NUR 353 EXAM 2 ACTUAL QUESTIONS AND ANSWERS
A nurse is assessing a patient with preeclampsia who delivered 12 hours ago.
Which of the following assessments would indicate that the condition has not yet resolved?
a. blood pressure reading at prenatal baseline
b. adequate urinary output and no proteinuria
c. presence of 1-2+ deep tendon reflexes
d. patient complaints of blurred vision and headache - CORRECT ANSWER✅✅D
A nurse is completing the admission assessment of a client who is at 38 weeks gestation and has severe
preeclampsia.
Which one of the following findings is consistent with the diagnosis of severe preeclampsia?
a. Polyuria
b. Absence of clonus
c. Epigastric pain
d. Tachycardia - CORRECT ANSWER✅✅C
Why is magnesium sulfate is given to women with preeclampsia and eclampsia?
a. To improve patellar reflexes and increase respiratory efficiency
b. To prevent and treat convulsions
c. To decrease blood pressure readings
d. To prevent a boggy uterus and lessen lochial flow - CORRECT ANSWER✅✅B
A nurse in a prenatal clinic is reviewing results from recent one-hour oral glucose tolerance tests.
Which one of the 4 pregnant clients needs to be scheduled for a follow-up, diagnostic three-hour
glucose tolerance test?
,a. One hour GTT result: 115 mg/dl
b. One hour GTT result: 95 mg/dl
c. One hour GTT result: 125 mg/dl
d. One hour GTT result: 160 mg/dl - CORRECT ANSWER✅✅D
A nurse is caring for a client at 30 weeks gestation who has just been diagnosed with gestational
diabetes.
The client has a lot of questions about the risks to her baby with GDM.
What is the best explanation by the nurse for why her fetus is at risk for macrosomia and hypoglycemia
at delivery?
a. To prevent macrosomia, you should only gain 11-20 lbs. total during this pregnancy.
b. When your blood sugar levels are too high, the insulin that you make can cross the placenta and
affect your baby's metabolism.
c. Extra sugar (glucose) can cross the placenta to your baby. This may cause your baby to gain extra
weight and to have sudden low blood glucose after birth.
d. Your baby may be born with diabetes. - CORRECT ANSWER✅✅C
What are three classic clinical manifestations of preeclampsia? - CORRECT ANSWER✅✅1. Proteinuria
2. Epigastric pain
3. Headaches
Pathophysiology of preeclampsia. - CORRECT ANSWER✅✅In a normal pregnancy, spiral arteries widen
to improve perfusion to the placenta. In a preeclamptic pregnancy, the spiral arteries do widen, but not
nearly as much which decreases blood flow to the placenta. Your brain perceives hypo perfusion, and
your brain thinks that you are bleeding out. Your brain is going to release vasoconstrictor hormones and
try to redirect that blood to vital organs, such as the heart, brain, lungs, etc. Your brain doesn't think of
the baby as a vital organ. This vasoconstriction leads to an increase in blood pressure. Over time, this
increase in BP causes wear and tear in your blood vessels, leading to little holes in the vessels. Your brain
stimulates a lipoprotein to be released to try to repair the vessels, but they are not able to. The
lipoprotein leaks out from the vessels and into the intravascular space. The proteins attract water which
causes edema. Liver necrosis can occur long term due to the initiation of the clotting cascade by the
brain, causing hypoxia, then ischemia, then necrosis.
,Hypertensive disorder of pregnancy whereby the woman has an elevated blood pressure at 140/90
mmHg or greater recorded on two different occasions at least 4 hours apart. Proteinuria is absent. -
CORRECT ANSWER✅✅Gestational hypertension
This occurs when expulsion of the products of conception occurs. Premature cervical dilations. A cause
of bleeding during pregnancy. - CORRECT ANSWER✅✅Cervical insufficiency
What length is considered a short cervix? - CORRECT ANSWER✅✅Less than 25 mm in length
True or false. Dehydration stimulates uterine contractions. - CORRECT ANSWER✅✅True
Client education for a pregnant woman experiencing cervical insufficiency. (3) - CORRECT
ANSWER✅✅1. Client will be on activity restriction or bed rest.
2. Hydrate more, because dehydration stimulates uterine contractions.
3. Avoid intercourse, tampons, and douching. Anything that can be inserted into the vagina.
List two risk factors for cervical insufficiency. - CORRECT ANSWER✅✅1. History of cervical trauma
(Cervical tears, excessive dilations, surgical procedures.)
2. Congenital structural defects
List four expected findings for cervical insufficiency. - CORRECT ANSWER✅✅1. Increase in pelvic
pressure or urge to push.
2. Pink stained vaginal discharge or bleeding
3. Water may break
4. Miscarriage (Uterus contracts with the expulsion of the fetus)
Presence of cervical funneling - CORRECT ANSWER✅✅Beaking
An impaired tolerance to glucose with the first onset or recognition during pregnancy. - CORRECT
ANSWER✅✅Gestational diabetes mellitus (GDM)
, List four laboratory tests conducted on a pregnant woman who is suspected to have GDM. - CORRECT
ANSWER✅✅1. Routine urinalysis to test for glycosuria
2. 1 hour GTT
3. 3 hour oral GTT
4. Urinalysis to test for presence of ketones in urine
List three interventions for a patient who is experiencing gestational hypertension. - CORRECT
ANSWER✅✅1. Antihypertensive medications
2. Diet
3. Exercise
What alteration in deep tendon reflexes is manifested in preeclampsia? - CORRECT
ANSWER✅✅Hyperreflexia
What level is a positive 1-hour GTT? - CORRECT ANSWER✅✅Over 140 mg/dL
Do you have to fast for a 1-hour GTT? - CORRECT ANSWER✅✅No, but you do have to fast for a 3-hour
GTT.
List three things you cannot do before a 3-hour GTT. - CORRECT ANSWER✅✅1. No eating 12 hours
before test.
2. Do not drink caffeine.
3. Do not smoke 12 hr prior to testing.
What are three diagnostic procedures that would be conducted on a patient with GDM to assess fetal
well-being? - CORRECT ANSWER✅✅1. BPP
2. Amniocentesis
3. NST
A nurse is assessing a patient with preeclampsia who delivered 12 hours ago.
Which of the following assessments would indicate that the condition has not yet resolved?
a. blood pressure reading at prenatal baseline
b. adequate urinary output and no proteinuria
c. presence of 1-2+ deep tendon reflexes
d. patient complaints of blurred vision and headache - CORRECT ANSWER✅✅D
A nurse is completing the admission assessment of a client who is at 38 weeks gestation and has severe
preeclampsia.
Which one of the following findings is consistent with the diagnosis of severe preeclampsia?
a. Polyuria
b. Absence of clonus
c. Epigastric pain
d. Tachycardia - CORRECT ANSWER✅✅C
Why is magnesium sulfate is given to women with preeclampsia and eclampsia?
a. To improve patellar reflexes and increase respiratory efficiency
b. To prevent and treat convulsions
c. To decrease blood pressure readings
d. To prevent a boggy uterus and lessen lochial flow - CORRECT ANSWER✅✅B
A nurse in a prenatal clinic is reviewing results from recent one-hour oral glucose tolerance tests.
Which one of the 4 pregnant clients needs to be scheduled for a follow-up, diagnostic three-hour
glucose tolerance test?
,a. One hour GTT result: 115 mg/dl
b. One hour GTT result: 95 mg/dl
c. One hour GTT result: 125 mg/dl
d. One hour GTT result: 160 mg/dl - CORRECT ANSWER✅✅D
A nurse is caring for a client at 30 weeks gestation who has just been diagnosed with gestational
diabetes.
The client has a lot of questions about the risks to her baby with GDM.
What is the best explanation by the nurse for why her fetus is at risk for macrosomia and hypoglycemia
at delivery?
a. To prevent macrosomia, you should only gain 11-20 lbs. total during this pregnancy.
b. When your blood sugar levels are too high, the insulin that you make can cross the placenta and
affect your baby's metabolism.
c. Extra sugar (glucose) can cross the placenta to your baby. This may cause your baby to gain extra
weight and to have sudden low blood glucose after birth.
d. Your baby may be born with diabetes. - CORRECT ANSWER✅✅C
What are three classic clinical manifestations of preeclampsia? - CORRECT ANSWER✅✅1. Proteinuria
2. Epigastric pain
3. Headaches
Pathophysiology of preeclampsia. - CORRECT ANSWER✅✅In a normal pregnancy, spiral arteries widen
to improve perfusion to the placenta. In a preeclamptic pregnancy, the spiral arteries do widen, but not
nearly as much which decreases blood flow to the placenta. Your brain perceives hypo perfusion, and
your brain thinks that you are bleeding out. Your brain is going to release vasoconstrictor hormones and
try to redirect that blood to vital organs, such as the heart, brain, lungs, etc. Your brain doesn't think of
the baby as a vital organ. This vasoconstriction leads to an increase in blood pressure. Over time, this
increase in BP causes wear and tear in your blood vessels, leading to little holes in the vessels. Your brain
stimulates a lipoprotein to be released to try to repair the vessels, but they are not able to. The
lipoprotein leaks out from the vessels and into the intravascular space. The proteins attract water which
causes edema. Liver necrosis can occur long term due to the initiation of the clotting cascade by the
brain, causing hypoxia, then ischemia, then necrosis.
,Hypertensive disorder of pregnancy whereby the woman has an elevated blood pressure at 140/90
mmHg or greater recorded on two different occasions at least 4 hours apart. Proteinuria is absent. -
CORRECT ANSWER✅✅Gestational hypertension
This occurs when expulsion of the products of conception occurs. Premature cervical dilations. A cause
of bleeding during pregnancy. - CORRECT ANSWER✅✅Cervical insufficiency
What length is considered a short cervix? - CORRECT ANSWER✅✅Less than 25 mm in length
True or false. Dehydration stimulates uterine contractions. - CORRECT ANSWER✅✅True
Client education for a pregnant woman experiencing cervical insufficiency. (3) - CORRECT
ANSWER✅✅1. Client will be on activity restriction or bed rest.
2. Hydrate more, because dehydration stimulates uterine contractions.
3. Avoid intercourse, tampons, and douching. Anything that can be inserted into the vagina.
List two risk factors for cervical insufficiency. - CORRECT ANSWER✅✅1. History of cervical trauma
(Cervical tears, excessive dilations, surgical procedures.)
2. Congenital structural defects
List four expected findings for cervical insufficiency. - CORRECT ANSWER✅✅1. Increase in pelvic
pressure or urge to push.
2. Pink stained vaginal discharge or bleeding
3. Water may break
4. Miscarriage (Uterus contracts with the expulsion of the fetus)
Presence of cervical funneling - CORRECT ANSWER✅✅Beaking
An impaired tolerance to glucose with the first onset or recognition during pregnancy. - CORRECT
ANSWER✅✅Gestational diabetes mellitus (GDM)
, List four laboratory tests conducted on a pregnant woman who is suspected to have GDM. - CORRECT
ANSWER✅✅1. Routine urinalysis to test for glycosuria
2. 1 hour GTT
3. 3 hour oral GTT
4. Urinalysis to test for presence of ketones in urine
List three interventions for a patient who is experiencing gestational hypertension. - CORRECT
ANSWER✅✅1. Antihypertensive medications
2. Diet
3. Exercise
What alteration in deep tendon reflexes is manifested in preeclampsia? - CORRECT
ANSWER✅✅Hyperreflexia
What level is a positive 1-hour GTT? - CORRECT ANSWER✅✅Over 140 mg/dL
Do you have to fast for a 1-hour GTT? - CORRECT ANSWER✅✅No, but you do have to fast for a 3-hour
GTT.
List three things you cannot do before a 3-hour GTT. - CORRECT ANSWER✅✅1. No eating 12 hours
before test.
2. Do not drink caffeine.
3. Do not smoke 12 hr prior to testing.
What are three diagnostic procedures that would be conducted on a patient with GDM to assess fetal
well-being? - CORRECT ANSWER✅✅1. BPP
2. Amniocentesis
3. NST
