Page 1 of 162
NUR 353 PEDS Exam 2 NEWEST 500
QUESTIONS AND VERIFIED SOLUTIONS
LATEST UPDATE THIS YEAR
NUR 353 Exam 2
QUESTION: 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 - ANSWER-D
QUESTION: 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.
1
, Page 2 of 162
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. - ANSWER-C
QUESTION: What are three classic clinical manifestations of preeclampsia? - ANSWER-1.
Proteinuria
2. Epigastric pain
3. Headaches
QUESTION: Pathophysiology of preeclampsia. - 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
2
, Page 3 of 162
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.
QUESTION: 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. - ANSWER-Gestational hypertension
QUESTION: This occurs when expulsion of the products of conception occurs. Premature
cervical dilations. A cause of bleeding during pregnancy. - ANSWER-Cervical insufficiency
QUESTION: What length is considered a short cervix? - ANSWER-Less than 25 mm in length
QUESTION: True or false. Dehydration stimulates uterine contractions. - ANSWER-True
QUESTION: Client education for a pregnant woman experiencing cervical insufficiency. (3) -
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.
3
, Page 4 of 162
QUESTION: List two risk factors for cervical insufficiency. - ANSWER-1. History of cervical
trauma (Cervical tears, excessive dilations, surgical procedures.)
2. Congenital structural defects
QUESTION: List four expected findings for cervical insufficiency. - 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)
QUESTION: Presence of cervical funneling - ANSWER-Beaking
QUESTION: An impaired tolerance to glucose with the first onset or recognition during
pregnancy. - ANSWER-Gestational diabetes mellitus (GDM)
QUESTION: List four laboratory tests conducted on a pregnant woman who is suspected to have
GDM. - 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
4
NUR 353 PEDS Exam 2 NEWEST 500
QUESTIONS AND VERIFIED SOLUTIONS
LATEST UPDATE THIS YEAR
NUR 353 Exam 2
QUESTION: 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 - ANSWER-D
QUESTION: 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.
1
, Page 2 of 162
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. - ANSWER-C
QUESTION: What are three classic clinical manifestations of preeclampsia? - ANSWER-1.
Proteinuria
2. Epigastric pain
3. Headaches
QUESTION: Pathophysiology of preeclampsia. - 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
2
, Page 3 of 162
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.
QUESTION: 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. - ANSWER-Gestational hypertension
QUESTION: This occurs when expulsion of the products of conception occurs. Premature
cervical dilations. A cause of bleeding during pregnancy. - ANSWER-Cervical insufficiency
QUESTION: What length is considered a short cervix? - ANSWER-Less than 25 mm in length
QUESTION: True or false. Dehydration stimulates uterine contractions. - ANSWER-True
QUESTION: Client education for a pregnant woman experiencing cervical insufficiency. (3) -
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.
3
, Page 4 of 162
QUESTION: List two risk factors for cervical insufficiency. - ANSWER-1. History of cervical
trauma (Cervical tears, excessive dilations, surgical procedures.)
2. Congenital structural defects
QUESTION: List four expected findings for cervical insufficiency. - 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)
QUESTION: Presence of cervical funneling - ANSWER-Beaking
QUESTION: An impaired tolerance to glucose with the first onset or recognition during
pregnancy. - ANSWER-Gestational diabetes mellitus (GDM)
QUESTION: List four laboratory tests conducted on a pregnant woman who is suspected to have
GDM. - 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
4
