A client with a hydatidiform mole has hCG that remains elevated 6 months
after treatment. The nurse understands this may indicate:
A.A successful new pregnancy
B.Residual tissue or malignant transformation to choriocarcinoma
C.Normal variation in hCG clearance
D.Laboratory error requiring a repeat test
B.Residual tissue or malignant transformation to choriocarcinoma
Rising or persistent hCG after molar pregnancy treatment indicates either
residual molar tissue or malignant transformation to choriocarcinoma. This is
why hCG is monitored for a full year and pregnancy is delayed — a new
pregnancy would interfere with this surveillance.
A client with Gestational Diabetes Mellitus has a blood glucose of 52
mg/dL. She is sweating and shaking.
,The nurse's priority action is:
A.Administer the morning insulin
B.Give 15 to 20 grams of fast-acting carbohydrate
C.Call the provider before treating
D.Administer glucagon IM
B.Give 15 to 20 grams of fast-acting carbohydrate
RATIONALE: Blood glucose of 52 mg/dL with sweating and shakiness =
hypoglycemia. First-line for a CONSCIOUS patient is 15 to 20 grams of fast-
acting carbohydrate. Never give insulin to a hypoglycemic patient. Glucagon is
for patients who cannot swallow.
When should iron supplements be taken for best absorption?
A.With milk at bedtime
B.With a glass of orange juice
C.With the prenatal vitamin
D.With a meal containing high-fiber foods
B.With a glass of orange juice
RATIONALE: Iron absorption is enhanced by vitamin C (orange juice). It is
inhibited by calcium (milk), coffee, tea, and antacids. Taking iron with a
prenatal vitamin containing calcium would reduce absorption. Dark stools are
expected and normal. Fiber does not enhance iron absorption and may slightly
inhibit it.
The client has delivered her first client at 37 weeks. The nurse would
describe this to the client as what type of delivery?
a. preterm
b. postterm
c. early term
d. near term
c. early term
,Rationale:
Preterm refers to delivery before 37 weeks gestation.
Postterm means the pregnancy extends beyond 42 weeks.
A baby born at 37 weeks is considered early term.
“Near term” is not the standard clinical classification used for gestational age.
The prenatal visit schedule for an uncomplicated pregnancy includes visits
every 2 weeks during which period?
A.Conception to 28 weeks
B.29 to 36 weeks
C.37 weeks to birth
D.20 to 28 weeks
B.29 to 36 weeks
RATIONALE:
Schedule: every 4 weeks to 28 weeks, every 2 weeks from 29 to 36 weeks, then
weekly from 37 weeks to birth. GBS culture is performed at 35 to 37 weeks.
A client has a previous cesarean section. During labor she reports sudden
severe pain that then stops. Fetal parts are easily palpable through the
abdomen. BP is 84/52, pulse 124.
The nurse recognizes this as:
A.Normal labor progress
B.Placenta previa
C.Uterine rupture
D.Abruptio placentae
C.Uterine rupture
Sudden severe pain that STOPS, fetal parts palpable through the abdomen (fetus
in abdominal cavity), and hypovolemic shock = UTERINE RUPTURE.
Previous cesarean is the primary risk factor. This is a surgical emergency.
Which antihypertensive is CONTRAINDICATED in pregnancy?
A.Hydralazine
, B.Labetalol
C.Nifedipine
D.Lisinopril
D.Lisinopril
RATIONALE: ACE inhibitors SUCH AS LISINOPRIL are
CONTRAINDICATED in pregnancy because they cause fetal renal damage —
specifically renal tubular dysgenesis, oligohydramnios, and neonatal renal
failure. Safe options include hydralazine, labetalol, and long-acting nifedipine.
A client at 38 weeks says she can breathe more easily and her heartburn
has improved but now she has more pelvic pressure. The nurse explains
this is because:
A.The baby's position changed to breech
B.Lightening has occurred — the fetus has descended into the pelvis
C.Labor is about to begin within the next hour
D.The placenta has moved lower in the uterus
B.Lightening has occurred — the fetus has descended into the pelvis
Lightening (engagement) occurs when the fetal presenting part descends into
the pelvis. This relieves upward pressure on the diaphragm — improving
breathing and heartburn — but increases pelvic pressure and urinary frequency.
In primigravidas it may occur 2 to 4 weeks before labor.
Magnesium sulfate is continued for how long AFTER delivery in a woman
with severe preeclampsia?
A.It is stopped immediately after delivery
B.6 to 8 hours postpartum
C.12 to 24 hours postpartum
D.48 to 72 hours postpartum
C.12 to 24 hours postpartum
The textbook states magnesium sulfate administration continues for AT LEAST
12 to 24 HOURS AFTER BIRTH because the woman remains at risk for
after treatment. The nurse understands this may indicate:
A.A successful new pregnancy
B.Residual tissue or malignant transformation to choriocarcinoma
C.Normal variation in hCG clearance
D.Laboratory error requiring a repeat test
B.Residual tissue or malignant transformation to choriocarcinoma
Rising or persistent hCG after molar pregnancy treatment indicates either
residual molar tissue or malignant transformation to choriocarcinoma. This is
why hCG is monitored for a full year and pregnancy is delayed — a new
pregnancy would interfere with this surveillance.
A client with Gestational Diabetes Mellitus has a blood glucose of 52
mg/dL. She is sweating and shaking.
,The nurse's priority action is:
A.Administer the morning insulin
B.Give 15 to 20 grams of fast-acting carbohydrate
C.Call the provider before treating
D.Administer glucagon IM
B.Give 15 to 20 grams of fast-acting carbohydrate
RATIONALE: Blood glucose of 52 mg/dL with sweating and shakiness =
hypoglycemia. First-line for a CONSCIOUS patient is 15 to 20 grams of fast-
acting carbohydrate. Never give insulin to a hypoglycemic patient. Glucagon is
for patients who cannot swallow.
When should iron supplements be taken for best absorption?
A.With milk at bedtime
B.With a glass of orange juice
C.With the prenatal vitamin
D.With a meal containing high-fiber foods
B.With a glass of orange juice
RATIONALE: Iron absorption is enhanced by vitamin C (orange juice). It is
inhibited by calcium (milk), coffee, tea, and antacids. Taking iron with a
prenatal vitamin containing calcium would reduce absorption. Dark stools are
expected and normal. Fiber does not enhance iron absorption and may slightly
inhibit it.
The client has delivered her first client at 37 weeks. The nurse would
describe this to the client as what type of delivery?
a. preterm
b. postterm
c. early term
d. near term
c. early term
,Rationale:
Preterm refers to delivery before 37 weeks gestation.
Postterm means the pregnancy extends beyond 42 weeks.
A baby born at 37 weeks is considered early term.
“Near term” is not the standard clinical classification used for gestational age.
The prenatal visit schedule for an uncomplicated pregnancy includes visits
every 2 weeks during which period?
A.Conception to 28 weeks
B.29 to 36 weeks
C.37 weeks to birth
D.20 to 28 weeks
B.29 to 36 weeks
RATIONALE:
Schedule: every 4 weeks to 28 weeks, every 2 weeks from 29 to 36 weeks, then
weekly from 37 weeks to birth. GBS culture is performed at 35 to 37 weeks.
A client has a previous cesarean section. During labor she reports sudden
severe pain that then stops. Fetal parts are easily palpable through the
abdomen. BP is 84/52, pulse 124.
The nurse recognizes this as:
A.Normal labor progress
B.Placenta previa
C.Uterine rupture
D.Abruptio placentae
C.Uterine rupture
Sudden severe pain that STOPS, fetal parts palpable through the abdomen (fetus
in abdominal cavity), and hypovolemic shock = UTERINE RUPTURE.
Previous cesarean is the primary risk factor. This is a surgical emergency.
Which antihypertensive is CONTRAINDICATED in pregnancy?
A.Hydralazine
, B.Labetalol
C.Nifedipine
D.Lisinopril
D.Lisinopril
RATIONALE: ACE inhibitors SUCH AS LISINOPRIL are
CONTRAINDICATED in pregnancy because they cause fetal renal damage —
specifically renal tubular dysgenesis, oligohydramnios, and neonatal renal
failure. Safe options include hydralazine, labetalol, and long-acting nifedipine.
A client at 38 weeks says she can breathe more easily and her heartburn
has improved but now she has more pelvic pressure. The nurse explains
this is because:
A.The baby's position changed to breech
B.Lightening has occurred — the fetus has descended into the pelvis
C.Labor is about to begin within the next hour
D.The placenta has moved lower in the uterus
B.Lightening has occurred — the fetus has descended into the pelvis
Lightening (engagement) occurs when the fetal presenting part descends into
the pelvis. This relieves upward pressure on the diaphragm — improving
breathing and heartburn — but increases pelvic pressure and urinary frequency.
In primigravidas it may occur 2 to 4 weeks before labor.
Magnesium sulfate is continued for how long AFTER delivery in a woman
with severe preeclampsia?
A.It is stopped immediately after delivery
B.6 to 8 hours postpartum
C.12 to 24 hours postpartum
D.48 to 72 hours postpartum
C.12 to 24 hours postpartum
The textbook states magnesium sulfate administration continues for AT LEAST
12 to 24 HOURS AFTER BIRTH because the woman remains at risk for
