Chapter 11: CarŤng for the
Woman ExperŤencŤng
ComplŤcatŤons DurŤng
Pregnancy NursŤng School
Test Banks
Chapter 11: Caring for the Woman Experiencing
Complications During Pregnancy
MULTIPLE CHOICE
1. A woman presents to the perinatal clinic with abdominal
pain. She has missed one period and, following a
transvaginal ultrasound, pregnancy is confirmed. However,
implantation has occurred in the right fallopian tube. The
ectopic mass is 3 cm and has not ruptured. The nurse
prepares the patient for which therapy?
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,A. Laparoscopic salpingostomy
B. Methotrexate
C. Partial salpingectomy
D. Salpingectomy by laparotomy
ANS: B
Methotrexate, a chemotherapeutic drug and folic acid
inhibitor that stops cell production and destroys remaining
trophoblastic tissue, is used in the management of
uncomplicated, non-life-threatening ectopic pregnancies.
Patients are considered to be eligible for methotrexate
therapy if the ectopic mass is unruptured and measures 4
cm or less on ultrasound examination. The other options
would not be needed.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Pharmacological
and Parenteral Therapies
Integrated Process: Nursing Process: Implementation
Difficulty: Moderate
PTS: 1
2. The prenatal clinic nurse assesses a woman at 15 weeks
gestation. The patients blood pressure, measured twice at
intervals 1 hour apart with a cuff that fits appropriately, is
146/96 mm Hg. The nurse understands the patient has
which condition?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia
D. Transient hypertension
ANS: A
Chronic hypertension is defined as hypertension that is
present and observable prior to pregnancy, or
hypertension that is diagnosed before the 20th week of
gestation. Hypertension is defined as a blood pressure
greater than 140/90 mm Hg. Hypertension for which a
diagnosis is confirmed for the first time during pregnancy
and that persists beyond the 84th day postpartum is also
classified as chronic hypertension. Gestational
hypertension occurs after 28 weeks without proteinuria
2/46
,and is a temporary diagnosis used until more diagnostic
testing can be accomplished. Preeclampsia is an increased
blood pressure seen after 20 weeks gestation
accompanied by proteinuria. Transient hypertension
describes women who develop gestational hypertension
but have no preeclampsia and whose blood pressure
returns to normal within 12 weeks postpartum. This
diagnosis is used only after pregnancy.
Cognitive Level: Knowledge/Remembering
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Physiological
Adaptation
Integrated Process: Nursing Process: Assessment
Difficulty: Easy
PTS: 1
3. The perinatal nurse is assessing a woman who is at 35
weeks gestation in her first pregnancy. She is worried
about having her baby too soon, and she is experiencing
uterine contractions every 10 to 15 minutes. The fetal
heart rate is 136 beats/minute. A vaginal examination
performed by the health-care provider reveals no cervical
changes since her last examination. Ultrasound
examination reveals the presence of V-shaped cervical
funneling. Which action by the nurse is most appropriate?
A. Educate the woman on benefits of corticosteroids.
B. Facilitate admission to the high-risk OB unit.
C. Prepare to administer a dose of magnesium sulfate.
D. Reassure the woman that she is not in preterm labor.
ANS: D
Preterm labor is defined as regular uterine contractions
and cervical changes before the end of the 37th week of
gestation. Many patients present with preterm contractions
but only those who demonstrate changes in the cervix are
diagnosed with preterm labor. Because this woman has no
demonstrated cervical changes, she does not have the
diagnosis. Also reassuring is the infrequency of her
contractions; a defining characteristic of preterm labor is
persistent uterine contractions (4 every 20 minutes or 8
per hour). Another reassuring finding is the presence of V-
3/46
, shaped cervical funneling ; a change to U-shaped cervical
funneling in a woman with a shortened cervix is associated
with preterm labor in high-risk women with a prior
spontaneous preterm birth. The woman does not require
corticosteroids or magnesium sulfate or admission to the
high-risk OB unit.
Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Implementation
Difficulty: Difficult
PTS: 1
4. The perinatal nurse is caring for a woman at 26 weeks
gestation who has a history of hypertension that has been
well controlled. Today she presents with a blood pressure
of 156/102 mm Hg and she has 2+ protein on urine
dipstick. Which initial action by the nurse is most
appropriate?
A. Arrange admission to the high-risk OB unit.
B. Instruct the woman on strict bedrest.
C. Obtain a clean-catch urine sample.
D. Prepare to administer IV anti-hypertensives.
ANS: C
Preeclampsia can occur in a woman who has chronic
hypertension. This woman has the characteristics of
hypertension after a period of good control and
proteinuria of at least 2+ on dipstick (100 mg/dL). The
nurse needs to ensure protein levels are assessed in two
samples at least 4 hours apart and ensure the woman has
no signs of a urinary tract infection, as protein can occur
in a sample of infected urine. The nurse should obtain a
clean-catch urine sample to send to the laboratory for
analysis. Asymptomatic UTI can occur in up to 11% of
pregnant women, so assessing for signs and symptoms
may not be accurate. The woman does not need admission
to the high-risk OB unit, strict bedrest, or IV anti-
hypertensives at this point.
4/46
Woman ExperŤencŤng
ComplŤcatŤons DurŤng
Pregnancy NursŤng School
Test Banks
Chapter 11: Caring for the Woman Experiencing
Complications During Pregnancy
MULTIPLE CHOICE
1. A woman presents to the perinatal clinic with abdominal
pain. She has missed one period and, following a
transvaginal ultrasound, pregnancy is confirmed. However,
implantation has occurred in the right fallopian tube. The
ectopic mass is 3 cm and has not ruptured. The nurse
prepares the patient for which therapy?
1/46
,A. Laparoscopic salpingostomy
B. Methotrexate
C. Partial salpingectomy
D. Salpingectomy by laparotomy
ANS: B
Methotrexate, a chemotherapeutic drug and folic acid
inhibitor that stops cell production and destroys remaining
trophoblastic tissue, is used in the management of
uncomplicated, non-life-threatening ectopic pregnancies.
Patients are considered to be eligible for methotrexate
therapy if the ectopic mass is unruptured and measures 4
cm or less on ultrasound examination. The other options
would not be needed.
Cognitive Level: Application/Applying
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Pharmacological
and Parenteral Therapies
Integrated Process: Nursing Process: Implementation
Difficulty: Moderate
PTS: 1
2. The prenatal clinic nurse assesses a woman at 15 weeks
gestation. The patients blood pressure, measured twice at
intervals 1 hour apart with a cuff that fits appropriately, is
146/96 mm Hg. The nurse understands the patient has
which condition?
A. Chronic hypertension
B. Gestational hypertension
C. Preeclampsia
D. Transient hypertension
ANS: A
Chronic hypertension is defined as hypertension that is
present and observable prior to pregnancy, or
hypertension that is diagnosed before the 20th week of
gestation. Hypertension is defined as a blood pressure
greater than 140/90 mm Hg. Hypertension for which a
diagnosis is confirmed for the first time during pregnancy
and that persists beyond the 84th day postpartum is also
classified as chronic hypertension. Gestational
hypertension occurs after 28 weeks without proteinuria
2/46
,and is a temporary diagnosis used until more diagnostic
testing can be accomplished. Preeclampsia is an increased
blood pressure seen after 20 weeks gestation
accompanied by proteinuria. Transient hypertension
describes women who develop gestational hypertension
but have no preeclampsia and whose blood pressure
returns to normal within 12 weeks postpartum. This
diagnosis is used only after pregnancy.
Cognitive Level: Knowledge/Remembering
Content Area: Pediatrics/Maternity
Patient Needs: Physiological Integrity: Physiological
Adaptation
Integrated Process: Nursing Process: Assessment
Difficulty: Easy
PTS: 1
3. The perinatal nurse is assessing a woman who is at 35
weeks gestation in her first pregnancy. She is worried
about having her baby too soon, and she is experiencing
uterine contractions every 10 to 15 minutes. The fetal
heart rate is 136 beats/minute. A vaginal examination
performed by the health-care provider reveals no cervical
changes since her last examination. Ultrasound
examination reveals the presence of V-shaped cervical
funneling. Which action by the nurse is most appropriate?
A. Educate the woman on benefits of corticosteroids.
B. Facilitate admission to the high-risk OB unit.
C. Prepare to administer a dose of magnesium sulfate.
D. Reassure the woman that she is not in preterm labor.
ANS: D
Preterm labor is defined as regular uterine contractions
and cervical changes before the end of the 37th week of
gestation. Many patients present with preterm contractions
but only those who demonstrate changes in the cervix are
diagnosed with preterm labor. Because this woman has no
demonstrated cervical changes, she does not have the
diagnosis. Also reassuring is the infrequency of her
contractions; a defining characteristic of preterm labor is
persistent uterine contractions (4 every 20 minutes or 8
per hour). Another reassuring finding is the presence of V-
3/46
, shaped cervical funneling ; a change to U-shaped cervical
funneling in a woman with a shortened cervix is associated
with preterm labor in high-risk women with a prior
spontaneous preterm birth. The woman does not require
corticosteroids or magnesium sulfate or admission to the
high-risk OB unit.
Cognitive Level: Analysis/Analyzing
Content Area: Pediatrics/Maternity
Patient Needs: Health Promotion and Maintenance
Integrated Process: Nursing Process: Implementation
Difficulty: Difficult
PTS: 1
4. The perinatal nurse is caring for a woman at 26 weeks
gestation who has a history of hypertension that has been
well controlled. Today she presents with a blood pressure
of 156/102 mm Hg and she has 2+ protein on urine
dipstick. Which initial action by the nurse is most
appropriate?
A. Arrange admission to the high-risk OB unit.
B. Instruct the woman on strict bedrest.
C. Obtain a clean-catch urine sample.
D. Prepare to administer IV anti-hypertensives.
ANS: C
Preeclampsia can occur in a woman who has chronic
hypertension. This woman has the characteristics of
hypertension after a period of good control and
proteinuria of at least 2+ on dipstick (100 mg/dL). The
nurse needs to ensure protein levels are assessed in two
samples at least 4 hours apart and ensure the woman has
no signs of a urinary tract infection, as protein can occur
in a sample of infected urine. The nurse should obtain a
clean-catch urine sample to send to the laboratory for
analysis. Asymptomatic UTI can occur in up to 11% of
pregnant women, so assessing for signs and symptoms
may not be accurate. The woman does not need admission
to the high-risk OB unit, strict bedrest, or IV anti-
hypertensives at this point.
4/46
