Nursing Management of Pregnancy at Risk: Pregnancy-Related complications

Physiology and Clinical Manifestations

100

 Which of the following is the most common cause of first trimester spontaneous abortion?

• A) Maternal disease
• B) Drug use
• C) Fetal genetic abnormalities
• D) Cervical insufficiency

C) Fetal genetic abnormalities

200

What is the primary nursing assessment for a woman experiencing a spontaneous abortion?

• A) Measuring blood pressure
• B) Monitoring fetal heart rate
• C) Assessing the color and amount of vaginal bleeding
• D) Performing an ultrasound

1. C) Assessing the color and amount of vaginal bleeding

300

What physical finding is associated with placenta previa during a physical exam?

• A) Firm, contracted uterus
• B) Soft, relaxed, and non-tender uterus
• C) Cervical effacement
• D) Abdominal bruising

B) Soft, relaxed, and non-tender uterus

400

What should a nurse avoid when managing a client with placenta previa?

• A) Administering IV fluids
• B) Performing a sterile vaginal exam
• C) Monitoring fetal heart rate
• D) Assessing maternal vital signs

B) Performing a sterile vaginal exam

500

What is the primary symptom of placenta previa?

• A) Severe abdominal cramps
• B) Painful vaginal bleeding
• C) Painless vaginal bleeding
• D) Elevated blood pressure

C) Painless vaginal bleeding

Medications and Treatments in High-Risk Pregnancies

100

Which medication is administered to Rh-negative women after a spontaneous abortion?

• A) Oxytocin
• B) RhoGAM
• C) Misoprostol
• D) Magnesium sulfate

B) RhoGAM

200

How frequently should pad counts be monitored in a patient experiencing vaginal bleeding during pregnancy?

• A) Every 4 hours
• B) Every 6 hours
• C) Every 8 hours
• D) Every 12 hours

A) Every 4 hours

300

What is the purpose of hCG monitoring in a first trimester abortion without D&C?

• A) To confirm pregnancy
• B) To ensure conceptus tissues have been expelled
• C) To assess fetal heart rate
• D) To monitor maternal blood pressure

B) To ensure conceptus tissues have been expelled

400

Which instruction is essential for a client with cervical insufficiency upon discharge?

• A) Refrain from sexual intercourse
• B) Increase fluid intake to 3 liters per day
• C) Engage in regular strenuous exercise
• D) Monitor blood glucose levels

A) Refrain from sexual intercourse

500

What is a key component of home care for a client with placenta previa who is less than 36 weeks gestation with no active bleeding?

• A) Performing daily kick counts
• B) Engaging in moderate exercise
• C) Monitoring blood pressure twice daily
• D) Regular vaginal examinations

A) Performing daily kick counts

Plan of Care and Client Teaching

100

In developing a plan of care for a client with a high-risk pregnancy, which is a primary goal?

• A) Preventing infection
• B) Ensuring adequate nutrition
• C) Reducing maternal anxiety
• D) Maintaining uterine stability

D) Maintaining uterine stability

200

 When should RhoGAM be administered to an Rh-negative woman after a spontaneous abortion?

• A) Within 24 hours
• B) Within 48 hours
• C) Within 72 hours
• D) Within 96 hours

C) Within 72 hours

300

What is the ultimate treatment for preeclampsia?

• A) Administration of magnesium sulfate
• B) Bedrest and hydration
• C) Delivery of the placenta
• D) Antihypertensive medications

C) Delivery of the placenta

400

Which sign should prompt a client with cervical insufficiency to contact their healthcare provider immediately?

• A) Mild pelvic discomfort
• B) Increased fetal movement
• C) Purulent vaginal discharge
• D) Mild back pain

C) Purulent vaginal discharge

500

Which symptom should prompt immediate medical attention in a patient receiving magnesium sulfate for severe preeclampsia?

• A) Diaphoresis
• B) Elevated blood pressure
• C) Absence of deep tendon reflexes
• D) Increased urinary output

C) Absence of deep tendon reflexes

High-Risk Pregnancies/ Preclampsia

100

Which medication is crucial in the management of severe preeclampsia to prevent seizures?

• A) Calcium gluconate
• B) Magnesium sulfate
• C) Terbutaline
• D) Betamethasone

B) Magnesium sulfate

200

Which medication should be administered if signs of magnesium toxicity occur?

• A) Calcium gluconate
• B) Potassium chloride
• C) Sodium bicarbonate
• D) Hydralazine

A) Calcium gluconate

300

What is the loading dose of magnesium sulfate for preventing seizure activity in severe preeclampsia?

• A) 1-2 grams over 15-20 minutes
• B) 2-4 grams over 10-15 minutes
• C) 4-6 grams over 15-20 minutes
• D) 6-8 grams over 10-15 minutes

C) 4-6 grams over 15-20 minutes

400

What is a crucial component of home care for a patient with mild preeclampsia?

• A) Strict bedrest without monitoring
• B) Blood pressure monitoring every 4-6 hours while awake
• C) Increased physical activity
• D) Daily intake of high-protein diet

B) Blood pressure monitoring every 4-6 hours while awake

500

DOUBLE THE POINTS

At what gestational age is Rho(D) Immunoglobulin (RhoGAM) typically administered to Rh-negative mothers?

• A) 18-22 weeks
• B) 24-28 weeks
• C) 28-32 weeks
• D) 34-38 weeks

Which condition may arise in a newborn due to Rh incompatibility?

• A) Hypoglycemia
• B) Anemia
• C) Hypertension
• D) Hypercalcemia

C) 28-32 weeks

B) Anemia

Physiology and Clinical manifestations Pt.2

100

Which clinical manifestation is associated with placental abruption?

• A) Painless vaginal bleeding
• B) Dull abdominal pain and/or low back pain
• C) Soft, relaxed uterus
• D) Increased fetal movement

B) Dull abdominal pain and/or low back pain

200

What are signs of hypovolemic shock in a mother with placental abruption?

• A) Bradycardia, bradypnea, increased urine output
• B) Tachycardia, tachypnea, decreased urine output
• C) Hypertension, hyperthermia, increased urine output
• D) Hypotension, hypothermia, decreased urine output

B) Tachycardia, tachypnea, decreased urine output

300

What is a significant clinical sign of a concealed hemorrhage in placental abruption?

• A) Hard, board-like abdomen
• B) Decreased fetal movement
• C) Soft, relaxed uterus
• D) Increased uterine contraction

A) Hard, board-like abdomen

400

Which therapeutic range of serum magnesium level is considered safe during magnesium sulfate therapy?

• A) 2-4 mg/dL
• B) 4-7 mg/dL
• C) 8-10 mg/dL
• D) 10-12 mg/dL

B) 4-7 mg/dL

500

DOUBLE THE POINTS

What causes Rh incompatibility during pregnancy?

• A) Mother is Rh-positive and fetus is Rh-negative
• B) Mother is Rh-negative and fetus is Rh-positive
• C) Both mother and fetus are Rh-positive
• D) Both mother and fetus are Rh-negative

Which pregnancy is typically not affected by Rh incompatibility?

• A) First pregnancy
• B) Second pregnancy
• C) Third pregnancy
• D) All pregnancies are equally affected

B) Mother is Rh-negative and fetus is Rh-positive 

A) First pregnancy