NUR 353 Exam 2 Questions with Verified
Correct 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
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
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
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
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.
C
What are three classic clinical manifestations of preeclampsia?
1. Proteinuria
2. Epigastric pain
3. Headaches
Pathophysiology of preeclampsia.
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.
, Gestational hypertension
This occurs when expulsion of the products of conception occurs. Premature cervical
dilations. A cause of bleeding during pregnancy.
Cervical insufficiency
What length is considered a short cervix?
Less than 25 mm in length
True or false. Dehydration stimulates uterine contractions.
True
Client education for a pregnant woman experiencing cervical insufficiency. (3)
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.
1. History of cervical trauma (Cervical tears, excessive dilations, surgical procedures.)
2. Congenital structural defects
List four expected findings for cervical insufficiency.
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 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
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
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
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
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.
C
What are three classic clinical manifestations of preeclampsia?
1. Proteinuria
2. Epigastric pain
3. Headaches
Pathophysiology of preeclampsia.
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.
, Gestational hypertension
This occurs when expulsion of the products of conception occurs. Premature cervical
dilations. A cause of bleeding during pregnancy.
Cervical insufficiency
What length is considered a short cervix?
Less than 25 mm in length
True or false. Dehydration stimulates uterine contractions.
True
Client education for a pregnant woman experiencing cervical insufficiency. (3)
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.
1. History of cervical trauma (Cervical tears, excessive dilations, surgical procedures.)
2. Congenital structural defects
List four expected findings for cervical insufficiency.
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
