Test Bank For Maternal & Child Health Nursing
Test Bank 4 For Maternal & Child Health Nursing
Care of the Childbearing & Childrearing Family
9th Edition By JoAnne Silbert-Flagg.
|GRADED A+| (EXAM READY)
(Solved) SCORE A
A client with GDM has a blood glucose of 285 mg/dL. Her skin is flushed, hot, and dry. She is breathing
deeply and rapidly. The nurse recognizes this as:
A.Hypoglycemia — administer fast-acting carbohydrate
A+ TEST BANK 1
, Test Bank For Maternal & Child Health Nursing
B.Hyperglycemia with possible DKA — notify provider immediately
C.Normal blood glucose variation in GDM
D.Anxiety reaction to the labor process
B.Hyperglycemia with possible DKA — notify provider immediately
RATIONALE: Flushed hot dry skin, blood glucose of 285, and Kussmaul respirations (deep rapid
breathing to compensate for metabolic acidosis) indicate hyperglycemia and possible DKA.
Hyperglycemia has a GRADUAL onset with flushed hot dry skin. Hypoglycemia has SUDDEN onset with
pale cold moist skin.
Which maternal position is contraindicated for fetal kick counts in the third trimester?
A.Left lateral
B.Right lateral
C.Semi-Fowler's
D.Supine
D.Supine
rationale: Supine position in the third trimester compresses the inferior vena cava, causing supine
hypotension syndrome and reducing uteroplacental blood flow. Fetal kick counts should be
performed in the SIDE-LYING (preferably left lateral) position.
Which finding indicates magnesium sulfate toxicity is developing?
A.Blood pressure of 148/94
B.Urine output of 25 mL per hour
C.Respiratory rate of 14 breaths per minute
A+ TEST BANK 2
, Test Bank For Maternal & Child Health Nursing
D.Deep tendon reflexes rated 2+
B.Urine output of 25 mL per hour
rationale: Poor urine output (less than 30 mL/hr) is the first warning sign of toxicity — the kidneys
excrete magnesium, and reduced output allows toxic accumulation. Loss of DTRs is the first sign of
actual toxicity. Respiratory depression follows.
Elevated BP indicates the preeclampsia itself — not magnesium toxicity.
Respiratory rate of 14 is above the 12/min threshold — not yet a toxicity sign.
DTRs of 2+ are normal — loss of DTRs indicates toxicity.
A client with mild preeclampsia is being managed at home. Which instruction is incorrect?
A.Rest frequently lying on your side
B.Monitor blood pressure two to four times daily
C.Take diuretics as prescribed to reduce swelling
D.Report sudden weight gain or worsening headache immediately
C.Take diuretics as prescribed to reduce swelling
rationale: The textbook explicitly states: DIURETICS are NOT prescribed for preeclampsia. Diuretics
reduce circulating volume which worsens placental perfusion and is harmful to the fetus. Sodium
restriction is also not prescribed. The other options are all correct teaching.
The magnesium sulfate therapeutic serum level for seizure prevention is:
A.1 to 3 mg/dL
A+ TEST BANK 3
, Test Bank For Maternal & Child Health Nursing
B.4 to 8 mg/dL
C.9 to 12 mg/dL
D.12 to 16 mg/dL
B.4 to 8 mg/dL
rationale: The textbook states the therapeutic serum level is 4 to 8 mg/dL. At this level the woman is
slightly drowsy, retains all reflexes, and has normal respiratory function — high enough to prevent
convulsions. Above 8 mg/dL, toxicity progresses: DTR loss → respiratory depression → cardiac arrest.
After abruptio placentae, DIC is suspected. Which laboratory finding supports this?
A.Elevated hemoglobin
B.Prolonged prothrombin time and decreased fibrinogen
C.Elevated platelet count
D.Decreased serum creatinine
B.Prolonged prothrombin time and decreased fibrinogen
rationale: DIC depletes clotting factors throughout the body. Lab findings in DIC: prolonged PT and
PTT, DECREASED fibrinogen (consumed by widespread clotting), DECREASED platelets, and elevated
D-dimer. Bleeding occurs because clotting factors are exhausted.
A client at 28 weeks has not felt the baby move in 3 hours. She normally feels movement throughout
the day. The nurse advises:
A.Call back if no movement in 24 hours
B.Drink a glass of juice and recheck in 2 hours
C.Come in for evaluation immediately
A+ TEST BANK 4
Test Bank 4 For Maternal & Child Health Nursing
Care of the Childbearing & Childrearing Family
9th Edition By JoAnne Silbert-Flagg.
|GRADED A+| (EXAM READY)
(Solved) SCORE A
A client with GDM has a blood glucose of 285 mg/dL. Her skin is flushed, hot, and dry. She is breathing
deeply and rapidly. The nurse recognizes this as:
A.Hypoglycemia — administer fast-acting carbohydrate
A+ TEST BANK 1
, Test Bank For Maternal & Child Health Nursing
B.Hyperglycemia with possible DKA — notify provider immediately
C.Normal blood glucose variation in GDM
D.Anxiety reaction to the labor process
B.Hyperglycemia with possible DKA — notify provider immediately
RATIONALE: Flushed hot dry skin, blood glucose of 285, and Kussmaul respirations (deep rapid
breathing to compensate for metabolic acidosis) indicate hyperglycemia and possible DKA.
Hyperglycemia has a GRADUAL onset with flushed hot dry skin. Hypoglycemia has SUDDEN onset with
pale cold moist skin.
Which maternal position is contraindicated for fetal kick counts in the third trimester?
A.Left lateral
B.Right lateral
C.Semi-Fowler's
D.Supine
D.Supine
rationale: Supine position in the third trimester compresses the inferior vena cava, causing supine
hypotension syndrome and reducing uteroplacental blood flow. Fetal kick counts should be
performed in the SIDE-LYING (preferably left lateral) position.
Which finding indicates magnesium sulfate toxicity is developing?
A.Blood pressure of 148/94
B.Urine output of 25 mL per hour
C.Respiratory rate of 14 breaths per minute
A+ TEST BANK 2
, Test Bank For Maternal & Child Health Nursing
D.Deep tendon reflexes rated 2+
B.Urine output of 25 mL per hour
rationale: Poor urine output (less than 30 mL/hr) is the first warning sign of toxicity — the kidneys
excrete magnesium, and reduced output allows toxic accumulation. Loss of DTRs is the first sign of
actual toxicity. Respiratory depression follows.
Elevated BP indicates the preeclampsia itself — not magnesium toxicity.
Respiratory rate of 14 is above the 12/min threshold — not yet a toxicity sign.
DTRs of 2+ are normal — loss of DTRs indicates toxicity.
A client with mild preeclampsia is being managed at home. Which instruction is incorrect?
A.Rest frequently lying on your side
B.Monitor blood pressure two to four times daily
C.Take diuretics as prescribed to reduce swelling
D.Report sudden weight gain or worsening headache immediately
C.Take diuretics as prescribed to reduce swelling
rationale: The textbook explicitly states: DIURETICS are NOT prescribed for preeclampsia. Diuretics
reduce circulating volume which worsens placental perfusion and is harmful to the fetus. Sodium
restriction is also not prescribed. The other options are all correct teaching.
The magnesium sulfate therapeutic serum level for seizure prevention is:
A.1 to 3 mg/dL
A+ TEST BANK 3
, Test Bank For Maternal & Child Health Nursing
B.4 to 8 mg/dL
C.9 to 12 mg/dL
D.12 to 16 mg/dL
B.4 to 8 mg/dL
rationale: The textbook states the therapeutic serum level is 4 to 8 mg/dL. At this level the woman is
slightly drowsy, retains all reflexes, and has normal respiratory function — high enough to prevent
convulsions. Above 8 mg/dL, toxicity progresses: DTR loss → respiratory depression → cardiac arrest.
After abruptio placentae, DIC is suspected. Which laboratory finding supports this?
A.Elevated hemoglobin
B.Prolonged prothrombin time and decreased fibrinogen
C.Elevated platelet count
D.Decreased serum creatinine
B.Prolonged prothrombin time and decreased fibrinogen
rationale: DIC depletes clotting factors throughout the body. Lab findings in DIC: prolonged PT and
PTT, DECREASED fibrinogen (consumed by widespread clotting), DECREASED platelets, and elevated
D-dimer. Bleeding occurs because clotting factors are exhausted.
A client at 28 weeks has not felt the baby move in 3 hours. She normally feels movement throughout
the day. The nurse advises:
A.Call back if no movement in 24 hours
B.Drink a glass of juice and recheck in 2 hours
C.Come in for evaluation immediately
A+ TEST BANK 4
