Chapter 10: Complications of Pregnancy
Foundations of Maternal-Newborn &
Women's Health Nursing, 7th Edition
exam with complete solutions
1. A patient with preeclampsia is being treated with bed rest and intravenous
magnesium sulfate. The drug classification of this medication is a
a.
diuretic.
b.
tocolytic.
c.
anticonvulsant.
d.
antihypertensive. - ANSWER-ANS: C
Anticonvulsant drugs act by blocking neuromuscular transmission and depress the
central nervous system to control seizure activity. Diuresis is a therapeutic response to
magnesium sulfate. A tocolytic drug slows the frequency and intensity of uterine
contractions but is not used for that purpose in this scenario. Decreased peripheral
blood pressure is a therapeutic response (side effect) of the anticonvulsant magnesium
sulfate.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
2. Which clinical intervention is the only known cure for preeclampsia?
a.
Magnesium sulfate
b.
Delivery of the fetus
,c.
Antihypertensive medications
d.
Administration of aspirin (ASA) every day of the pregnancy - ANSWER-ANS: B
Delivery of the infant is the only known intervention to halt the progression of
preeclampsia. Magnesium sulfate is one of the medications used to treat but not cure
preeclampsia. Antihypertensive medications are used to lower the dangerously elevated
blood pressures in preeclampsia and eclampsia. Low doses of aspirin (81 mg/day) have
been administered to women at high risk for developing preeclampsia. This intervention
appears to have little benefit.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
3. The clinic nurse is performing a prenatal assessment on a pregnant patient at risk for
preeclampsia. Which clinical sign would not present as a symptom of preeclampsia?
a.
Edema
b.
Proteinuria
c.
Glucosuria
d.
Hypertension - ANSWER-ANS: C
Glucose into the urine is not one of the three classic symptoms of preeclampsia. The
first sign noted by the pregnant patient is rapid weight gain and edema of the hands and
face. Proteinuria usually develops later than the edema and hypertension. The first
indication of preeclampsia is usually an increase in the maternal blood pressure.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
4. Which intrapartal assessment should be avoided when caring for a patient with
HELLP syndrome?
a.
Abdominal palpation
b.
Venous sample of blood
c.
Checking deep tendon reflexes
d.
Auscultation of the heart and lungs - ANSWER-ANS: A
, Palpation of the abdomen and liver could result in a sudden increase in intraabdominal
pressure, leading to rupture of the subcapsular hematoma. Assessment of heart and
lungs is performed on every patient. Checking reflexes is not contraindicated. Venous
blood is checked frequently to observe for thrombocytopenia.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
5. A nurse is explaining to the nursing students working on the antepartum unit how to
assess for edema. Which edema assessment score indicates edema of the lower
extremities, face, hands, and sacral area?
a.
+1
b.
+2
c.
+3
d.
+4 - ANSWER-ANS: C
Edema of the extremities, face, and sacral area is classified as +3 edema. Edema
classified as +1 indicates minimal edema of the lower extremities. Marked edema of the
lower extremities is +2 edema. Generalized massive edema (+4) includes the
accumulation of fluid in the peritoneal cavity.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
6. Which maternal condition always necessitates delivery by cesarean birth?
a.
Partial abruptio placentae
b.
Total placenta previa
c.
Ectopic pregnancy
d.
Eclampsia - ANSWER-ANS: B
In total placenta previa, the placenta completely covers the cervical os. The fetus would
die if a vaginal birth occurred. If the patient has stable vital signs and the fetus is alive, a
vaginal birth can be attempted. If the fetus has already expired, a vaginal birth is
preferred. The most common ectopic pregnancy is a tubal pregnancy, which is usually
detected and treated in the first trimester. Labor can be safely induced if the eclampsia
is under control.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
Foundations of Maternal-Newborn &
Women's Health Nursing, 7th Edition
exam with complete solutions
1. A patient with preeclampsia is being treated with bed rest and intravenous
magnesium sulfate. The drug classification of this medication is a
a.
diuretic.
b.
tocolytic.
c.
anticonvulsant.
d.
antihypertensive. - ANSWER-ANS: C
Anticonvulsant drugs act by blocking neuromuscular transmission and depress the
central nervous system to control seizure activity. Diuresis is a therapeutic response to
magnesium sulfate. A tocolytic drug slows the frequency and intensity of uterine
contractions but is not used for that purpose in this scenario. Decreased peripheral
blood pressure is a therapeutic response (side effect) of the anticonvulsant magnesium
sulfate.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
2. Which clinical intervention is the only known cure for preeclampsia?
a.
Magnesium sulfate
b.
Delivery of the fetus
,c.
Antihypertensive medications
d.
Administration of aspirin (ASA) every day of the pregnancy - ANSWER-ANS: B
Delivery of the infant is the only known intervention to halt the progression of
preeclampsia. Magnesium sulfate is one of the medications used to treat but not cure
preeclampsia. Antihypertensive medications are used to lower the dangerously elevated
blood pressures in preeclampsia and eclampsia. Low doses of aspirin (81 mg/day) have
been administered to women at high risk for developing preeclampsia. This intervention
appears to have little benefit.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
3. The clinic nurse is performing a prenatal assessment on a pregnant patient at risk for
preeclampsia. Which clinical sign would not present as a symptom of preeclampsia?
a.
Edema
b.
Proteinuria
c.
Glucosuria
d.
Hypertension - ANSWER-ANS: C
Glucose into the urine is not one of the three classic symptoms of preeclampsia. The
first sign noted by the pregnant patient is rapid weight gain and edema of the hands and
face. Proteinuria usually develops later than the edema and hypertension. The first
indication of preeclampsia is usually an increase in the maternal blood pressure.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
4. Which intrapartal assessment should be avoided when caring for a patient with
HELLP syndrome?
a.
Abdominal palpation
b.
Venous sample of blood
c.
Checking deep tendon reflexes
d.
Auscultation of the heart and lungs - ANSWER-ANS: A
, Palpation of the abdomen and liver could result in a sudden increase in intraabdominal
pressure, leading to rupture of the subcapsular hematoma. Assessment of heart and
lungs is performed on every patient. Checking reflexes is not contraindicated. Venous
blood is checked frequently to observe for thrombocytopenia.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
5. A nurse is explaining to the nursing students working on the antepartum unit how to
assess for edema. Which edema assessment score indicates edema of the lower
extremities, face, hands, and sacral area?
a.
+1
b.
+2
c.
+3
d.
+4 - ANSWER-ANS: C
Edema of the extremities, face, and sacral area is classified as +3 edema. Edema
classified as +1 indicates minimal edema of the lower extremities. Marked edema of the
lower extremities is +2 edema. Generalized massive edema (+4) includes the
accumulation of fluid in the peritoneal cavity.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
6. Which maternal condition always necessitates delivery by cesarean birth?
a.
Partial abruptio placentae
b.
Total placenta previa
c.
Ectopic pregnancy
d.
Eclampsia - ANSWER-ANS: B
In total placenta previa, the placenta completely covers the cervical os. The fetus would
die if a vaginal birth occurred. If the patient has stable vital signs and the fetus is alive, a
vaginal birth can be attempted. If the fetus has already expired, a vaginal birth is
preferred. The most common ectopic pregnancy is a tubal pregnancy, which is usually
detected and treated in the first trimester. Labor can be safely induced if the eclampsia
is under control.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
