Ati maternity exam 4 moitiso
Total Questions : 29
Showing 25 questions, Sign in for moreA nurse is caring for a client who has been diagnosed with hyperemesis gravidarum.Which of the following conditions are risk factors for hyperemesis gravidarum?
Explanation
Choice A rationale
Oligohydramnios refers to a condition characterized by a deficiency in amniotic fluid. It is not a common risk factor for hyperemesis gravidarum, which is more related to hormonal changes and genetic predisposition.
Choice B rationale
Twin gestations significantly increase the levels of human chorionic gonadotropin (hCG), leading to a higher incidence of hyperemesis gravidarum. Elevated hCG levels correlate directly with the severity of nausea and vomiting in pregnancy.
Choice C rationale
Anemia does not have a direct causal relationship with hyperemesis gravidarum. Hyperemesis may contribute to the development of anemia due to nutritional deficiencies, but it is not a predisposing risk factor.
Choice D rationale
Molar pregnancy, a gestational trophoblastic disease, causes significantly elevated levels of hCG, leading to an increased likelihood of hyperemesis gravidarum. This condition triggers extreme nausea and vomiting due to excessively high hormone levels.
Choice E rationale
A history of hyperemesis in previous pregnancies strongly predicts recurrence in subsequent pregnancies. This suggests a genetic or environmental predisposition to severe nausea and vomiting.
You are receiving report from the night shift nurse on a laboring client.She is 39 weeks gestation, cervical exam is 9cm/100%/0, shehas an epidural in place for pain management.ROM occurred 25 hours ago with a moderate amount of clear fluid.EFM assessment includes baseline 175bpm, minimal variability, no accelerations, no decelerations.Vital signs: Blood pressure: 118/84 mmHg.Respiratory Rate: 16/min.O2 saturation: 99% on RA. Heart rate: 106/min.Temperature: 39.2°C (102.6°F) oral.What complication does the nurse suspect?
Explanation
Choice A rationale
Intraamniotic infection (chorioamnionitis) is suspected due to the combination of prolonged rupture of membranes (25 hours), maternal fever (39.2°C), and fetal tachycardia (baseline of 175 bpm). These are key indicators of infection within the amniotic sac.
Choice B rationale
Pyelonephritis, an infection of the kidneys, is unlikely without the presence of symptoms such as flank pain, dysuria, and significant changes in urinalysis. The primary signs point towards intraamniotic infection.
Choice C rationale
Cholestasis of pregnancy primarily presents with intense itching, especially on the hands and feet, and does not typically involve fever or abnormal fetal heart rates. Thus, it is less likely in this scenario.
Choice D rationale
Placental abruption involves the separation of the placenta from the uterine wall before delivery, often presenting with abdominal pain, vaginal bleeding, and uterine contractions. The absence of these symptoms makes this diagnosis less likely.
A nurse is admitting a client at 33 weeks gestation who experienced PPROM 4 hours ago.The client is asking when her next vaginal exam will be since her first exam revealed she is 2 cm dilated.Which of the following reasons does the nurse explain for not performing another vaginal exam?
Explanation
Choice A rationale
Performing another vaginal exam does not directly influence labor progress. Labor can progress naturally without repeated exams, which can introduce unnecessary risk.
Choice B rationale
While vaginal exams can be uncomfortable, pain is not the primary reason to avoid multiple exams, especially when managing potential complications.
Choice C rationale
Vaginal exams might lead to minor bleeding due to irritation, but the risk of bleeding is not a primary concern in this context.
Choice D rationale
The most significant reason to avoid frequent vaginal exams after PPROM is the increased risk of infection. Each exam provides a potential pathway for bacteria to ascend, leading to complications like chorioamnionitis.
A nurse is educating a client at the end of her second trimester about car safety.Which statement by the client indicates a correct understanding of the nurse's education?
Explanation
Choice A rationale
Wearing the seatbelt under the arm is not recommended as it may not distribute the force of a collision evenly and could increase the risk of injury to both the mother and the baby. Proper positioning is crucial for safety.
Choice B rationale
Positioning the lap belt under the abdomen and the shoulder belt between the breasts and above the abdomen minimizes the risk of abdominal trauma and ensures both mother and baby are protected in the event of a collision. This is the recommended positioning for pregnant women.
Choice C rationale
Avoiding a seatbelt during pregnancy is not advised as it significantly increases the risk of injury or death for both the mother and the baby in the event of an accident. Seatbelts are crucial for safety.
Choice D rationale
Removing the seatbelt when driving at a slow speed still poses a significant risk. Even at low speeds, sudden stops or collisions can cause harm to both mother and baby. Consistent seatbelt use is essential.
A client arrives to OB triage at 37 weeks gestation with a known complete placenta previa this pregnancy.She reports feeling someinconsistent contractions over the last 4 hours and wants to know if she is in labor.The client asks the nurse why the provider did not perform a vaginal exam.What is the most appropriate answer by the nurse?
Explanation
Choice A rationale
While rupturing membranes can be a concern, the primary issue with a vaginal exam in the presence of placenta previa is the risk of severe bleeding. This choice is partially correct but not the most accurate answer.
Choice B rationale
With placenta previa, the placenta covers the cervix, and a vaginal exam could easily disrupt it, leading to significant vaginal bleeding. This bleeding can be dangerous for both the mother and the baby, making this the most accurate reason to avoid a vaginal exam.
Choice C rationale
Infection risk is a concern with any invasive procedure, but it is not the primary reason to avoid a vaginal exam in the case of placenta previa. The main concern is the risk of bleeding.
Choice D rationale
Initiating preterm labor is a possible risk with any vaginal exam late in pregnancy, but it is not the primary concern in cases of placenta previa. The main issue is the potential for causing severe bleeding.
A nurse is providing education about TORCH infections to a pregnant client and her partner.The nurse identifies that the client is at risk for which infection?
Explanation
Choice A rationale
Cytomegalovirus (CMV) is a common infection that can be transmitted to the fetus, leading to serious complications such as hearing loss, vision impairment, and developmental delays. It is one of the TORCH infections.
Choice B rationale
Herpes Simplex Virus (HSV) can be transmitted to the baby during delivery, especially if there is an active outbreak. It can cause severe neonatal infections, making it a significant concern during pregnancy.
Choice C rationale
Hepatitis B is not classified under the TORCH infections. While it is a serious concern in pregnancy, it is typically managed through vaccination and other precautions to prevent vertical transmission to the baby.
Choice D rationale
Rubella is part of the TORCH complex and can lead to congenital rubella syndrome, causing serious birth defects such as heart problems, developmental delays, and hearing loss if the mother contracts it during pregnancy.
Choice E rationale
Toxoplasmosis is included in the TORCH infections and can cause severe fetal complications such as brain damage, vision problems, and developmental delays if the mother is infected during pregnancy.
A client is at risk for a spontaneous abortion at 14 weeks gestation.The client's two previous pregnancies were miscarriages in the same gestational time frame.The client states, "They want to sew my cervix shut.”. The nurse shares the terminology for surgical treatment of an incompetent cervix.Which of the following would the nurse explain?
Explanation
Choice A rationale
Aminoinfusion is a procedure where fluid is infused into the amniotic sac. It is used to treat certain complications during labor but is not related to treating an incompetent cervix.
Choice B rationale
Hysterectomy is a surgical procedure to remove the uterus and is not a treatment for an incompetent cervix. It is typically performed for conditions such as cancer, severe bleeding, or other significant uterine issues.
Choice C rationale
Cerclage is the correct term for the surgical procedure used to treat an incompetent cervix. It involves stitching the cervix closed to prevent premature dilation, which can lead to miscarriage or preterm birth.
Choice D rationale
Beta-adrenergic agonist therapy is used to delay preterm labor by relaxing the uterus but does not address the structural issue of an incompetent cervix. It is a medication-based approach rather than a surgical one.
A nurse is caring for a client who was recently diagnosed with Hyperemesis Gravidarum.Which of the following medications should the nurse anticipate administering?
Explanation
Choice A rationale
Ibuprofen is not recommended during pregnancy, especially in the later stages, as it can cause harm to the fetus and affect amniotic fluid levels.
Choice B rationale
While hydration is crucial for managing Hyperemesis Gravidarum, 0.9% Sodium Chloride alone won't address the underlying symptoms like nausea and vomiting effectively.
Choice C rationale
Magnesium Sulfate is typically used to prevent seizures in preeclampsia, not for Hyperemesis Gravidarum.
Choice D rationale
Pyridoxine (vitamin B6) is often recommended for Hyperemesis Gravidarum as it can help reduce nausea and vomiting.
A nurse is caring for a client receiving Magnesium Sulfate therapy IV for preterm labor.Which of the following medications should the nurse anticipate administering if the client exhibits hypotension, decreased urine output, and a respiratory rate of 10/min?
Explanation
Choice A rationale
Methotrexate is used for treating ectopic pregnancies and certain cancers, but it is not an antidote for Magnesium Sulfate toxicity.
Choice B rationale
Labetalol is a beta-blocker used for hypertension management in pregnancy, not for reversing Magnesium Sulfate toxicity.
Choice C rationale
Nifedipine is a calcium channel blocker used to manage high blood pressure and preterm labor, not for counteracting Magnesium Sulfate toxicity.
Choice D rationale
Calcium gluconate is the specific antidote for Magnesium Sulfate toxicity, effectively reversing its effects.
A client at 34 weeks gestation arrives to OB triage and is concerned she may be in preterm labor.Which of the following are signs and symptoms of preterm labor? (Select all that apply.)
Explanation
Choice A rationale
Vaginal spotting can be an early sign of preterm labor as it may indicate changes in the cervix.
Choice B rationale
Regular contractions occurring every 10 minutes or less suggest the onset of labor.
Choice C rationale
Weight gain is not a sign of preterm labor and is common in normal pregnancy progression.
Choice D rationale
Lower back pain or pelvic pressure can indicate preterm labor as these symptoms reflect changes in the lower uterus and cervix.
An OB nurse is educating a new graduate nurse about the signs and symptoms of a hydatidiform mole.The new graduate nurse understands the teaching when he identifies the expected assessment findings with this condition.Which of the following signs and symptoms would the nurse identify?
Explanation
Choice A rationale
Nausea is typically present in patients with a hydatidiform mole due to high hCG levels.
Choice B rationale
Category II fetal heart rate patterns are indicative of intermediate fetal compromise but are not specific to hydatidiform mole.
Choice C rationale
hCG levels are typically elevated, not decreased, in a hydatidiform mole due to the abnormal growth of trophoblastic tissue.
Choice D rationale
An enlarged uterus is a classic sign of a hydatidiform mole due to the overgrowth of placental tissue without a viable fetus.
A nurse is at the bedside to provide additional education and resources to a client about a new diagnosis.The client in the OB clinic is visibly upset after their appointment with their provider and states, "My doctor told me that there is something wrong with my placenta and I will have to have a cesarean and hysterectomy when I deliver my baby.”. The nurse plans to provide education about which of the following placenta abnormalities?
Explanation
Choice A rationale
Placenta accreta spectrum involves abnormal adherence of the placenta to the uterine wall, leading to complications during delivery and often necessitating a cesarean and possibly a hysterectomy.
Choice B rationale
Placenta previa refers to the placenta covering the cervix, which can cause bleeding but is managed differently.
Choice C rationale
Placenta abruption is the premature separation of the placenta from the uterus, leading to pain and bleeding, managed differently from accreta spectrum.
Choice D rationale
Posterior placental location refers to the position of the placenta in the uterus and does not typically require a cesarean and hysterectomy unless complicated by other factors.
A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa.Which of the following findings support this diagnosis?
Explanation
Choice A rationale
Abdominal pain with no vaginal bleeding is not typically associated with placenta previa. This condition usually involves painless vaginal bleeding as the placenta covers or is near the cervix, not causing abdominal pain without bleeding.
Choice B rationale
Painless red vaginal bleeding is characteristic of placenta previa. The condition occurs when the placenta covers the cervix, leading to painless bleeding as the cervix begins to thin or dilate.
Choice C rationale
Sharp abdominal pain is not a common sign of placenta previa. This symptom is more indicative of conditions such as placental abruption, where the placenta detaches from the uterine wall.
Choice D rationale
Intermittent abdominal pain following the passage of bloody mucus is not typical of placenta previa. This pattern may suggest labor or other complications, not the classic presentation of painless bleeding seen in placenta previa.
A nurse in a provider's office is caring for a client who is at 37 weeks of gestation and at risk for placental abruption.The nurse should recognize that which of the following is a risk factor for abruption?
Explanation
Choice A rationale
Asthma is a respiratory condition and is not directly linked to an increased risk of placental abruption. While chronic conditions can affect pregnancy, asthma is not a direct risk factor for abruption.
Choice B rationale
Hyperthyroidism is a thyroid condition that can cause complications during pregnancy, but it is not a known risk factor for placental abruption. It affects the mother's metabolism and can impact fetal development, but does not typically cause placental detachment.
Choice C rationale
Previous cesarean delivery is associated with risks such as uterine rupture in future pregnancies, but not specifically with placental abruption. The scar tissue from a cesarean may affect the placenta's position, but does not increase the risk of abruption directly.
Choice D rationale
Hypertension, or high blood pressure, is a significant risk factor for placental abruption. It can damage the blood vessels in the placenta, leading to separation from the uterine wall and resulting in abruption, which can be dangerous for both mother and baby.
A client arrives at the emergency department with small amounts of vaginal bleeding and severe left-sided abdominal pain.The client tells the nurse she is unsure of when her last menstrual period was, but maybe about 7 weeks ago.The client's blood pressure is 82/55 mm/Hg, and her pulse is 120 bpm.The nurse notifies the healthcare provider immediately due to her concern about which complication?
Explanation
Choice A rationale
Abruptio placentae involves the premature separation of the placenta from the uterus, causing abdominal pain and bleeding. However, the severe left-sided pain and uncertain last menstrual period suggest another condition rather than abruption.
Choice B rationale
Gestational trophoblastic disease is characterized by abnormal growth of trophoblasts, the cells that normally develop into the placenta. It is usually identified by abnormal bleeding and unusually high hCG levels, not the acute symptoms described.
Choice C rationale
Complete abortion refers to the expulsion of all products of conception, typically accompanied by heavy bleeding and cramping. While it involves vaginal bleeding, the severe unilateral pain and low blood pressure suggest a different diagnosis.
Choice D rationale
Ectopic pregnancy, where a fertilized egg implants outside the uterus, typically causes severe unilateral pain and can lead to internal bleeding, resulting in low blood pressure and a high heart rate. These symptoms align with the client's presentation and are a medical emergency.
A nurse reviews the assessment findings and determines the findings are consistent with which of the following complications?
Explanation
Choice A rationale
Placenta previa involves painless vaginal bleeding due to the placenta covering the cervical opening. It does not typically cause significant abdominal pain or the hemodynamic instability described in the scenario.
Choice B rationale
Abruptio placentae is the premature separation of the placenta from the uterine wall, causing severe abdominal pain, vaginal bleeding, and can lead to shock, consistent with the assessment findings.
Choice C rationale
Uterine rupture, often a complication in women with a previous cesarean section, involves the tearing of the uterine wall, causing sudden, severe abdominal pain and bleeding. However, it is less common than placental abruption.
Choice D rationale
Amniotic fluid embolism is a rare but life-threatening condition where amniotic fluid enters the mother's bloodstream, causing cardiovascular collapse and severe respiratory distress, which is less consistent with the described findings.
A nurse is caring for a client who is at 32 weeks of gestation.Continuous fetal monitoring and vital signs per protocol are required.Prepare for cesarean birth.A nurse reviews the assessment findings and determines the findings are consistent with which of the following complications?
Explanation
Choice A rationale
Placenta previa leads to painless vaginal bleeding when the placenta covers the cervix. It does not typically require continuous fetal monitoring or prepare for cesarean birth based on the findings alone.
Choice B rationale
Abruptio placentae is the premature detachment of the placenta, causing abdominal pain, and can lead to fetal distress. Continuous fetal monitoring and preparation for cesarean birth are consistent with this complication.
Choice C rationale
Gestational hypertension is high blood pressure that develops after 20 weeks of pregnancy but without the presence of protein in the urine or other symptoms of preeclampsia. It would not typically necessitate the measures described.
Choice D rationale
Preeclampsia involves high blood pressure and proteinuria after 20 weeks of gestation and can cause severe complications for both the mother and fetus. However, it does not directly lead to the specific intervention of continuous fetal monitoring and cesarean preparation.
A nurse is caring for a client who is at 32 weeks of gestation.Hemoglobin level is 8 g/dL (normal: 12 to 16 g/dL). Platelet count is 100,000/mm³ (normal: 150,000 to 400,000/mm³). Which of the following complications is the nurse most likely dealing with?
Explanation
Choice A rationale
Placenta previa is characterized by painless, bright red vaginal bleeding in the third trimester, not by low hemoglobin and platelet levels.
Choice B rationale
Abruptio placentae involves painful vaginal bleeding, uterine tenderness, and contractions, and is not primarily associated with low hemoglobin and platelet counts.
Choice C rationale
Gestational hypertension is identified by high blood pressure without proteinuria or severe systemic symptoms, and typically doesn't lead to low platelet counts or hemoglobin levels.
Choice D rationale
Preeclampsia includes hypertension, proteinuria, and systemic symptoms like low platelet count and hemoglobin level, indicating a more severe form such as HELLP syndrome.
A client at 27 weeks gestation has completed the 1-hour Glucose Tolerance Test (GTT) with a result of 160 mg/dL (expected: less than 130-140 mg/dL). What education would the nurse provide following this test result?
Explanation
Choice A rationale
Prescribing insulin is premature based on a single elevated glucose test without further diagnostic confirmation through a 3-hour Glucose Tolerance Test.
Choice B rationale
Increasing carbohydrate intake is not recommended for managing elevated glucose levels in gestational diabetes.
Choice C rationale
No changes are recommended only if the GTT results are within the expected range. Further testing is required due to the elevated result.
Choice D rationale
A 3-hour Glucose Tolerance Test is needed to confirm gestational diabetes following an elevated 1-hour test result to ensure accurate diagnosis and appropriate management.
A nurse is caring for a client in the OB clinic at 34 weeks gestation.Which of the following symptoms reported by the client is indicative of cholestasis of pregnancy?
Explanation
Choice A rationale
Pruritus of the palms of the hands is a hallmark symptom of cholestasis of pregnancy, a liver disorder causing bile acid accumulation.
Choice B rationale
Back pain and pelvic pressure are common pregnancy symptoms but are not specific to cholestasis.
Choice C rationale
Nausea and vomiting can be due to many conditions in pregnancy and are not indicative of cholestasis.
Choice D rationale
Headaches and blurred vision are associated with preeclampsia, not cholestasis.
You are attending a staff meeting when the discussion about preeclampsia complications arises.Which of the following statements by the nurse educator is correct regarding HELLP syndrome?
Explanation
Choice A rationale
HELLP syndrome includes elevated LDH levels, indicating hemolysis, not decreased levels.
Choice B rationale
HELLP syndrome involves hemolysis, reducing red blood cells, not increasing their production.
Choice C rationale
Elevated liver enzymes are a key feature of HELLP syndrome, reflecting liver damage.
Choice D rationale
HELLP syndrome is characterized by low platelets (thrombocytopenia), not increased platelets.
A nurse is preparing to administer magnesium sulfate IV to a client who is 30 weeks gestation and experiencing preterm labor.The nurse explains to the client the primary purpose of this medication for her condition is to do which of the following?
Explanation
Choice A rationale
Increasing contraction frequency is not the goal when administering magnesium sulfate. This medication actually works to relax the uterine muscles, thus preventing premature labor contractions.
Choice B rationale
Magnesium sulfate is sometimes used to prevent seizures in clients with preeclampsia, but this is not its primary purpose in the case of preterm labor.
Choice C rationale
Betamethasone or dexamethasone are typically given to improve fetal lung maturity, not magnesium sulfate.
Choice D rationale
Magnesium sulfate provides neuroprotection for the fetus by preventing intraventricular hemorrhage and cerebral palsy in preterm infants.
A nurse is caring for a client at 29 weeks gestation that arrived to OB triage with complaints of uterine contractions every 45 minutes.After the initial assessment, an order for Nifedipine was received.The nurse is now evaluating the effects of the medication.Which of the following assessments indicates the medication was effective?
Explanation
Choice A rationale
Nifedipine is a calcium channel blocker and can lower blood pressure, but this is not its primary intended effect in this scenario.
Choice B rationale
While nifedipine can increase heart rate as a side effect, this does not indicate its primary effectiveness.
Choice C rationale
Nifedipine effectively decreases uterine contractions in preterm labor by inhibiting calcium entry into muscle cells, thus reducing their contractility.
Choice D rationale
Nifedipine does not directly decrease nausea, so this is not an appropriate measure of its effectiveness.
A 38-year-old multigravida returns to the clinic for a routine prenatal visit at 36 weeks gestation.Assessment findings include blood pressure: 149/93 mm Hg, pulse: 80 beats/min, respiratory rate: 16 breaths/min.The nurse suspects preeclampsia.What additional finding would the nurse assess for?
Explanation
Choice A rationale
Uterine contractions are not a primary indicator of preeclampsia but rather of labor.
Choice B rationale
Preeclampsia is associated with hyperreflexia, not decreased deep tendon reflexes.
Choice C rationale
Preeclampsia is primarily monitored through blood pressure and proteinuria, not blood glucose levels.
Choice D rationale
Proteinuria is a key indicator of preeclampsia, caused by kidney damage due to high blood pressure.
A nurse is caring for a client who has preeclampsia and is being treated with magnesium sulfate.The client's respiratory rate is 10/min and deep-tendon reflexes are absent.Which of the following actions should the nurse take first?
Explanation
Choice A rationale
Calcium gluconate is the antidote for magnesium sulfate toxicity but is administered after stopping the infusion.
Choice B rationale
The first action is to stop the magnesium sulfate infusion to prevent further respiratory depression and absent reflexes.
Choice C rationale
Preparing for an urgent cesarean birth is not the immediate first action for treating magnesium sulfate toxicity.
Choice D rationale
Administering IV fluid bolus does not address the immediate issue of magnesium sulfate toxicity.
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