NSG 233 EXAM 1,2,3 AND FINAL EXAM /NSG 233 MED
SURG III FINAL EXAM NEWEST 2025/2026 COMPLETE 200
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!!
Differentiate the types of diabetes mellitus and their respective risk factors in pregnancy.
- correct answers1) type 1 DM - usually have an absolute insulin defiency. Caused by
autoimmune or unknown. Prone to ketoacidosis.
2) type 2 DM- individuals who are insulin resistant and usually relative insulin deficiency.
Etiology is unknown. Classic signs polyuria, polydipsia, and polyphagia. Many people
with type 2 are obese or have an increase of fat in the abdominal area. other risk factors
aging, sedentary lifestyle, hypertension, and prior gestational diabetes.
3) Pregestational diabetes - is the label sometimes given to type 1 or 2 diabetes that
existed before pregnancy.
4) GDM - is any degree of glucose intolerance with its onset or first recognition during
pregnancy.
Compare insulin requirements during pregnancy, the postpartum period, and lactation. -
correct answersA) first trimester - Insulin need is reduced because of increased insulin
production by the pancreas and increased peripheral sensitivity; nausea, vomiting, and
decreased food intake by mother and glucose transfer to embryo/fetus contributes to
hypoglycemia.
B) Second trimester: Insulin need increases as placental hormones, cortisol, and
insulinase act as insulin antagonists, decreasing the effectiveness of insulin.
C)Third trimester: insulin requirements gradually increase increase until about 36 wks of
gestation.
D) Day of delivery: maternal insulin requirement drop drastically to approach
prepregnancy levels.
E) Breastfeeding mother maintains lower insulin requirements, as much as 25% less
than prepregnancy; insulin need of nonbreastfeeding mother returns to prepregnancy
levels in 7 to 10 days.
,F) at weaning of breastfeeding infant, mother's insulin need returns to prepregnancy
levels.
Identify maternal and fetal risks or complications associated with diabetes in pregnancy.
- correct answersA) Maternal risks/complications: GDM with an A1c > 6 there is a 28%
increase in early pregnancy loss. Cesarean birth - failure to progress or failure of
descent. Preterm birth & labor. Ketoacidosis in 2nd & 3rd trimesters. Hypoglycemia
occurs during sleep early in pregnancy when hepatic production of glucose is dimished
and peripheral use of glucose is enhanced. Hyadramnios - 10x more likely.
Hypertensive disorders - preeclampsia, eclampsia. UTI. severe diabetes.
B) Fetal risks/complications - Stillbirth. Congenital anomalies 6% - 10% increase. CNS
defects - anencephaly, open spina bifida. Cardiac defects - Ventricular septal defects
(VSD) & transposition of the great vessels. Caudal regression - 200 to 400x due to
diabetic mothers. Macrosomia. Hypoglycemia. Respiratory distress syndrome.
Polycythemia. Hyperbilirubinemia.
Develop a plan of care for the pregnant woman with pregestational or gestational
diabetes. - correct answers...
Compare the management of a pregnant woman with hyperthyroidism with one has
hypothyroidism. - correct answersHyperthyroidism - Tx propylthiouracil (PTU), B-
Adrenergic blockers, Radioactive iodine must not be used to diagnose because it
compromises the fetal thyroid. Thyroideectomy
Hypothyroidism - TX Levothyroxine (L-thyroxine [synthroid])
BOTH: need assistance with coping with the discomforts and frustrations associated
with symptoms of the disorder. both must adapt and wear appropriate clothing, avoiding
enviromental temperatures that cause them harm, and stress reduction activities.
EX. hyper- heat intolerance, nervousness, hyperactivity, weakness, fatigue.
Ex. hypo - cold intolerance.
Both- need nutrional counseling the woman with hyper have an increased appetite and
poor weight gain and the hypo woman who are lethargy to ensure adequate intake of
nutrition to meet both maternal and fetal needs.
Differentiate the management of various cardiovascular disorders in pregnant woman. -
correct answers1) Peripartum Cardiomyopathy - TX diuretics, sodium restriction,
afterload-reducing agents, anticoagulants, digoxin. ACE- inhibitor only postpartum
because it is teratogenic agent.
2) Rheumatic heart disease - The American heart association recommends prophylaxis
to prevent infective endocarditis only in those who are highest risk.
3) Mitral and Aortic Valve Stenosis - Reducing activity, sodium restriction, diuretic
therapy, B-blocking medication to lower HR, and increased bed rest.
, 4) Mitral Valve Prolapse (MVP) - specific tx is not necessary except for symptomatic
tachyarrythmias. Antibiotic prophylaxis may be given for invasive procedures.
5) Eisenmenger's Syndrome - physical activity is strictly limited and prophylactic
anticoagulation. intensive care monitoring .
6) Atrial and Ventricular Septal Defects - like eisenmenger syndrome
7) Tetralogy of Fallot - Surgical correction, anticoagulant therapy, high concetration
oxygen administration, hemodynamic monitoring during labor and birth as well as
prophylactic antibiotics.
8) Marfan syndrome -Limiting physical activity, preventing hypertensive or hypotensive
complications and administering B-blockers as needed.
9) Heart Transplantation - B-blocking agent during labor to prevent tachycardia. After
birth the neonate may exhibit immunosuppresive effects in the first week life. Mother
taking cyclosporine should not breast feed.
therapy focus on minimizing stress on the heart, stress is greatest 28 to 32 wks
gestation when hemodynamic changes peak.The workload of the heart in decreased
when Tx of any existing emotional stress, hypertension, anemia, hyperthydism or
obesity.
Discuss the different types of anemia and their effects during pregnancy. - correct
answers1) Iron defiency anemia - pathologic anemia of pregnancy is mainly the result of
iron defiency. Iron is needed for erythropoises.
2) Folic acid defiency anemia - increases incidence of neural tube defects, cleft lip and
cleft palate.
3) Sickle cell hemoglobinopathy - caused by the presence of abnormal hemoglobin in
the blood.
Recurrent attacks of fever, pain in the abdomen or extremeties. Fetal complications-
small for gestational age, IUGR, and skeletal changes.
Pregnant woman are prone to pyelonephritis, leg ulcers, infections, bone abnormalities,
strokes, cardiopathy, congestive heart failure and preeclampsia.
4) Thalassemia - in which insufficient amount of globin is produced to fill the red blood
cells. 50% stillbirth, IUGR, preeclampsia and preterm birth.
Explain the care of pregnant women with pulmonary diseases. - correct answers...
Describe the effects of gastrointestinal disorders on pregnancy. - correct answers...
Review the effects of neurologic disorders on pregnancy. - correct answers...
Describe the care of women whose pregnancies are complicated by autoimmune
diseases. - correct answers...
SURG III FINAL EXAM NEWEST 2025/2026 COMPLETE 200
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!!
Differentiate the types of diabetes mellitus and their respective risk factors in pregnancy.
- correct answers1) type 1 DM - usually have an absolute insulin defiency. Caused by
autoimmune or unknown. Prone to ketoacidosis.
2) type 2 DM- individuals who are insulin resistant and usually relative insulin deficiency.
Etiology is unknown. Classic signs polyuria, polydipsia, and polyphagia. Many people
with type 2 are obese or have an increase of fat in the abdominal area. other risk factors
aging, sedentary lifestyle, hypertension, and prior gestational diabetes.
3) Pregestational diabetes - is the label sometimes given to type 1 or 2 diabetes that
existed before pregnancy.
4) GDM - is any degree of glucose intolerance with its onset or first recognition during
pregnancy.
Compare insulin requirements during pregnancy, the postpartum period, and lactation. -
correct answersA) first trimester - Insulin need is reduced because of increased insulin
production by the pancreas and increased peripheral sensitivity; nausea, vomiting, and
decreased food intake by mother and glucose transfer to embryo/fetus contributes to
hypoglycemia.
B) Second trimester: Insulin need increases as placental hormones, cortisol, and
insulinase act as insulin antagonists, decreasing the effectiveness of insulin.
C)Third trimester: insulin requirements gradually increase increase until about 36 wks of
gestation.
D) Day of delivery: maternal insulin requirement drop drastically to approach
prepregnancy levels.
E) Breastfeeding mother maintains lower insulin requirements, as much as 25% less
than prepregnancy; insulin need of nonbreastfeeding mother returns to prepregnancy
levels in 7 to 10 days.
,F) at weaning of breastfeeding infant, mother's insulin need returns to prepregnancy
levels.
Identify maternal and fetal risks or complications associated with diabetes in pregnancy.
- correct answersA) Maternal risks/complications: GDM with an A1c > 6 there is a 28%
increase in early pregnancy loss. Cesarean birth - failure to progress or failure of
descent. Preterm birth & labor. Ketoacidosis in 2nd & 3rd trimesters. Hypoglycemia
occurs during sleep early in pregnancy when hepatic production of glucose is dimished
and peripheral use of glucose is enhanced. Hyadramnios - 10x more likely.
Hypertensive disorders - preeclampsia, eclampsia. UTI. severe diabetes.
B) Fetal risks/complications - Stillbirth. Congenital anomalies 6% - 10% increase. CNS
defects - anencephaly, open spina bifida. Cardiac defects - Ventricular septal defects
(VSD) & transposition of the great vessels. Caudal regression - 200 to 400x due to
diabetic mothers. Macrosomia. Hypoglycemia. Respiratory distress syndrome.
Polycythemia. Hyperbilirubinemia.
Develop a plan of care for the pregnant woman with pregestational or gestational
diabetes. - correct answers...
Compare the management of a pregnant woman with hyperthyroidism with one has
hypothyroidism. - correct answersHyperthyroidism - Tx propylthiouracil (PTU), B-
Adrenergic blockers, Radioactive iodine must not be used to diagnose because it
compromises the fetal thyroid. Thyroideectomy
Hypothyroidism - TX Levothyroxine (L-thyroxine [synthroid])
BOTH: need assistance with coping with the discomforts and frustrations associated
with symptoms of the disorder. both must adapt and wear appropriate clothing, avoiding
enviromental temperatures that cause them harm, and stress reduction activities.
EX. hyper- heat intolerance, nervousness, hyperactivity, weakness, fatigue.
Ex. hypo - cold intolerance.
Both- need nutrional counseling the woman with hyper have an increased appetite and
poor weight gain and the hypo woman who are lethargy to ensure adequate intake of
nutrition to meet both maternal and fetal needs.
Differentiate the management of various cardiovascular disorders in pregnant woman. -
correct answers1) Peripartum Cardiomyopathy - TX diuretics, sodium restriction,
afterload-reducing agents, anticoagulants, digoxin. ACE- inhibitor only postpartum
because it is teratogenic agent.
2) Rheumatic heart disease - The American heart association recommends prophylaxis
to prevent infective endocarditis only in those who are highest risk.
3) Mitral and Aortic Valve Stenosis - Reducing activity, sodium restriction, diuretic
therapy, B-blocking medication to lower HR, and increased bed rest.
, 4) Mitral Valve Prolapse (MVP) - specific tx is not necessary except for symptomatic
tachyarrythmias. Antibiotic prophylaxis may be given for invasive procedures.
5) Eisenmenger's Syndrome - physical activity is strictly limited and prophylactic
anticoagulation. intensive care monitoring .
6) Atrial and Ventricular Septal Defects - like eisenmenger syndrome
7) Tetralogy of Fallot - Surgical correction, anticoagulant therapy, high concetration
oxygen administration, hemodynamic monitoring during labor and birth as well as
prophylactic antibiotics.
8) Marfan syndrome -Limiting physical activity, preventing hypertensive or hypotensive
complications and administering B-blockers as needed.
9) Heart Transplantation - B-blocking agent during labor to prevent tachycardia. After
birth the neonate may exhibit immunosuppresive effects in the first week life. Mother
taking cyclosporine should not breast feed.
therapy focus on minimizing stress on the heart, stress is greatest 28 to 32 wks
gestation when hemodynamic changes peak.The workload of the heart in decreased
when Tx of any existing emotional stress, hypertension, anemia, hyperthydism or
obesity.
Discuss the different types of anemia and their effects during pregnancy. - correct
answers1) Iron defiency anemia - pathologic anemia of pregnancy is mainly the result of
iron defiency. Iron is needed for erythropoises.
2) Folic acid defiency anemia - increases incidence of neural tube defects, cleft lip and
cleft palate.
3) Sickle cell hemoglobinopathy - caused by the presence of abnormal hemoglobin in
the blood.
Recurrent attacks of fever, pain in the abdomen or extremeties. Fetal complications-
small for gestational age, IUGR, and skeletal changes.
Pregnant woman are prone to pyelonephritis, leg ulcers, infections, bone abnormalities,
strokes, cardiopathy, congestive heart failure and preeclampsia.
4) Thalassemia - in which insufficient amount of globin is produced to fill the red blood
cells. 50% stillbirth, IUGR, preeclampsia and preterm birth.
Explain the care of pregnant women with pulmonary diseases. - correct answers...
Describe the effects of gastrointestinal disorders on pregnancy. - correct answers...
Review the effects of neurologic disorders on pregnancy. - correct answers...
Describe the care of women whose pregnancies are complicated by autoimmune
diseases. - correct answers...
