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WorksheetsNUR 221 Pathophysiology: Chapter 22 Complications of Pregnancy
Total questions: 30
Worksheet time: 15mins
Severe preeclampsia case: A 28-year-old G1P0 woman at 34 weeks’ gestation presents to triage with a 48-hour history of worsening headache, blurred vision, and right upper-quadrant discomfort. She is anxious but alert. Current data: BP 160/100 mm Hg; HR 88 bpm; RR 18; T 98.6 °F. Urinalysis: 3+ protein. Deep tendon reflexes: 3+ with 1+ clonus. Labs: platelets 150 × 10^3/µL; AST 40 U/L; ALT 45 U/L; Cr 0.8 mg/dL. Fetal testing: NST reactive. Which nursing action is the priority for this client at this time?
Place the client on bed rest in the left lateral position and continue routine observation.
Begin a magnesium sulfate infusion per protocol to prevent eclamptic seizures.
Assess and document deep tendon reflexes and respiratory rate every 15 minutes only.
Provide education about a sodium-restricted diet and arrange outpatient home BP monitoring.
Gestational diabetes: A 29-year-old G1 at 28 weeks’ gestation with newly diagnosed gestational diabetes asks the nurse, "What is the recommended fasting blood glucose goal each morning for pregnant clients with GDM?"
≤ 140 mg/dL
≤ 120 mg/dL
≤ 110 mg/dL
≤ 95 mg/dL
Placenta previa: A 35-year-old at 37 weeks reports painless bright-red vaginal bleeding. Which nursing actions are appropriate immediate priorities? (Select all that apply.)
Prepare for a guarded sterile vaginal examination when indicated by the provider.
Monitor maternal vital signs and assess for hypovolemia
Position the patient in the left lateral decubitus position to optimize uteroplacental perfusion
Initiate continuous external fetal monitoring
Rh incompatibility: A Rh-negative mother delivers a Rh-positive infant. Which actions should the nurse include in postpartum care? (Select all that apply.)
Administer Rh immune globulin (Rho[D] IG) within 72 hours postpartum
Obtain maternal antibody screen (indirect Coombs) at delivery and follow-up
Encourage early breastfeeding to transfer maternal antibodies
Schedule routine invasive testing in subsequent pregnancies without counseling
Gestational age: What is the usual interval between the first day of the last menstrual period and the term of birth?
38 weeks
40 weeks
Gravidity
Embryonic period
Pregnancy: Which of the following is NOT a common physiological consequence of the expanding uterus during pregnancy?
Compression of the urinary bladder
Reduced inspiratory volume due to diaphragmatic elevation
Persistent low systemic blood pressure
Development of varicose veins in the lower extremities
Pregnancy-induced hypertension: Which clinical finding best indicates the development of pregnancy-induced hypertension?
New proteinuria with edema and acute weight gain
Nausea and vomiting relieved by rest
Increased fetal heart rate variability without maternal symptoms
Mild dependent ankle edema that resolves overnight
Fetal Hemolysis in Rh Incompatibility: What is the usual cause of hemolysis of fetal erythrocytes in Rh incompatibility?
Maternal Rh-negative status with an Rh-positive fetus leading to maternal alloimmunization
Parental blood-type differences unrelated to Rh status
Maternal receipt of Rh immune globulin in a prior pregnancy
Transfer of fetal antibodies into maternal circulation
Placenta Previa: Which condition most commonly causes painless, bright-red vaginal bleeding in the third trimester?
Ectopic pregnancy
Placenta previa
Abruptio placentae
Disseminated intravascular coagulation (DIC)
Adolescent Pregnancy: Why is adolescent pregnancy considered high risk? (Select all that apply.)
Inadequate or delayed prenatal care
Poor nutrition and lack of prenatal vitamin supplementation
Increased prevalence of iron deficiency anemia
Higher risk of gestational diabetes compared with older adult mothers
Psychosocial stress and limited social support
Teratogen-Sensitive Period: During which time are teratogens most likely to cause significant structural damage to developing organs?
First week after fertilization
Weeks 3–8 post-conception (first 2 months)
Up to 6 months of gestation
During labor and delivery
Pregnancy-Associated Edema: Edema and vascular congestion commonly develop in pregnancy because of which physiological change?
Reduced kidney filtration rate
Decreased serum albumin concentration
Increased circulating blood volume and cardiac output
Marked increases in systemic blood pressure
Gestational Diabetes: Gestational diabetes in the mother usually results in which neonatal outcome if poorly controlled?
Normal birth weight if maternal glucose is controlled
No evidence of diabetes after delivery for both mother and infant
Delivery of a large-for-gestational-age infant (macrosomia)
No additional complications for mother or infant
Rh Incompatibility: Which events correctly describe the sequence and consequences of Rh incompatibility? (Select all that apply.) Options include the following clinical events.
Fetal Rh-positive red blood cells enter the maternal circulation.
The mother produces anti-Rh antibodies.
Maternal anti-Rh antibodies cross the placenta and enter fetal circulation.
Maternal Rh-negative erythrocytes attack fetal red blood cells.
Hemolysis of fetal erythrocytes occurs, causing fetal anemia.
Rh Incompatibility: Which events correctly describe the sequence and consequences of Rh incompatibility? (Select all that apply.) Options include the following clinical events.
Elevated fetal bilirubin levels develop.
Rh incompatibility occurs only during labor and delivery.
Eclampsia: A 28-year-old primigravida at 36 weeks’ gestation is evaluated for severe preeclampsia. Which statement best describes eclampsia?
Blood pressure typically normalizes immediately after delivery, and no seizures occur.
Kidney and liver tests remain within normal limits despite severe hypertension.
Eclampsia most often occurs in ectopic pregnancies.
Severe hypertension with progression to tonic-clonic seizures may occur.
Gestational diabetes mellitus: A 29-year-old woman at 28 weeks’ gestation asks, "What should my fasting blood sugar be each morning?" Which fasting blood glucose goal is recommended for a pregnant client with GDM?
≤110 mg/dL
≤95 mg/dL
≤120 mg/dL
≤140 mg/dL
Gestational diabetes mellitus: Which complication is the fetus at the most significant risk for if maternal blood glucose is poorly controlled?
Intrauterine growth restriction (IUGR)
Macrosomia (large-for-gestational-age infant)
Neural tube defects
Preterm labor
Third-trimester bleeding: A 35-year-old at 37 weeks reports painless bright red vaginal bleeding. What are appropriate nursing interventions? (Select all that apply.)
Prepare for immediate vaginal examination.
Monitor maternal vital signs and assess for hypovolemia.
Position the patient in left lateral decubitus.
Apply external fetal monitoring.
Rh prophylaxis: A 28-year-old Rh-negative mother delivers a Rh-positive infant. Which interventions should the nurse include? (Select all that apply.)
Administer Rh immunoglobulin within 72 hours postpartum.
Obtain maternal antibody titer at 28 weeks.
Encourage early breastfeeding to boost immunity.
Schedule middle-third trimester amniocentesis.
What is the usual time between the first day of the last menstrual period and the time of birth?
38 weeks
Termed the gestation period
Referred to as gravidity
The embryonic period
Common effects of the expanding uterus during pregnancy include all the following EXCEPT:
Compression of the urinary bladder.
Restricted inspiratory volume.
Low blood pressure.
Varicose veins.
Which of the following indicates the development of pregnancy-induced hypertension?
Proteinuria, edema, and weight gain
Persistent blood pressure measuring above 140/90
Vaginal bleeding
Blood clots are forming in the legs
What is the likely cause of painless, bright red vaginal bleeding during the last trimester?
Ectopic pregnancy
Abruptio placentae
Disseminated intravascular coagulation (DIC)
Placenta previa
A nurse is performing health education with a woman who has just learned that she is pregnant. The nurse has explained the concept of teratogenic drugs and emphasized the need to have her health care provider assess any medications she should consider taking. The nurse should teach the woman that drug-induced teratogenicity is most likely to occur at what point in her pregnancy?
During the second half of her third trimester
In the 7 to 10 days after conception
In the first trimester during organogenesis
During 30 to 34 weeks of gestation
Which physiological change during pregnancy most contributes to the development of lower extremity edema?
Elevated serum albumin
Reduced plasma osmolality
Decreased cardiac output
Increased circulating blood volume
What is a classic sign of preeclampsia developing in a pregnant woman?
Sudden onset of proteinuria and elevated blood pressure
Frequent urination without edema
Increased appetite and weight loss
Decreased urine output with normal blood pressure
Which laboratory finding is most consistent with the diagnosis of preeclampsia in a pregnant client?
Elevated platelet count
Decreased liver enzymes
Low urine protein levels
Increased serum creatinine
What is the most common clinical sign indicating the onset of preeclampsia in a pregnant woman?
Frequent urination without edema
Decreased urine output with normal blood pressure
Increased appetite and weight loss
New-onset hypertension and proteinuria
What is the most likely cause of sudden-onset tonic-clonic seizures in a pregnant woman with severe hypertension and proteinuria?
Gestational diabetes
Rh incompatibility
Eclampsia
Placenta previa
