Chapter 05: Nursing Care of Women with Complications During Pregnancy
Leifer: Introduction to Maternity and Pediatric Nursing, 8th Edition
MULTIPLE CHOICE
1. A pregnant patient tells the nurse that she has been nauseated and vomiting. How will the
nurse explain that hyperemesis gravidarum is distinguished from morning sickness?
a. Hyperemesis gravidarum usually lasts for the duration of the pregnancy.
b. Hyperemesis gravidarum causes dehydration and electrolyte imbalances.
c. Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum.
d. The woman with hyperemesis gravidarum will have persistent vomiting without
weight loss.
ANS: B
Dehydration and electrolyte imbalances result from persistent nausea and vomiting associated
with hyperemesis gravidarum. Dehydration impairs the perfusion to the placenta.
DIF: Cognitive Level: Comprehension REF: p. 88 OBJ: 3
TOP: Hyperemesis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. A woman is 9 weeks pregnant and experiencing heavy bleeding and cramping. She reports
passing some tissue. Cervical dilation is noted on examination. What is the most likely cause
of these symptoms?
a. Inevitable abortion
b. Incomplete abortion
c. Complete abortion
d. Missed abortion
ANS: B
Signs and symptoms of an incomplete abortion are similar to those of an inevitable abortion,
but some tissue is passed.
DIF: Cognitive Level: Comprehension REF: p. 90|Table 5-2|Figure 5-2
OBJ: 3 TOP: Incomplete Abortion
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. The nurse finds a woman crying after she has undergone a dilation and evacuation (D&E) for
a missed abortion. What is the most appropriate statement by the nurse?
a. “There is usually something wrong with the fetus when this happens early in
pregnancy.”
b. “Now there. You can try to conceive on your next cycle.”
c. “I’m here if you need to talk.”
d. “You are young and strong. I know you can have a healthy pregnancy.”
ANS: C
An effective technique when communicating with a woman experiencing pregnancy loss is to
say, “I’m here if you need to talk.” The nurse listens and acknowledges the woman’s grief.
DIF: Cognitive Level: Application REF: pp. 91-92 OBJ: 3
, TOP: Dilation and Evacuation (D&E) KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
4. A woman who is 8 weeks pregnant becomes concerned when she has light vaginal bleeding
accompanied by abdominal pain. An ectopic pregnancy is confirmed by ultrasound. Which
statement indicates that the woman understands the explanation of an ectopic pregnancy?
a. “The chorionic villi develop vesicles within the uterus.”
b. “The placenta develops in the lower part of the uterus.”
c. “The fetus dies in the uterus during the first half of the pregnancy.”
d. “The embryo is implanted in the fallopian tube.”
ANS: D
Ectopic pregnancy occurs when the fertilized ovum is implanted outside of the uterine cavity.
DIF: Cognitive Level: Comprehension REF: p. 93 OBJ: 3
TOP: Ectopic Pregnancy KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
5. An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the
entire cervical os. What does the nurse understand best describes this condition?
a. Low-lying placenta
b. Marginal placenta previa
c. Partial placenta previa
d. Total placenta previa
ANS: D
A total placenta previa describes a condition in which the placenta completely covers the
cervical opening.
DIF: Cognitive Level: Comprehension REF: p. 95 OBJ: 3
TOP: Placenta Previa KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
6. What symptom presented by a pregnant women is indicative of abruptio placentae?
a. Painless vaginal bleeding
b. Uterine irritability with contractions
c. Vaginal bleeding and back pain
d. Premature rupture of membranes
ANS: C
Bleeding accompanied by abdominal or lower back pain is a typical manifestation of abruptio
placentae.
DIF: Cognitive Level: Knowledge REF: p. 96 OBJ: 3
TOP: Abruptio Placenta KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
7. What situation would concern the nurse about the presence of Rh incompatibility?
a. Rh-negative mother, Rh-positive fetus
b. Rh-positive mother, Rh-negative fetus
c. Rh-negative mother, Rh-negative fetus
d. Rh-positive mother, Rh-positive fetus
Leifer: Introduction to Maternity and Pediatric Nursing, 8th Edition
MULTIPLE CHOICE
1. A pregnant patient tells the nurse that she has been nauseated and vomiting. How will the
nurse explain that hyperemesis gravidarum is distinguished from morning sickness?
a. Hyperemesis gravidarum usually lasts for the duration of the pregnancy.
b. Hyperemesis gravidarum causes dehydration and electrolyte imbalances.
c. Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum.
d. The woman with hyperemesis gravidarum will have persistent vomiting without
weight loss.
ANS: B
Dehydration and electrolyte imbalances result from persistent nausea and vomiting associated
with hyperemesis gravidarum. Dehydration impairs the perfusion to the placenta.
DIF: Cognitive Level: Comprehension REF: p. 88 OBJ: 3
TOP: Hyperemesis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. A woman is 9 weeks pregnant and experiencing heavy bleeding and cramping. She reports
passing some tissue. Cervical dilation is noted on examination. What is the most likely cause
of these symptoms?
a. Inevitable abortion
b. Incomplete abortion
c. Complete abortion
d. Missed abortion
ANS: B
Signs and symptoms of an incomplete abortion are similar to those of an inevitable abortion,
but some tissue is passed.
DIF: Cognitive Level: Comprehension REF: p. 90|Table 5-2|Figure 5-2
OBJ: 3 TOP: Incomplete Abortion
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. The nurse finds a woman crying after she has undergone a dilation and evacuation (D&E) for
a missed abortion. What is the most appropriate statement by the nurse?
a. “There is usually something wrong with the fetus when this happens early in
pregnancy.”
b. “Now there. You can try to conceive on your next cycle.”
c. “I’m here if you need to talk.”
d. “You are young and strong. I know you can have a healthy pregnancy.”
ANS: C
An effective technique when communicating with a woman experiencing pregnancy loss is to
say, “I’m here if you need to talk.” The nurse listens and acknowledges the woman’s grief.
DIF: Cognitive Level: Application REF: pp. 91-92 OBJ: 3
, TOP: Dilation and Evacuation (D&E) KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
4. A woman who is 8 weeks pregnant becomes concerned when she has light vaginal bleeding
accompanied by abdominal pain. An ectopic pregnancy is confirmed by ultrasound. Which
statement indicates that the woman understands the explanation of an ectopic pregnancy?
a. “The chorionic villi develop vesicles within the uterus.”
b. “The placenta develops in the lower part of the uterus.”
c. “The fetus dies in the uterus during the first half of the pregnancy.”
d. “The embryo is implanted in the fallopian tube.”
ANS: D
Ectopic pregnancy occurs when the fertilized ovum is implanted outside of the uterine cavity.
DIF: Cognitive Level: Comprehension REF: p. 93 OBJ: 3
TOP: Ectopic Pregnancy KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
5. An ultrasound on a woman who is 32 weeks pregnant reveals the placenta implanted over the
entire cervical os. What does the nurse understand best describes this condition?
a. Low-lying placenta
b. Marginal placenta previa
c. Partial placenta previa
d. Total placenta previa
ANS: D
A total placenta previa describes a condition in which the placenta completely covers the
cervical opening.
DIF: Cognitive Level: Comprehension REF: p. 95 OBJ: 3
TOP: Placenta Previa KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
6. What symptom presented by a pregnant women is indicative of abruptio placentae?
a. Painless vaginal bleeding
b. Uterine irritability with contractions
c. Vaginal bleeding and back pain
d. Premature rupture of membranes
ANS: C
Bleeding accompanied by abdominal or lower back pain is a typical manifestation of abruptio
placentae.
DIF: Cognitive Level: Knowledge REF: p. 96 OBJ: 3
TOP: Abruptio Placenta KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
7. What situation would concern the nurse about the presence of Rh incompatibility?
a. Rh-negative mother, Rh-positive fetus
b. Rh-positive mother, Rh-negative fetus
c. Rh-negative mother, Rh-negative fetus
d. Rh-positive mother, Rh-positive fetus
