NR 2313C EXAM Pregnancy at Risk: Gestational Conditions
QUESTIONS WITH COMPLETE SOLUTIONS 100% SOLVED
2023 A+
MULTIPLE CHOICE
1. Women with hyperemesis gravidarum:
a.
Are a majority, because 80% of all pregnant women suffer from it at some time.
b.
Have vomiting severe and persistent enough to cause weight loss, dehydration, and
electrolyte imbalance.
c.
Need intravenous (IV) fluid and nutrition for most of their pregnancy.
d.
Often inspire similar, milder symptoms in their male partners and mothers.
ANS: B
Women with hyperemesis gravidarum have severe vomiting; however, treatment for
several days sets things right in most cases. Although 80% of pregnant women
experience nausea and vomiting, fewer than 1% (0.5%) proceed to this severe level. IV
administration may be used at first to restore fluid levels, but it is seldom needed for very
long. Women suffering from this condition want sympathy because some authorities
believe that difficult relationships with mothers and/or partners may be the cause.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 316
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
2. Because pregnant women may need surgery during pregnancy, nurses should
be aware that:
a.
The diagnosis of appendicitis may be difficult because the normal signs
and symptoms mimic some normal changes in pregnancy.
b.
Rupture of the appendix is less likely in pregnant women because of the
close monitoring.
c.
Surgery for intestinal obstructions should be delayed as long as possible because
it usually affects the pregnancy.
d.
When pregnancy takes over, a woman is less likely to have ovarian problems
that require invasive responses.
ANS: A
Both appendicitis and pregnancy are linked with nausea, vomiting, and increased white
blood cell count. Rupture of the appendix is two to three times more likely in pregnant
women. Surgery to remove obstructions should be done right away. It usually does not
affect the pregnancy. Pregnancy predisposes a woman to ovarian problems.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 333
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. What laboratory marker is indicative of disseminated intravascular coagulation
(DIC)?
a.
Bleeding time of 10 minutes c. Thrombocytopenia
b.
Presence of fibrin split products d. Hyperfibrinogenemia
ANS: B
, NR 2313C EXAM Pregnancy at Risk: Gestational Conditions
QUESTIONS WITH COMPLETE SOLUTIONS 100% SOLVED
2023 A+
Degradation of fibrin leads to the accumulation of fibrin split products in the blood.
Bleeding time in DIC is normal. Low platelets may occur with but are not indicative of
DIC because they may result from other coagulopathies. Hypofibrinogenemia would
occur with DIC.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 330
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
4. In caring for an immediate postpartum client, you note petechiae and oozing from
her IV site. You would monitor her closely for the clotting disorder:
a.
Disseminated intravascular coagulation (DIC)
b.
Amniotic fluid embolism (AFE)
c.
Hemorrhage
d.
HELLP syndrome
ANS: A
The diagnosis of DIC is made according to clinical findings and laboratory markers.
Physical examination reveals unusual bleeding. Petechiae may appear around a blood
pressure cuff on the woman’s arm. Excessive bleeding may occur from the site of slight
trauma such as venipuncture sites. These symptoms are not associated with AFE, nor is
AFE a bleeding disorder. Hemorrhage occurs for a variety of reasons in the postpartum
client. These symptoms are associated with DIC. Hemorrhage would be a finding
associated with DIC and is not a clotting disorder in and of itself. HELLP is not a clotting
disorder, but it may contribute to the clotting disorder DIC.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 331
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
5. In caring for the woman with disseminated intravascular coagulation (DIC), what
order should the nurse anticipate?
a.
Administration of blood
b.
Preparation of the client for invasive hemodynamic monitoring
c.
Restriction of intravascular fluids
d.
Administration of steroids
ANS: A
Primary medical management in all cases of DIC involves correction of the underlying
cause, volume replacement, blood component therapy, optimization of oxygenation and
perfusion status, and continued reassessment of laboratory parameters. Central
monitoring would not be ordered initially in a client with DIC because this can contribute
to more areas of bleeding. Management of DIC would include volume replacement, not
volume restriction. Steroids are not indicated for the management of DIC.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 332
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
6. A primigravida is being monitored in her prenatal clinic for preeclampsia. What
finding should concern her nurse?
, NR 2313C EXAM Pregnancy at Risk: Gestational Conditions
QUESTIONS WITH COMPLETE SOLUTIONS 100% SOLVED
2023 A+
a.
Blood pressure (BP) increase to 138/86 mm Hg
b.
Weight gain of 0.5 kg during the past 2 weeks
c.
A dipstick value of 3+ for protein in her urine
d.
Pitting pedal edema at the end of the day
ANS: C
Proteinuria is defined as a concentration of 1+ or greater via dipstick measurement. A
dipstick value of 3+ should alert the nurse that additional testing or assessment should be
made. Generally, hypertension is defined as a BP of 140/90 or an increase in systolic
pressure of 30 mm Hg or in diastolic pressure of 15 mm Hg. Preeclampsia may be
manifested as a rapid weight gain of more than 2 kg in 1 week. Edema occurs in many
normal pregnancies and in women with preeclampsia. Therefore, the presence of edema
is no longer considered diagnostic of preeclampsia.
PTS: 1 DIF: Cognitive Level: Analysis REF: 303
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
7. The labor of a pregnant woman with preeclampsia is going to be induced. Before
initiating the Pitocin infusion, the nurse reviews the woman’s latest laboratory test
findings, which reveal a platelet count of 90,000, an elevated aspartate transaminase
(AST) level, and a falling hematocrit. The nurse notifies the physician because the
laboratory results are indicative of:
a.
Eclampsia.
b.
Disseminated intravascular coagulation (DIC).
c.
HELLP syndrome.
d.
Idiopathic thrombocytopenia.
ANS: C
HELLP syndrome is a laboratory diagnosis for a variant of severe preeclampsia that
involves hepatic dysfunction characterized by hemolysis (H), elevated liver enzymes
(EL), and low platelets (LP). Eclampsia is determined by the presence of seizures. DIC is
a potential complication associated with HELLP syndrome. Idiopathic thrombocytopenia
is the presence of low platelets of unknown cause and is not associated with
preeclampsia.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 306
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
8. A woman with preeclampsia has a seizure. The nurse’s primary duty during the
seizure is to:
a.
Insert an oral airway.
b.
Suction the mouth to prevent aspiration.
c.
Administer oxygen by mask.
d.
Stay with the client and call for help.
ANS: D
If a client becomes eclamptic, the nurse should stay her and call for help.
QUESTIONS WITH COMPLETE SOLUTIONS 100% SOLVED
2023 A+
MULTIPLE CHOICE
1. Women with hyperemesis gravidarum:
a.
Are a majority, because 80% of all pregnant women suffer from it at some time.
b.
Have vomiting severe and persistent enough to cause weight loss, dehydration, and
electrolyte imbalance.
c.
Need intravenous (IV) fluid and nutrition for most of their pregnancy.
d.
Often inspire similar, milder symptoms in their male partners and mothers.
ANS: B
Women with hyperemesis gravidarum have severe vomiting; however, treatment for
several days sets things right in most cases. Although 80% of pregnant women
experience nausea and vomiting, fewer than 1% (0.5%) proceed to this severe level. IV
administration may be used at first to restore fluid levels, but it is seldom needed for very
long. Women suffering from this condition want sympathy because some authorities
believe that difficult relationships with mothers and/or partners may be the cause.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 316
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
2. Because pregnant women may need surgery during pregnancy, nurses should
be aware that:
a.
The diagnosis of appendicitis may be difficult because the normal signs
and symptoms mimic some normal changes in pregnancy.
b.
Rupture of the appendix is less likely in pregnant women because of the
close monitoring.
c.
Surgery for intestinal obstructions should be delayed as long as possible because
it usually affects the pregnancy.
d.
When pregnancy takes over, a woman is less likely to have ovarian problems
that require invasive responses.
ANS: A
Both appendicitis and pregnancy are linked with nausea, vomiting, and increased white
blood cell count. Rupture of the appendix is two to three times more likely in pregnant
women. Surgery to remove obstructions should be done right away. It usually does not
affect the pregnancy. Pregnancy predisposes a woman to ovarian problems.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 333
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. What laboratory marker is indicative of disseminated intravascular coagulation
(DIC)?
a.
Bleeding time of 10 minutes c. Thrombocytopenia
b.
Presence of fibrin split products d. Hyperfibrinogenemia
ANS: B
, NR 2313C EXAM Pregnancy at Risk: Gestational Conditions
QUESTIONS WITH COMPLETE SOLUTIONS 100% SOLVED
2023 A+
Degradation of fibrin leads to the accumulation of fibrin split products in the blood.
Bleeding time in DIC is normal. Low platelets may occur with but are not indicative of
DIC because they may result from other coagulopathies. Hypofibrinogenemia would
occur with DIC.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 330
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
4. In caring for an immediate postpartum client, you note petechiae and oozing from
her IV site. You would monitor her closely for the clotting disorder:
a.
Disseminated intravascular coagulation (DIC)
b.
Amniotic fluid embolism (AFE)
c.
Hemorrhage
d.
HELLP syndrome
ANS: A
The diagnosis of DIC is made according to clinical findings and laboratory markers.
Physical examination reveals unusual bleeding. Petechiae may appear around a blood
pressure cuff on the woman’s arm. Excessive bleeding may occur from the site of slight
trauma such as venipuncture sites. These symptoms are not associated with AFE, nor is
AFE a bleeding disorder. Hemorrhage occurs for a variety of reasons in the postpartum
client. These symptoms are associated with DIC. Hemorrhage would be a finding
associated with DIC and is not a clotting disorder in and of itself. HELLP is not a clotting
disorder, but it may contribute to the clotting disorder DIC.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 331
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
5. In caring for the woman with disseminated intravascular coagulation (DIC), what
order should the nurse anticipate?
a.
Administration of blood
b.
Preparation of the client for invasive hemodynamic monitoring
c.
Restriction of intravascular fluids
d.
Administration of steroids
ANS: A
Primary medical management in all cases of DIC involves correction of the underlying
cause, volume replacement, blood component therapy, optimization of oxygenation and
perfusion status, and continued reassessment of laboratory parameters. Central
monitoring would not be ordered initially in a client with DIC because this can contribute
to more areas of bleeding. Management of DIC would include volume replacement, not
volume restriction. Steroids are not indicated for the management of DIC.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 332
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
6. A primigravida is being monitored in her prenatal clinic for preeclampsia. What
finding should concern her nurse?
, NR 2313C EXAM Pregnancy at Risk: Gestational Conditions
QUESTIONS WITH COMPLETE SOLUTIONS 100% SOLVED
2023 A+
a.
Blood pressure (BP) increase to 138/86 mm Hg
b.
Weight gain of 0.5 kg during the past 2 weeks
c.
A dipstick value of 3+ for protein in her urine
d.
Pitting pedal edema at the end of the day
ANS: C
Proteinuria is defined as a concentration of 1+ or greater via dipstick measurement. A
dipstick value of 3+ should alert the nurse that additional testing or assessment should be
made. Generally, hypertension is defined as a BP of 140/90 or an increase in systolic
pressure of 30 mm Hg or in diastolic pressure of 15 mm Hg. Preeclampsia may be
manifested as a rapid weight gain of more than 2 kg in 1 week. Edema occurs in many
normal pregnancies and in women with preeclampsia. Therefore, the presence of edema
is no longer considered diagnostic of preeclampsia.
PTS: 1 DIF: Cognitive Level: Analysis REF: 303
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
7. The labor of a pregnant woman with preeclampsia is going to be induced. Before
initiating the Pitocin infusion, the nurse reviews the woman’s latest laboratory test
findings, which reveal a platelet count of 90,000, an elevated aspartate transaminase
(AST) level, and a falling hematocrit. The nurse notifies the physician because the
laboratory results are indicative of:
a.
Eclampsia.
b.
Disseminated intravascular coagulation (DIC).
c.
HELLP syndrome.
d.
Idiopathic thrombocytopenia.
ANS: C
HELLP syndrome is a laboratory diagnosis for a variant of severe preeclampsia that
involves hepatic dysfunction characterized by hemolysis (H), elevated liver enzymes
(EL), and low platelets (LP). Eclampsia is determined by the presence of seizures. DIC is
a potential complication associated with HELLP syndrome. Idiopathic thrombocytopenia
is the presence of low platelets of unknown cause and is not associated with
preeclampsia.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 306
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
8. A woman with preeclampsia has a seizure. The nurse’s primary duty during the
seizure is to:
a.
Insert an oral airway.
b.
Suction the mouth to prevent aspiration.
c.
Administer oxygen by mask.
d.
Stay with the client and call for help.
ANS: D
If a client becomes eclamptic, the nurse should stay her and call for help.
