TESTBANK FOR Pregnancy at Risk: Preexisting Conditions{ CHAPTERS
11;112;13;14;15;16;}
Chapter 11: Pregnancy at Risk: Preexisting Conditions
MULTIPLE CHOICE
In assessing the knowledge of a pregestational woman with type 1 diabetes
concerning changing insulin needs during pregnancy, the nurse recognizes that
further teaching is warranted when the client states:
a. “I will need to increase my insulin
dosage during the first 3 months of
pregnancy.”
b. “Insulin dosage will likely need to be
increased during the second and
third
trimesters.”
c. “Episodes of hypoglycemia are more
likely to occur during the first 3
months.”
d. “Insulin needs should return to
normal within 7 to 10 days after birth
if I am
bottle-feeding.”
ANS: A
Insulin needs are reduced in the first trimester because of increased insulin
production by the pancreas and increased peripheral sensitivity to insulin. “Insulin
dosage will likely need to be increased during the second and third trimesters,”
“Episodes of hypoglycemia are more likely to occur during the first 3 months,” and
“Insulin needs should return to normal within 7 to 10 days after birth if I am bottle-
feeding” are accurate statements and signify that the woman has understood the
teachings regarding control of her diabetes during pregnancy.
PTS: 1 DIF: Cognitive Level: Application REF: 269
OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity
Preconception counseling is critical to the outcome of diabetic pregnancies because
poor glycemic control before and during early pregnancy is associated with:
a. Frequent episodes of maternal
hypoglycemia.
b. Congenital anomalies in the fetus.
c. Polyhydramnios.
d. Hyperemesis gravidarum.
ANS: B
Preconception counseling is particularly important because strict metabolic control
before conception and in the early weeks of gestation is instrumental in decreasing
the risks of congenital anomalies. Frequent episodes of maternal hypoglycemia may
occur during the first trimester (not before conception) as a result of hormone
changes and the effects on insulin production and usage. Hydramnios occurs about
,TESTBANK FOR Pregnancy at Risk: Preexisting Conditions{ CHAPTERS
11;112;13;14;15;16;}
10 times more often in diabetic pregnancies than in nondiabetic pregnancies.
Typically it is seen in the third trimester of pregnancy. Hyperemesis gravidarum
may exacerbate hypoglycemic events because the decreased food intake by the
mother and glucose transfer to the fetus contribute to
,TESTBANK FOR Pregnancy at Risk: Preexisting Conditions{ CHAPTERS
11;112;13;14;15;16;}
hypoglycemia.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 270
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
In planning for the care of a 30-year-old woman with pregestational diabetes, the
nurserecognizes that the most important factor affecting pregnancy outcome is the:
a. Mother’s age.
b. Number of years since diabetes was
diagnosed.
c. Amount of insulin required
prenatally.
d. Degree of glycemic control during
pregnancy.
ANS: D
Women with excellent glucose control and no blood vessel disease should have good
pregnancy outcomes.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 273
OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion andMaintenance
Concerning the use and abuse of legal drugs or substances, nurses should be aware
that:
a. Although cigarette smoking causes a
number of health problems, it has
little direct effect on maternity-
related health.
b. Caucasian women are more likely to
experience alcohol-related problems.
c. Coffee is a stimulant that can
interrupt body functions and has been
related to
birth defects.
d. Prescription psychotherapeutic drugs
taken by the mother do not affect the
fetus; otherwise, they would not have
been prescribed.
ANS: B
African-American and poor women are more likely to use illicit substances,
particularly cocaine, whereas Caucasian and educated women are more likely to use
alcohol.
Cigarette smoking impairs fertility and is a cause of low birth weight. Caffeine
consumption has not been related to birth defects. Psychotherapeutic drugs have
some effect on the fetus, and that risk must be weighed against their benefit to the
mother.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 297
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
, TESTBANK FOR Pregnancy at Risk: Preexisting Conditions{ CHAPTERS
11;112;13;14;15;16;}
Screening at 24 weeks of gestation reveals that a pregnant woman has gestational
diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually
agree
11;112;13;14;15;16;}
Chapter 11: Pregnancy at Risk: Preexisting Conditions
MULTIPLE CHOICE
In assessing the knowledge of a pregestational woman with type 1 diabetes
concerning changing insulin needs during pregnancy, the nurse recognizes that
further teaching is warranted when the client states:
a. “I will need to increase my insulin
dosage during the first 3 months of
pregnancy.”
b. “Insulin dosage will likely need to be
increased during the second and
third
trimesters.”
c. “Episodes of hypoglycemia are more
likely to occur during the first 3
months.”
d. “Insulin needs should return to
normal within 7 to 10 days after birth
if I am
bottle-feeding.”
ANS: A
Insulin needs are reduced in the first trimester because of increased insulin
production by the pancreas and increased peripheral sensitivity to insulin. “Insulin
dosage will likely need to be increased during the second and third trimesters,”
“Episodes of hypoglycemia are more likely to occur during the first 3 months,” and
“Insulin needs should return to normal within 7 to 10 days after birth if I am bottle-
feeding” are accurate statements and signify that the woman has understood the
teachings regarding control of her diabetes during pregnancy.
PTS: 1 DIF: Cognitive Level: Application REF: 269
OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity
Preconception counseling is critical to the outcome of diabetic pregnancies because
poor glycemic control before and during early pregnancy is associated with:
a. Frequent episodes of maternal
hypoglycemia.
b. Congenital anomalies in the fetus.
c. Polyhydramnios.
d. Hyperemesis gravidarum.
ANS: B
Preconception counseling is particularly important because strict metabolic control
before conception and in the early weeks of gestation is instrumental in decreasing
the risks of congenital anomalies. Frequent episodes of maternal hypoglycemia may
occur during the first trimester (not before conception) as a result of hormone
changes and the effects on insulin production and usage. Hydramnios occurs about
,TESTBANK FOR Pregnancy at Risk: Preexisting Conditions{ CHAPTERS
11;112;13;14;15;16;}
10 times more often in diabetic pregnancies than in nondiabetic pregnancies.
Typically it is seen in the third trimester of pregnancy. Hyperemesis gravidarum
may exacerbate hypoglycemic events because the decreased food intake by the
mother and glucose transfer to the fetus contribute to
,TESTBANK FOR Pregnancy at Risk: Preexisting Conditions{ CHAPTERS
11;112;13;14;15;16;}
hypoglycemia.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 270
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
In planning for the care of a 30-year-old woman with pregestational diabetes, the
nurserecognizes that the most important factor affecting pregnancy outcome is the:
a. Mother’s age.
b. Number of years since diabetes was
diagnosed.
c. Amount of insulin required
prenatally.
d. Degree of glycemic control during
pregnancy.
ANS: D
Women with excellent glucose control and no blood vessel disease should have good
pregnancy outcomes.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 273
OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion andMaintenance
Concerning the use and abuse of legal drugs or substances, nurses should be aware
that:
a. Although cigarette smoking causes a
number of health problems, it has
little direct effect on maternity-
related health.
b. Caucasian women are more likely to
experience alcohol-related problems.
c. Coffee is a stimulant that can
interrupt body functions and has been
related to
birth defects.
d. Prescription psychotherapeutic drugs
taken by the mother do not affect the
fetus; otherwise, they would not have
been prescribed.
ANS: B
African-American and poor women are more likely to use illicit substances,
particularly cocaine, whereas Caucasian and educated women are more likely to use
alcohol.
Cigarette smoking impairs fertility and is a cause of low birth weight. Caffeine
consumption has not been related to birth defects. Psychotherapeutic drugs have
some effect on the fetus, and that risk must be weighed against their benefit to the
mother.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 297
OBJ: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
, TESTBANK FOR Pregnancy at Risk: Preexisting Conditions{ CHAPTERS
11;112;13;14;15;16;}
Screening at 24 weeks of gestation reveals that a pregnant woman has gestational
diabetes mellitus (GDM). In planning her care, the nurse and the woman mutually
agree
