Exam (elaborations)
Chapter 14 Pregnancy at Risk, Gestational Conditions
- Course
- Maternal child nursing
- Institution
- Rutgers School Of Nursing
Chapter 14 Pregnancy at Risk, Gestational Conditions
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Chapter 14: Pregnancy at Risk: Gestational ConditionsMULTIPLE CHOICE
1. Which is true about women who experience hyperemesis gravidarum?
a. Seventy percent of all pregnant women
suffer from it at some point in pregnancy.
b. Such women have vomiting severe and
persistent enough to cause weight loss,
dehydration, and electrolyte imbalance.
c. They need intravenous (IV) fluid and
nutrition for most of their pregnancy.
d. They often inspire similar, milder
symptoms in their male partners and
mothers.
ANS: B
Women with hyperemesis gravidarum have severe vomiting; however, treatment for several
days sets things right in most cases. Although 70% of pregnant women experience nausea and
vomiting, about 0.5 to 2% proceed to this severe level. IV administration may be used at first to
restore fluid levels, but it is seldom needed for very long. Women suffering from this condition
want sympathy, because some authorities believe that difficult relationships with mothers or
partners may be the cause.
DIF: Cognitive Level: Comprehension REF: p. 326
OBJ: Nursing Process: Assessment
2. What should the nurse be aware of in relation to women who may need surgery during
pregnancy?
,a. The diagnosis of appendicitis may be
difficult, because the normal signs and
symptoms mimic some normal changes in
pregnancy.
b. Rupture of the appendix is less likely in
pregnant women because of the close
monitoring.
c. Surgery for intestinal obstructions should
be delayed as long as possible because it
usually affects the pregnancy.
d. When pregnancy takes over, a woman
is less likely to have ovarian problems
that require invasive responses.
ANS: A
Both appendicitis and pregnancy are linked with nausea, vomiting, and increased white blood
cell count. Rupture of the appendix is two to three times more likely in pregnant women.
Surgery to remove obstructions should be done right away. It usually does not affect the
pregnancy. Pregnancy predisposes a woman to ovarian problems.
, DIF: Cognitive Level: Comprehension REF: p. 346 OBJ: Nursing
Process: Assessment
3. Which laboratory result is indicative of disseminated intravascular coagulation (DIC)?
a. Increased platelets
b. Decreased fibrinogen
c. Increased factor V
d. Decreased fibrin degradation fragment
ANS: B
Decreased fibrinogen is seen with DIC. With DIC, platelets are decreased, factor V is decreased,
and fibrin degradation fragment is increased.
DIF: Cognitive Level: Analysis REF: p. 344 | Box 14-6 OBJ:
Nursing Process: Assessment
4. In caring for an immediate postpartum patient, the nurse notes petechiae and oozing from her
IV site. Based on this assessment, what clotting disorder would the nurse monitor this patient
closely for?
a. Disseminated intravascular coagulation
(DIC )
b. Amniotic fluid embolism (AFE)
c. Hemorrhage
d. HELLP syndrome
ANS: A
The diagnosis of DIC is made according to clinical findings and laboratory markers. Physical
examination reveals unusual bleeding. Petechiae may appear around a blood pressure cuff on
the woman’s arm. Excessive bleeding may occur from the site of a slight trauma such as
venipuncture sites. These symptoms are not associated with AFE, nor is AFE a bleeding
disorder. Hemorrhage occurs for a variety of reasons in the postpartum patient. These
symptoms are associated with DIC. Hemorrhage would be a finding associated with DIC and is
not a clotting disorder in and of itself. HELLP is not a clotting disorder, but it may contribute to
the clotting disorder DIC.
DIF: Cognitive Level: Comprehension REF: p. 344 OBJ: Nursing Process: Planning
5. In caring for the woman with disseminated intravascular coagulation (DIC), which order should
the nurse anticipate?
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