RICCI CHAPTER 20 - TEST BANK - 4TH EDITION
QUESTION AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
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 produc�on, 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." - ansAnswer: C
Ra�onale: In pregnancy, placental hormones cause insulin resistance at a level that tends to
parallel growth of the fetoplacental unit. Nutri�onal 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' gesta�on has a glycosylated hemoglobin
(HbA1c) level of 13%. At this �me the nurse should be most concerned about which possible
fetal outcome?
A. congenital anomalies
B. incompetent cervix
C. placenta previa
D. placental abrup�on (abrup�o placentae) - ansAnswer: A
Ra�onale: A HbA1c level of 13% indicates poor glucose control. This, in conjunc�on 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
abrup�on (abrup�o placentae).
3. A nurse is conduc�ng a review class for a group of perinatal nurses working at the local clinic.
The clinic sees a high popula�on of women who are HIV posi�ve. A�er discussing the
,RICCI CHAPTER 20 - TEST BANK - 4TH EDITION
QUESTION AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
recommenda�ons for an�retroviral therapy with the group, the nurse determines that the teaching
was successful when the group iden�fies which ra�onale as the underlying principle for the
therapy?
A. reduc�on in viral loads in the blood
B. treatment of opportunis�c infec�ons
C. adjunct therapy to radia�on and chemotherapy
D. can cure acute HIV/AIDS infec�ons - ansAnswer: A
Ra�onale: Drug therapy is the mainstay of treatment and is important in reducing the viral load
as much as possible. An�retroviral agents do not treat opportunis�c infec�ons and are not
adjunc�ve 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 sugges�ng vasoconstric�on. The nurse would ques�on the woman about use of
which substance?
A. marijuana
B. alcohol
C. heroin
D. cocaine - ansAnswer: D
Ra�onale: Cocaine use produces vasoconstric�on, tachycardia, and hypertension in both the
mother and fetus. The effects of marijuana are not yet fully understood. Alcohol inges�on would
lead to cogni�ve 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
, RICCI CHAPTER 20 - TEST BANK - 4TH EDITION
QUESTION AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
B. excessive weight gain
C. higher pain tolerance
D. longer gesta�onal periods - ansAnswer: A
Ra�onale: Substance use during pregnancy is associated with low birth weight infants, preterm
labor, abor�on, intrauterine growth restric�on, abrup�o placentae, neurobehavioral
abnormali�es, and long-term childhood developmental consequences. Excessive weight gain,
higher pain tolerance, and longer gesta�onal periods are not associated with substance use.
6. A client who is HIV-posi�ve is in her second trimester and remains asymptoma�c. She voices
concern about her newborn's risk for the infec�on. Which statement by the nurse would be most
appropriate?
A. "You'll probably have a cesarean birth to prevent exposing your newborn."
B. "An�bodies cross the placenta and provide immunity to the newborn."
C. "Wait un�l a�er the infant is born, and then something can be done."
D. "An�retroviral medica�ons are available to help reduce the risk of transmission." - ansAnswer: D
Ra�onale: 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, dura�on of ruptured membranes, progress of labor, and other per�nent clinical factors.
The newborn is at risk for HIV because of poten�al perinatal transmission. Wai�ng un�l a�er
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 un�l 32 weeks, then bi-monthly visits
B. bi-monthly visits un�l 28 weeks, then weekly visits
QUESTION AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
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 produc�on, 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." - ansAnswer: C
Ra�onale: In pregnancy, placental hormones cause insulin resistance at a level that tends to
parallel growth of the fetoplacental unit. Nutri�onal 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' gesta�on has a glycosylated hemoglobin
(HbA1c) level of 13%. At this �me the nurse should be most concerned about which possible
fetal outcome?
A. congenital anomalies
B. incompetent cervix
C. placenta previa
D. placental abrup�on (abrup�o placentae) - ansAnswer: A
Ra�onale: A HbA1c level of 13% indicates poor glucose control. This, in conjunc�on 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
abrup�on (abrup�o placentae).
3. A nurse is conduc�ng a review class for a group of perinatal nurses working at the local clinic.
The clinic sees a high popula�on of women who are HIV posi�ve. A�er discussing the
,RICCI CHAPTER 20 - TEST BANK - 4TH EDITION
QUESTION AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
recommenda�ons for an�retroviral therapy with the group, the nurse determines that the teaching
was successful when the group iden�fies which ra�onale as the underlying principle for the
therapy?
A. reduc�on in viral loads in the blood
B. treatment of opportunis�c infec�ons
C. adjunct therapy to radia�on and chemotherapy
D. can cure acute HIV/AIDS infec�ons - ansAnswer: A
Ra�onale: Drug therapy is the mainstay of treatment and is important in reducing the viral load
as much as possible. An�retroviral agents do not treat opportunis�c infec�ons and are not
adjunc�ve 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 sugges�ng vasoconstric�on. The nurse would ques�on the woman about use of
which substance?
A. marijuana
B. alcohol
C. heroin
D. cocaine - ansAnswer: D
Ra�onale: Cocaine use produces vasoconstric�on, tachycardia, and hypertension in both the
mother and fetus. The effects of marijuana are not yet fully understood. Alcohol inges�on would
lead to cogni�ve 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
, RICCI CHAPTER 20 - TEST BANK - 4TH EDITION
QUESTION AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
B. excessive weight gain
C. higher pain tolerance
D. longer gesta�onal periods - ansAnswer: A
Ra�onale: Substance use during pregnancy is associated with low birth weight infants, preterm
labor, abor�on, intrauterine growth restric�on, abrup�o placentae, neurobehavioral
abnormali�es, and long-term childhood developmental consequences. Excessive weight gain,
higher pain tolerance, and longer gesta�onal periods are not associated with substance use.
6. A client who is HIV-posi�ve is in her second trimester and remains asymptoma�c. She voices
concern about her newborn's risk for the infec�on. Which statement by the nurse would be most
appropriate?
A. "You'll probably have a cesarean birth to prevent exposing your newborn."
B. "An�bodies cross the placenta and provide immunity to the newborn."
C. "Wait un�l a�er the infant is born, and then something can be done."
D. "An�retroviral medica�ons are available to help reduce the risk of transmission." - ansAnswer: D
Ra�onale: 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, dura�on of ruptured membranes, progress of labor, and other per�nent clinical factors.
The newborn is at risk for HIV because of poten�al perinatal transmission. Wai�ng un�l a�er
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 un�l 32 weeks, then bi-monthly visits
B. bi-monthly visits un�l 28 weeks, then weekly visits
