Ricci Chapter 20 - Test Bank - 4th Edition || 100% Exact
Answers.
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." Correct
Answer: C
Rationale: 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.
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) Correct Answer: A
Rationale: 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).
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 Correct Answer: A
Rationale: 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.
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 Correct Answer: D
Rationale: 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.
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 Correct Answer: A
Rationale: 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.
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." Correct
Answer: D
Rationale: 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.
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 Correct 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.
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
Answers.
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." Correct
Answer: C
Rationale: 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.
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) Correct Answer: A
Rationale: 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).
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 Correct Answer: A
Rationale: 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.
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 Correct Answer: D
Rationale: 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.
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 Correct Answer: A
Rationale: 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.
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." Correct
Answer: D
Rationale: 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.
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 Correct 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.
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
