Diabetes/ Hypertension
2. A pregnant woman with diabetes at 10 weeks' gestation has a glycosylated hemoglobin (HbA1c) level of 13%. At this time the nurse should be most concerned about which possible fetal outcome?
A. congenital anomalies
B. incompetent cervix
C. placenta previa
D. placental abruption (abruptio placentae)
Answer: A
A HbA1c level of 13% indicates poor glucose control. This, in conjunction with the woman being in the first trimester, increases the risk for congenital anomalies in the fetus. Elevated glucose levels are not associated with incompetent cervix, placenta previa, or placental abruption (abruptio placentae). Question format: Multiple Choice Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Reference:
p. 708
14. A pregnant woman asks the nurse, "I'm a big coffee drinker. Will the caffeine in my coffee
hurt my baby?" Which response by the nurse would be most appropriate?
A. "The caffeine in coffee has been linked to birth defects."
B. "Caffeine has been shown to restrict growth in the fetus."
C. "Caffeine is a stimulant and needs to be avoided completely."
D. "If you keep your intake to less than 200 mg/day, you should be okay."
Answer: D
Rationale: The effect of caffeine intake during pregnancy on fetal growth and development is
still unclear. A recent study found that caffeine intake of no more than 200 mg/day during
pregnancy does not affect pregnancy duration and the condition of the newborn. Birth defects
have not been linked to caffeine consumption, but maternal coffee consumption decreases iron
absorption and may increase the risk of anemia during pregnancy. It is not known if there is a
correlation between high caffeine intake and miscarriage due to lack of sufficient studies.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance
Reference: p. 754
18. A nurse is preparing a teaching program for a group of pregnant women about preventing infections during pregnancy. When describing measures for preventing cytomegalovirus infection, which measure would the nurse include as a priority? A. frequent handwashing
B. immunization
C. prenatal screening
D. antibody titer screening
Answer: A
Rationale: Most women are asymptomatic and do not know they have been exposed to CMV.
Prenatal screening for CMV infection is not routinely performed. Since there is no therapy that
prevents or treats CMV infections, nurses are responsible for educating and supporting
childbearing-age women at risk for CMV infection. Stressing the importance of good
handwashing and use of sound hygiene practices can help to reduce transmission of the virus.
There is no immunization for CMV. Antibody titer levels would be useful for identifying women
at risk for rubella.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Safety and Infection Control
Reference: p. 735
13. A nurse is preparing a presentation for a group of young adult pregnant women about
common infections and their effect on pregnancy. When describing the infections, which
infection would the nurse include as the most common congenital and perinatal viral infection in
the world?
A. rubella
B. hepatitis B
C. cytomegalovirus
D. parvovirus B19
Answer: C
Rationale: Although rubella, hepatitis B, and parovirus B19 can affect pregnant women and their
fetuses, cytomegalovirus (CMV) is the most common congenital and perinatal viral infection in
the world. CMV is the leading cause of congenital infection, with morbidity and mortality at
birth and sequelae. Each year approximately 1% to 7% of pregnant women acquire a primary
CMV infection. Of these, about 30% to 40% transmits infection to their fetuses.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance
Reference: p. 734
19. A pregnant woman comes to the clinic for her first evaluation. The woman is screened for
hepatitis B (HBV) and tests positive. The nurse would anticipate administering which agent?
A. HBV immune globulin
B. HBV vaccine
C. acylcovir
D. valacyclovir
Answer: A
Rationale: If a woman tests positive for HBV, expect to administer HBV immune globulin. The
newborn will also receive HBV vaccine within 12 hours of birth. Acyclovir or valacyclovir
would be used to treat herpes simplex virus infection.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Reference: p. 737
1. The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse's teaching was successful?
A. "I'll basically follow the same diet that I was following before I became pregnant."
B. "Because I need extra protein, I'll have to increase my intake of milk and meat."
C. "Pregnancy affects insulin production, so I'll need to make adjustments in my diet."
D. "I'll adjust my diet and insulin based on the results of my urine tests for glucose."
Answer: C
In pregnancy, placental hormones cause insulin resistance at a level that tends to parallel growth of the fetoplacental unit. Nutritional management focuses on maintaining balanced glucose levels. Thus, the woman will probably need to make adjustments in her diet. Protein needs increase during pregnancy, but this is unrelated to diabetes. Blood glucose monitoring results typically guide therapy. Question format: Multiple Choice Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations Cognitive Level: Analyze Client Needs: Physiological Integrity: Reduction of Risk Potential Reference:
p. 705
26. A pregnant client with iron-deficiency anemia is prescribed an iron supplement. After
teaching the woman about using the supplement, the nurse determines that more teaching is
needed based on which client statement?
A. "Taking the iron supplement with food will help with the side effects."
B. "I will need to avoid coffee and tea when I take this supplement."
C. "I will take the iron with milk instead of orange or grapefruit juice."
D. "If I happen to miss a dose, I will take it as soon as I remember."
Answer: C
Rationale: The pregnant client should take the iron supplement with vitamin C-containing fluids
such as orange juice, which will promote absorption, rather than milk, which can inhibit iron
absorption. Taking iron on an empty stomach improves its absorption, but many women cannot
tolerate the gastrointestinal discomfort it causes. In such cases, the woman is advised to take it
with meals. The woman also needs instruction about adverse effects, which are predominantly
gastrointestinal and include gastric discomfort, nausea, vomiting, anorexia, diarrhea, metallic
taste, and constipation. Taking the iron supplement with meals and increasing intake of fiber and
fluids helps overcome the most common side effects. If the woman misses a dose, she should
take a dose as soon as she remembers.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Integrated Process: Teaching/Learning
Reference: p. 729
4. Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?
A. marijuana
B. alcohol
C. heroin
D. cocaine
Answer: D
Cocaine use produces vasoconstriction, tachycardia, and hypertension in both the mother and fetus. The effects of marijuana are not yet fully understood. Alcohol ingestion would lead to cognitive and behavioral problems in the newborn. Heroin is a central nervous system depressant. Question format: Multiple Choice Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Reference:
p. 756
3. A nurse is conducting a review class for a group of perinatal nurses working at the local clinic. The clinic sees a high population of women who are HIV positive. After discussing the recommendations for antiretroviral therapy with the group, the nurse determines that the teaching was successful when the group identifies which rationale as the underlying principle for the therapy?
A. reduction in viral loads in the blood
B. treatment of opportunistic infections
C. adjunct therapy to radiation and chemotherapy
D. can cure acute HIV/AIDS infections
Answer: A
Drug therapy is the mainstay of treatment and is important in reducing the viral load as much as possible. Antiretroviral agents do not treat opportunistic infections and are not adjunctive therapy. There is no cure for HIV/AIDS. Question format: Multiple Choice Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations Cognitive Level: Analyze Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies Reference:
p. 742
7. When preparing a schedule of follow-up visits for a pregnant woman with chronic hypertension, which schedule would be most appropriate?
A. monthly visits until 32 weeks, then bi-monthly visits
B. bi-monthly visits until 28 weeks, then weekly visits
C. monthly visits until 20 weeks, then bi-monthly visits
D. bi-monthly visits until 36 weeks, then weekly visits
Answer: B
Rationale: For the woman with chronic hypertension, antepartum visits typically occur every 2
weeks until 28 weeks' gestation and then weekly to allow for frequent maternal and fetal
surveillance.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Management of Care
Reference: p. 722
21. A pregnant woman with gestational diabetes comes to the clinic for a fasting blood glucose level. When reviewing the results, the nurse determines that the woman is achieving good glucose control based on which result?
A. 88 mg/dL
B. 100 mg/dL
C. 110 mg/dL
D. 120 mg/dL
Answer: A
For a pregnant woman with diabetes, the ADA and ACOG recommend maintaining a fasting blood glucose level below 95 mg/dL, with postprandial levels below 140 mg/dL at 1 hour, below 120 mg/dL at 2 hours. Question format: Multiple Choice
8. A woman with a history of asthma comes to the clinic for evaluation for pregnancy. The woman's pregnancy test is positive. When reviewing the woman's medication therapy regimen for asthma, which medication would the nurse identify as problematic for the woman now that she is pregnant?
A. ipratropium
B. albuterol
C. salmeterol
D. Prednisone
Answer: D
Rationale: Oral corticosteroids such as prednisone are not preferred for the long-term treatment
of asthma during pregnancy. Inhaled steroids are the choice for maintenance medications to
reduce inflammation that leads to bronchospasm. Common ones prescribed include
beclomethasone and salmeterol. Rescue agents such as albuterol or ipratropium provide
immediate symptomatic relief by reducing acute bronchospasm.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Analyze
Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies
Reference: p. 724
5. When teaching a class of pregnant women about the effects of substance use during pregnancy, the nurse would include which effect?
A. low-birthweight infants
B. excessive weight gain
C. higher pain tolerance
D. longer gestational periods
Answer: A
Substance use during pregnancy is associated with low birth weight infants, preterm labor, abortion, intrauterine growth restriction, abruptio placentae, neurobehavioral abnormalities, and long-term childhood developmental consequences. Excessive weight gain, higher pain tolerance, and longer gestational periods are not associated with substance use. Question format: Multiple Choice Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations Cognitive Level: Apply Client Needs: Health Promotion and Maintenance Reference:
p. 752
6. A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn's risk for the infection. Which statement by the nurse would be most appropriate?
A. "You'll probably have a cesarean birth to prevent exposing your newborn."
B. "Antibodies cross the placenta and provide immunity to the newborn."
C. "Wait until after the infant is born, and then something can be done."
D. "Antiretroviral medications are available to help reduce the risk of transmission."
Answer: D
Drug therapy is the mainstay of treatment for pregnant women infected with HIV. The goal of therapy is to reduce the viral load as much as possible; this reduces the risk of transmission to the fetus. Decisions about the method of birth should be based on the woman's viral load, duration of ruptured membranes, progress of labor, and other pertinent clinical factors. The newborn is at risk for HIV because of potential perinatal transmission. Waiting until after the infant is born may be too late. Question format: Multiple Choice Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations Cognitive Level: Apply Client Needs: Safe, Effective Care Environment: Safety and Infection Control Reference:
p. 741
9. A pregnant woman is diagnosed with iron-deficiency anemia and is prescribed an iron supplement. After teaching her about her prescribed iron supplement, which statement indicates successful teaching?
A. "I should take my iron with milk."
B. "I should avoid drinking orange juice."
C. "I need to eat foods high in fiber."
D. "I'll call the primary care provider if my stool is black and tarry."
Answer: C
Rationale: Iron supplements can lead to constipation, so the woman needs to increase her intake of fluids and high-fiber foods. Milk inhibits absorption and should be discouraged. Vitamin Ccontaining fluids such as orange juice are encouraged because they promote absorption. Ideally the woman should take the iron on an empty stomach to improve absorption, but many women cannot tolerate the gastrointestinal discomfort it causes. In such cases, the woman should take it with meals. Iron typically causes the stool to become black and tarry; there is no need for the woman to notify her primary care provider. Question format: Multiple Choice Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and Vulnerable Populations Cognitive Level: Analyze Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies Reference: p. 729
31. A pregnant woman with chronic hypertension is entering her second trimester. The nurse is
providing anticipatory guidance to the woman about measures to promote a healthy outcome.
The nurse determines that the teaching was successful based on which client statement(s)? Select
all that apply.
A. "I will need to schedule follow-up appointments every 2 weeks until I reach 32 weeks'
gestation."
B. "I should try to lie down and rest on my left side for about an hour each day."
C. "I will start doing daily counts of my baby's activity at about 24 weeks' gestation."
D. "I will need to have an ultrasound at each visit beginning at 28 weeks' gestation."
E. "I should take my blood pressure frequently at home and report any high readings."
Answer: B, C, E
Rationale: The woman with chronic hypertension will be seen more frequently (every 2 weeks
until 28 weeks' gestation and then weekly until birth) to monitor her blood pressure and to assess
for any signs of preeclampsia. At approximately 24 weeks’ gestation, the woman will be
instructed to document fetal movement. At this same time, serial ultrasounds will be prescribed
to monitor fetal growth and amniotic fluid volume. The woman should also have daily periods of
rest (1 hour) in the left lateral recumbent position to maximize placental perfusion and use home
blood pressure monitoring devices frequently (daily checks would be preferred), reporting any
elevations.
Question format: Multiple Select
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Teaching/Learning
pg.722
28. A young adult woman comes to the clinic for a routine check-up. During the visit, the woman
who works in a day care facility tells the nurse that she and her partner are considering having a
baby. "We are concerned that I might be exposed to common childhood illnesses." The woman
undergoes testing and finds out that she is not immune from chickenpox. Based on this
information, which information would the nurse give to the client?
A. "You will need to be vaccinated now and wait at least 1 month before getting pregnant."
B. "It is very likely that you will need to quit your job if you do get pregnant."
C. "Because chickenpox is so rare nowadays, there is nothing to worry about."
D. "You will need to take a leave of absence during winter and spring months."
Answer: A
Rationale: Preconception counseling is important for preventing chickenpox (varicella). A major
component of counseling involves determining the woman's varicella immunity. Vaccination is
the cornerstone of prevention. The vaccine is administered if needed. Varicella vaccine is a live
attenuated viral vaccine. It should be administered to all adolescents and adults 13 years of age
and older who do not have evidence of varicella immunity. Therefore, the woman should be
vaccinated now before she becomes pregnant and then wait at least 1 month before getting
pregnant. The varicella vaccine is contraindicated for pregnant women because the effects of the
vaccine on the fetus are unknown. There is no need for the woman to quit her job once she is
immunized nor does she need to take a leave of abscence during the winter and spring months
when the incidence is highest. Chickenpox does occur and is highly contagious. Maternal
varicella can be transmitted to the fetus through the placenta, leading to congenital varicella
syndrome if the mother is infected during the first half of pregnancy via an ascending aorta.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Safe, Effective Care Environment: Safety and Infection Control
Integrated Process: Nursing Process
Reference: p. 738
10. The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which
newborn finding would provide additional evidence to support this suspicion?
A. wide, large eyes
B. thin upper lip
C. protruding jaw
D. elongated nose
Answer: B
Rationale: Newborn characteristics suggesting fetal alcohol spectrum disorder include thin upper
lip, small head circumference, small eyes, receding jaw, and short nose. Other features include a
low nasal bridge, short palpebral fissures, flat midface, epicanthal folds, and minor ear
abnormalities.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Physiological Integrity: Physiological Adaptation
Reference: p. 752
12. A nurse is conducting an in-service presentation to a group of perinatal nurses about sexually
transmitted infections and their effect on pregnancy. The nurse determines that the teaching was
successful when the group identifies which infection as being responsible for ophthalmia
neonatorum?
A. syphilis
B. gonorrhea
C. chlamydia
D. HPV
Answer: B
Rationale: Infection with gonorrhea during pregnancy can cause ophthalmia neonatorum in the
newborn from birth through an infected birth canal. Infection with syphilis can cause congenital
syphilis in the neonate. Infection with chlamydia can lead to conjunctivitis or pneumonia in the
newborn. Exposure to HPV during birth is associated with laryngeal papillomas.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Analyze
Client Needs: Safe, Effective Care Environment: Safety and Infection Control
Reference: p. 734
3. A nurse is providing care to several pregnant women at different weeks of gestation. The
nurse would expect to screen for group B streptococcus infection in the client who is at:
A. 16 weeks' gestation.
B. 28 weeks' gestation.
C. 32 weeks' gestation.
D. 36 weeks' gestation.
Answer: D
Rationale: Pregnant women between 36 and 37 weeks’ gestation should be universally screened
for GBS infection during a prenatal visit and if positive, receive appropriate intrapartum
antibiotic prophylaxis.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level:
Pg. 739
22. A nurse is conducting a program for pregnant women with gestational diabetes about
reducing complications. The nurse determines that the teaching was successful when the group
identifies which factor as being most important in helping to reduce complications associated
with pregnancy and diabetes?
A. stability of the woman's emotional and psychological status
B. degree of blood glucose control achieved during the pregnancy
C. reduction in retinopathy risk by frequent ophthalmologic evaluations
D. control of blood urea nitrogen (BUN) levels for optimal kidney function
Answer: B
Rationale: Therapeutic management for the woman with diabetes focuses on tight glucose
control, thereby minimizing the risks to the mother, fetus, and neonate. The woman's emotional
and psychological status is highly variable and may or may not affect the pregnancy. Evaluating
for long-term diabetic complications such as retinopathy or nephropathy, as evidenced by
laboratory testing such as BUN levels, is an important aspect of preconception care to ensure that
the mother enters the pregnancy in an optimal state.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Analyze
Client Needs: Physiological Integrity: Reduction of Risk Potential
Reference: p. 709
20. After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse
determines that the teaching was successful when the woman identifies which foods as being
good sources of iron in her diet? Select all that apply.
A. dried fruits
B. peanut butter
C. meats
D. milk
E. white bread
Answer: A, B, C
Rationale: Foods high in iron include meats, green leafy vegetables, legumes, dried fruits, whole
grains, peanut butter, bean dip, whole-wheat fortified breads, and cereals.
Question format: Multiple Select
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Analyze
Client Needs: Health Promotion and Maintenance
Reference: p. 729
15. A neonate born to a mother who was abusing heroin is exhibiting signs and symptoms of
withdrawal. Which signs would the nurse assess? Select all that apply.
A. low whimpering cry
B. hypertonicity
C. lethargy
D. excessive sneezing
E. overly vigorous sucking
F. tremors
Answer: B, D, F
Rationale: Signs and symptoms of withdrawal, or neonatal abstinence syndrome, include:
irritability, hypertonicity, excessive and often high-pitched crying, vomiting, diarrhea, feeding
disturbances, respiratory distress, disturbed sleeping, excessive sneezing and yawning, nasal
stuffiness, diaphoresis, fever, poor sucking, tremors, and seizures.
Question format: Multiple Select
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Physiological Integrity: Physiological Adaptation
Reference: p. 755
27. A client in her first trimester comes to the clinic for an evaluation. Assessment reveals reports of fatigue, anorexia, and frequent upper respiratory infections. The client's skin is pale and the client is slightly tachycardic. The client also reports drinking about 6 cups of coffee on average each day. A diagnosis of iron-deficiency anemia is suspected. The client is scheduled for laboratory testing and the results are as follows:
• Hemoglobin 11.5 g/dL (115 g/L) • Hematocrit 35% (0.35)
• Serum iron 32 µg/dL (5.73 µmol/L) • Serum ferritin 90 ng/dL (90 µg/L)
Which laboratory finding would the nurse correlate with the suspected diagnosis?
A. Hemoglobin
B. Hematocrit
C. Serum iron level
D. Serum ferritin level
Answer: D
Rationale: Laboratory tests for iron-deficiency anemia usually reveal low hemoglobin (less than
11 g/dL or 110 g/L), low hematocrit (less than 35% or 0.35), low serum iron (less than 30 µg/dL
or 5.37 µmol/L), microcytic and hypochromic cells, and low serum ferritin (less than 100 ng/dL
or 100 µg/L). The client's hemoglobin, hematocrit, and serum iron levels are borderline low
normal, but the client's serum ferritin is below 100 ng/dL (100 µg/L), helping to support the
diagnosis.
Question format: Multiple Choice
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Analyze
Client Needs: Physiological Integrity: Reduction of Risk Potential
Integrated Process: Nursing Process
Reference: p. 728
16. A nurse has been invited to speak at a local high school about adolescent pregnancy. When
developing the presentation, the nurse would incorporate information related to which aspects?
Select all that apply.
A. peer pressure to become sexually active
B. rise in teen birth rates over the years.
C. Asian Americans as having the highest teen birth rate
D. loss of self-esteem as a major impact
E. about half occurring within a year of first sexual intercourse
Answer: A, D
Rationale: Adolescent pregnancy has emerged as one of the most significant social problems
facing our society. Early pregnancies among adolescents have major health consequences for
mothers and their infants. The latest estimates show that approximately 1 million teenagers
become pregnant each year in the United States, accounting for 13% of all U.S. births, but the
rates have been declining in the last several years. Teen birth rates in the United States have
declined but remain high,especially among African American and Hispanic teenagers and
adolescents in southern states. The most important impact lies in the psychosocial area as it
contributes to a loss of self-esteem, a destruction of life projects, and the maintenance of the
circle of poverty. Moreover, about half of all teen pregnancies occur within 6 months of first
having sexual intercourse. About one in four teen mothers under age 18 have a second baby
within 2 years after the birth of the first baby.
Question format: Multiple Select
Chapter 20: Nursing Management of the Pregnancy at Risk: Selected Health Conditions and
Vulnerable Populations
Cognitive Level: Apply
Client Needs: Health Promotion and Maintenance
Reference: p. 747