnancy is already in its 6th month and no fetal movement is felt, the pregnancy is not normal either the fetus is already dead intra-uterine or it is an H-mole

Multiple Choice

     The neonate of a mother with diabetes mellitus is prone to developing hypoglycemia because:

• The pancreas is immature and unable to secrete the needed insulin.

• There is rapid diminution of glucose level in the baby’s circulating blood and his pancreas is normally secreting insulin

• The baby is reacting to the insulin given to the mother.

• His kidneys are immature leading to a high tolerance for glucose.

     The neonate of a mother with diabetes mellitus is prone to developing hypoglycemia because:

The pancreas is immature and unable to secrete the needed insulin.

There is rapid diminution of glucose level in the baby’s circulating blood and his pancreas is normally secreting insulin.

The baby is reacting to the insulin given to the mother.

His kidneys are immature leading to a high tolerance for glucose.

​

Correct Answer: B. There is rapid diminution of glucose level in the baby’s circulating blood and his pancreas is normally secreting insulin.

If the mother is diabetic, the fetus while in utero has a high supply of glucose. When the baby is born and is now separate from the mother, it no longer receives a high dose of glucose from the mother. In the first few hours after delivery, the neonate usually does not feed yet thus this can lead to hypoglycemia.

Multiple Choice

  A prenatal nurse is providing instructions to a group of pregnant clients regarding measures to prevent toxoplasmosis. Which statement if made by one of the clients indicates a need for further instructions?

•  “I need to cook meat thoroughly.”

•  “I need to avoid touching mucous membranes of the mouth or eyes while handling raw meat.”

•  “I need to drink unpasteurized milk only.”

•  “I need to avoid contact with materials that are possibly contaminated with cat feces.”

     A prenatal nurse is providing instructions to a group of pregnant clients regarding measures to prevent toxoplasmosis. Which statement if made by one of the clients indicates a need for further instructions?

 “I need to cook meat thoroughly.”

 “I need to avoid touching mucous membranes of the mouth or eyes while handling raw meat.”

 “I need to drink unpasteurized milk only.”

 “I need to avoid contact with materials that are possibly contaminated with cat feces.”

Correct Answer: C. “I need to drink unpasteurized milk only.”

All pregnant women should be advised to do the following to prevent the development of toxoplasmosis. Everyone, including immunocompetent patients, should be educated about toxoplasmosis risk factors and ways to minimize the risks. Preventing toxoplasmosis is particularly important in seronegative immunocompromised patients and in pregnant women.