Chapter 10: Complications of Pregnancy
Foundations of Maternal-Newborn &
Women's Health Nursing, 7th Edition
Questions and Correct Answers
1. A patient with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The
drug classification of this medication is a
a.
diuretic.
b.
tocolytic.
c.
anticonvulsant.
d.
antihypertensive. - correct answers:ANS: C
Anticonvulsant drugs act by blocking neuromuscular transmission and depress the central nervous
system to control seizure activity. Diuresis is a therapeutic response to magnesium sulfate. A tocolytic
drug slows the frequency and intensity of uterine contractions but is not used for that purpose in this
scenario. Decreased peripheral blood pressure is a therapeutic response (side effect) of the
anticonvulsant magnesium sulfate.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
2. Which clinical intervention is the only known cure for preeclampsia?
a.
Magnesium sulfate
b.
Delivery of the fetus
c.
Antihypertensive medications
,d.
Administration of aspirin (ASA) every day of the pregnancy - correct answers:ANS: B
Delivery of the infant is the only known intervention to halt the progression of preeclampsia. Magnesium
sulfate is one of the medications used to treat but not cure preeclampsia. Antihypertensive medications
are used to lower the dangerously elevated blood pressures in preeclampsia and eclampsia. Low doses
of aspirin (81 mg/day) have been administered to women at high risk for developing preeclampsia. This
intervention appears to have little benefit.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
3. The clinic nurse is performing a prenatal assessment on a pregnant patient at risk for preeclampsia.
Which clinical sign would not present as a symptom of preeclampsia?
a.
Edema
b.
Proteinuria
c.
Glucosuria
d.
Hypertension - correct answers:ANS: C
Glucose into the urine is not one of the three classic symptoms of preeclampsia. The first sign noted by
the pregnant patient is rapid weight gain and edema of the hands and face. Proteinuria usually develops
later than the edema and hypertension. The first indication of preeclampsia is usually an increase in the
maternal blood pressure.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
4. Which intrapartal assessment should be avoided when caring for a patient with HELLP syndrome?
a.
Abdominal palpation
b.
Venous sample of blood
,c.
Checking deep tendon reflexes
d.
Auscultation of the heart and lungs - correct answers:ANS: A
Palpation of the abdomen and liver could result in a sudden increase in intraabdominal pressure, leading
to rupture of the subcapsular hematoma. Assessment of heart and lungs is performed on every patient.
Checking reflexes is not contraindicated. Venous blood is checked frequently to observe for
thrombocytopenia.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
5. A nurse is explaining to the nursing students working on the antepartum unit how to assess for
edema. Which edema assessment score indicates edema of the lower extremities, face, hands, and
sacral area?
a.
+1
b.
+2
c.
+3
d.
+4 - correct answers:ANS: C
Edema of the extremities, face, and sacral area is classified as +3 edema. Edema classified as +1 indicates
minimal edema of the lower extremities. Marked edema of the lower extremities is +2 edema.
Generalized massive edema (+4) includes the accumulation of fluid in the peritoneal cavity.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
6. Which maternal condition always necessitates delivery by cesarean birth?
a.
Partial abruptio placentae
, b.
Total placenta previa
c.
Ectopic pregnancy
d.
Eclampsia - correct answers:ANS: B
In total placenta previa, the placenta completely covers the cervical os. The fetus would die if a vaginal
birth occurred. If the patient has stable vital signs and the fetus is alive, a vaginal birth can be attempted.
If the fetus has already expired, a vaginal birth is preferred. The most common ectopic pregnancy is a
tubal pregnancy, which is usually detected and treated in the first trimester. Labor can be safely induced
if the eclampsia is under control.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
7. Spontaneous termination of a pregnancy is considered to be an abortion if
a.
the pregnancy is less than 20 weeks.
b.
the fetus weighs less than 1000 g.
c.
the products of conception are passed intact.
d.
there is no evidence of intrauterine infection. - correct answers:ANS: A
An abortion is the termination of pregnancy before the age of viability (20 weeks). The weight of the
fetus is not considered because some fetuses of an older age may have a low birth weight. A
spontaneous abortion may be complete or incomplete. A spontaneous abortion may be caused by many
problems, one being intrauterine infection.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion and Maintenance
8. An abortion when the fetus dies but is retained in the uterus is called
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