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High-Risk Pregnancies

Total questions: 15

Worksheet time: 15mins

Name
Class
Date
1.
A nurse is caring for a client who is in labor and experiencing incomplete uterine relaxation between hypertonic contractions. The nurse recognizes the adverse effect of this contraction pattern is:
a)
prolonged labor
b)
reduced fetal oxygen supply
c)
delayed cervical dilation
d)
increased maternal stress
2.
A nurse is caring for a client who is in active labor and reports severe back pain. During assessment, the fetus is noted to be in the occiput posterior position. Which of the following maternal positions should the nurse suggest to the client to facilitate normal labor progress?
a)
hands and knees
b)
lithotomy
c)
trendelenburg
d)
supine with a rolled towel under one hip
3.
A nurse is caring for a client who is admitted to the labor and delivery unit. With the use of Leopold’s maneuver, it is noted that the fetus is in a breech presentation. For which of the following possible complications should the nurse observe?
a)
precipitous labor
b)
premature rupture of membranes
c)
post-maturity syndrome
d)
prolapsed umbilical cord
4.
A nurse is caring for a client who is at 42 weeks of gestation and in active labor. The nurse should understand that the fetus is at risk for which of the following?
a)
intrauterine growth restriction
b)
hyperglycemia
c)
meconium aspiration
d)
polyhydramnios
5.
A nurse is caring for a client in active labor. When last examined 2 hr. ago, the client’s cervix was 3 cm dilated, 100% effaced, membranes intact, and the fetus was at a -2 station. The client suddenly states “my water broke.” The monitor reveals a FHR of 80 to 85/min, and the nurse performs a vaginal examination, noticing clear fluid and a pulsing loop of umbilical cord in the client’s vagina. Which of the following actions should the nurse perform first?
a)
place the client in the Trendelenburg position
b)
apply pressure to the presenting part with her fingers
c)
administer oxygen at 10L/min via a face mask
d)
call for assistance
6.
Two clients arrive at the labor and delivery triage area at the same time. The first client states that her water has been leaking, but that she hasn’t had any contractions. The second client says she’s having 1-minute contractions every 3 minutes and that she feels like pushing. How should a nurse prioritize these clients? 
a)
It doesn’t matter which client receives priority; they’re at the same stage in labor.
b)
Triage observation is appropriate for both clients at this time.
c)
The nurse should assign priority to the first client. Her leaking amniotic fluid indicates she will go into labor soon.
d)
The nurse should assign priority to the second client. Her signs and symptoms indicate that her baby’s birth is imminent.
7.
A client in labor tells the nurse-midwife that she feels a strong urge to push. Physical examination reveals that her cervix is not completely dilated. The nurse-midwife tells her not to push yet. What is the rationale for this instruction?
a)
Early pushing may cause edema and impede fetal descent.
b)
The fetus hasn’t rotated into the proper position.
c)
Pushing at this time may cause rupture of the membranes.
d)
The nurse-midwife isn’t ready to assist her.
8.
The nurse providing care for the laboring woman understands that accelerations with fetal movement:
a)
Are caused by umbilical cord compression
b)
Warrant close observation
c)
Are caused by uteroplacental insufficiency
d)
Are reassuring 
9.
What kind of fetal anomalies are most often associated with oligohydramnios?
a)
cardiac
b)
gastrointestinal
c)
renal
d)
neurologic
10.
A pregnant woman at 25 weeks age of gestation tells the nurse that she dropped a pan last week and her baby jumped at the noise. Which response by the nurse is the most accurate?
a)
"That must have been a coincidence; babies can't respond like that."
b)
"The fetus is demonstrating the aural reflex."
c)
"Let me know if it happens again; we need to report that to your midwife."
d)
"Babies respond to sound starting at approximately 24 weeks of gestation."
11.
Which statement regarding the structure and function of the placenta is correct?
a)
produces nutrients for fetal nutrition
b)
secretes both estrogen and progesterone
c)
forms a productive, impenetrable barrier to microorganisms such as bacteria and viruses
d)
excretes prolactin and insulin
12.
Which structure is responsible for oxygen and carbon dioxide transport to and from the maternal bloodstream?
a)
chorionic villi
b)
decidua basalis
c)
blastocyst
d)
germ layer
13.
Which sign or symptom is considered a first - trimester warning sign and should be immediately reported by the pregnant woman to her health care provider?
a)
nausea with occasional vomiting
b)
fatigue
c)
urinary frequency
d)
vaginal bleeding
14.
A client has arrived for her first prenatal appointment. She asked the nurse to explain exactly how long the pregnancy will be. What is the nurse’s best response?
a)
Normal pregnancy is 10 lunar months.
b)
Pregnancy is made up of four trimesters.
c)
Pregnancy is considered term at 36 weeks.
d)
Estimated date of delivery (EDD is 40 completed weeks.
15.
Which consideration is essential for the nurse to understand regarding follow-up prenatal care visits?
a)
The interview portions become more intensive as the visits become more frequent over the course of the pregnancy.
b)
Monthly visits are scheduled for the first trimester, every 2 weeks for the second trimester, and weekly for the third trimester.
c)
During the abdominal examination, the nurse should be alert for supine hypotension.
d)
For pregnant women, a systolic BP of 130mmHg and a diastolic BP of 80mm Hg is sufficient to be considered hypertensive.