Test Bank For Olds Maternal-Newborn Nursing and Womens
Health Across the Lifespan, 11th Edition (Davidson, 2020),
Chapter 1- / All Chapters with Answers
and Rationals
The nurse is caring for a pregnant woman who admits to using cocaine and ecstasy on a regular basis.
The client states, "Everybody knows that alcohol is bad during pregnancy, but what's the big deal
about ecstasy?" What is the nurse's best response?
1. "Ecstasy can cause a high fever in you and therefore cause the baby harm."
2. "Ecstasy leads to deficiencies of thiamine and folic acid, which help the baby develop."
3. "Ecstasy produces babies with small heads and short bodies with brain function alterations."
4. "Ecstasy produces intrauterine growth restriction and meconium aspiration." - ANSWER: Answer: 1
Explanation: 1. Hyperthermia (elevated temperature) is a side effect of MDMA (ecstasy).
The nurse is doing preconception counseling with a 28-year-old woman with no prior pregnancies.
Which statement made by the client indicates to the nurse that the client has understood the
teaching?
1. "I can continue to drink alcohol until I am diagnosed as pregnant."
2. "I need to stop drinking alcohol completely when I start trying to get pregnant."
3. "A beer once a week will not damage the fetus."
4. "I can drink alcohol while breastfeeding because it doesn't pass into breast milk." - ANSWER:
Answer: 2
Explanation: 2. Women should discontinue drinking alcohol when they start to attempt to become
pregnant due to possible effects of alcohol on the fetus.
A woman's history and appearance suggest drug abuse. What is the nurse's best approach?
1. Ask the woman directly, "Do you use any street drugs?"
2. Ask the woman whether she would like to talk to a counselor.
3. Ask some questions about over-the-counter medications and avoid mention of illicit drugs.
4. Explain how harmful drugs can be for her baby. - ANSWER: Answer: 1
Explanation: 1. If drug abuse is suspected, the nurse should ask direct questions and be matter-of-fact
and nonjudgmental to elicit honest responses.
A 20-year-old woman is at 28 weeks' gestation. Her prenatal history reveals past drug abuse, and
urine screening indicates that she has recently used heroin. The nurse should recognize that the
woman is at increased risk for which condition?
1. Erythroblastosis fetalis
2. Diabetes mellitus
3. Abruptio placentae
4. Pregnancy-induced hypertension - ANSWER: Answer: 4
Explanation: 4. Women who use heroin are at risk for poor nutrition, anemia, and pregnancy-induced
hypertension (or preeclampsia-eclampsia).
The nurse is working with a woman who abuses stimulants. The nurse is aware that the fetus is at risk
for which of the following?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Withdrawal symptoms
2. Cardiac anomalies
3. Sudden infant death syndrome
4. Being small for gestational age
5. Fetal alcohol syndrome - ANSWER: Answer: 1, 2, 3, 4
Explanation: 1. Infants born to mothers who abuse stimulants such as amphetamines can have
withdrawal symptoms.
, 2. Infants born to mothers who abuse stimulants such as cocaine can be born with cardiac anomalies.
3. Infants born to mothers who abuse stimulants such as cocaine can have sudden infant death
syndrome.
4. Infants born to mothers who abuse stimulants such as nicotine can be small for gestational age.
The nurse is assessing a woman at 10 weeks' gestation who is addicted to alcohol. The woman asks
the nurse, "What is the point of stopping drinking now if my baby probably has been hurt by it
already?" What is the best response by the nurse?
1. "It won't help your baby, but you will feel better during your pregnancy if you stop now."
2. "If you stop now, you and your baby have less chance of serious complications."
3. "If you limit your drinking to once a week, your baby will be okay."
4. "You might as well stop it now, because once your baby is born, you'll have to give up alcohol if you
plan on breastfeeding." - ANSWER: Answer: 2
Explanation: 2. Chronic abuse of alcohol can undermine maternal health by causing malnutrition,
bone marrow suppression, increased incidence of infections, and liver disease. The effects of alcohol
on the fetus may result in fetal alcohol spectrum disorders (FASD).
The client has just been diagnosed as diabetic. The nurse knows teaching was effective when the
client makes which statement?
1. "Ketones in my urine mean that my body is using the glucose appropriately."
2. "I should be urinating frequently and in large amounts to get rid of the extra sugar."
3. "My pancreas is making enough insulin, but my body isn't using it correctly."
4. "I might be hungry frequently because the sugar isn't getting into the tissues the way it should." -
ANSWER: Answer: 4
Explanation: 4. The client who understands the disease process is aware that if the body is not getting
the glucose it needs, the message of hunger will be sent to the brain.
The client with insulin-dependent type 2 diabetes and an HbA1c of 5.0% is planning to become
pregnant soon. What anticipatory guidance should the nurse provide this client?
1. Insulin needs decrease in the first trimester and usually begin to rise late in the first trimester as
glucose use and glycogen storage by the woman and fetus increase.
2. The risk of ketoacidosis decreases during the length of the pregnancy.
3. Vascular disease that accompanies diabetes slows progression.
4. The baby is likely to have a congenital abnormality because of the diabetes. - ANSWER: Answer: 1
Explanation: 1. Insulin needs decrease in the first trimester and usually begin to rise late in the first
trimester as glucose use and glycogen storage by the woman and fetus increase.
A newly diagnosed insulin-dependent type 1 diabetic with good blood sugar control is at 20 weeks'
gestation. She asks the nurse how her diabetes will affect her baby. What would the best explanation
include?
1. "Your baby could be smaller than average at birth."
2. "Your baby will probably be larger than average at birth."
3. "As long as you control your blood sugar, your baby will not be affected at all."
4. "Your baby might have high blood sugar for several days." - ANSWER: Answer: 2
Explanation: 2. Characteristically, infants of mothers with diabetes are large for gestational age (LGA)
as a result of high levels of fetal insulin production stimulated by the high levels of glucose crossing
the placenta from the mother. Sustained fetal hyperinsulinism and hyperglycemia ultimately lead to
excessive growth, called macrosomia, and deposition of fat.
A 26-year-old client is 28 weeks pregnant. She has developed gestational diabetes. She is following a
program of regular exercise, which includes walking, bicycling, and swimming. What instructions
should be included in a teaching plan for this client?
1. "Exercise either just before meals or wait until 2 hours after a meal."
2. "Carry hard candy (or other simple sugar) when exercising."
3. "If your blood sugar is 120 mg/dL, eat 20 g of carbohydrate."
4. "If your blood sugar is more than 120 mg/dL, drink a glass of whole milk." - ANSWER: Answer: 2
Health Across the Lifespan, 11th Edition (Davidson, 2020),
Chapter 1- / All Chapters with Answers
and Rationals
The nurse is caring for a pregnant woman who admits to using cocaine and ecstasy on a regular basis.
The client states, "Everybody knows that alcohol is bad during pregnancy, but what's the big deal
about ecstasy?" What is the nurse's best response?
1. "Ecstasy can cause a high fever in you and therefore cause the baby harm."
2. "Ecstasy leads to deficiencies of thiamine and folic acid, which help the baby develop."
3. "Ecstasy produces babies with small heads and short bodies with brain function alterations."
4. "Ecstasy produces intrauterine growth restriction and meconium aspiration." - ANSWER: Answer: 1
Explanation: 1. Hyperthermia (elevated temperature) is a side effect of MDMA (ecstasy).
The nurse is doing preconception counseling with a 28-year-old woman with no prior pregnancies.
Which statement made by the client indicates to the nurse that the client has understood the
teaching?
1. "I can continue to drink alcohol until I am diagnosed as pregnant."
2. "I need to stop drinking alcohol completely when I start trying to get pregnant."
3. "A beer once a week will not damage the fetus."
4. "I can drink alcohol while breastfeeding because it doesn't pass into breast milk." - ANSWER:
Answer: 2
Explanation: 2. Women should discontinue drinking alcohol when they start to attempt to become
pregnant due to possible effects of alcohol on the fetus.
A woman's history and appearance suggest drug abuse. What is the nurse's best approach?
1. Ask the woman directly, "Do you use any street drugs?"
2. Ask the woman whether she would like to talk to a counselor.
3. Ask some questions about over-the-counter medications and avoid mention of illicit drugs.
4. Explain how harmful drugs can be for her baby. - ANSWER: Answer: 1
Explanation: 1. If drug abuse is suspected, the nurse should ask direct questions and be matter-of-fact
and nonjudgmental to elicit honest responses.
A 20-year-old woman is at 28 weeks' gestation. Her prenatal history reveals past drug abuse, and
urine screening indicates that she has recently used heroin. The nurse should recognize that the
woman is at increased risk for which condition?
1. Erythroblastosis fetalis
2. Diabetes mellitus
3. Abruptio placentae
4. Pregnancy-induced hypertension - ANSWER: Answer: 4
Explanation: 4. Women who use heroin are at risk for poor nutrition, anemia, and pregnancy-induced
hypertension (or preeclampsia-eclampsia).
The nurse is working with a woman who abuses stimulants. The nurse is aware that the fetus is at risk
for which of the following?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Withdrawal symptoms
2. Cardiac anomalies
3. Sudden infant death syndrome
4. Being small for gestational age
5. Fetal alcohol syndrome - ANSWER: Answer: 1, 2, 3, 4
Explanation: 1. Infants born to mothers who abuse stimulants such as amphetamines can have
withdrawal symptoms.
, 2. Infants born to mothers who abuse stimulants such as cocaine can be born with cardiac anomalies.
3. Infants born to mothers who abuse stimulants such as cocaine can have sudden infant death
syndrome.
4. Infants born to mothers who abuse stimulants such as nicotine can be small for gestational age.
The nurse is assessing a woman at 10 weeks' gestation who is addicted to alcohol. The woman asks
the nurse, "What is the point of stopping drinking now if my baby probably has been hurt by it
already?" What is the best response by the nurse?
1. "It won't help your baby, but you will feel better during your pregnancy if you stop now."
2. "If you stop now, you and your baby have less chance of serious complications."
3. "If you limit your drinking to once a week, your baby will be okay."
4. "You might as well stop it now, because once your baby is born, you'll have to give up alcohol if you
plan on breastfeeding." - ANSWER: Answer: 2
Explanation: 2. Chronic abuse of alcohol can undermine maternal health by causing malnutrition,
bone marrow suppression, increased incidence of infections, and liver disease. The effects of alcohol
on the fetus may result in fetal alcohol spectrum disorders (FASD).
The client has just been diagnosed as diabetic. The nurse knows teaching was effective when the
client makes which statement?
1. "Ketones in my urine mean that my body is using the glucose appropriately."
2. "I should be urinating frequently and in large amounts to get rid of the extra sugar."
3. "My pancreas is making enough insulin, but my body isn't using it correctly."
4. "I might be hungry frequently because the sugar isn't getting into the tissues the way it should." -
ANSWER: Answer: 4
Explanation: 4. The client who understands the disease process is aware that if the body is not getting
the glucose it needs, the message of hunger will be sent to the brain.
The client with insulin-dependent type 2 diabetes and an HbA1c of 5.0% is planning to become
pregnant soon. What anticipatory guidance should the nurse provide this client?
1. Insulin needs decrease in the first trimester and usually begin to rise late in the first trimester as
glucose use and glycogen storage by the woman and fetus increase.
2. The risk of ketoacidosis decreases during the length of the pregnancy.
3. Vascular disease that accompanies diabetes slows progression.
4. The baby is likely to have a congenital abnormality because of the diabetes. - ANSWER: Answer: 1
Explanation: 1. Insulin needs decrease in the first trimester and usually begin to rise late in the first
trimester as glucose use and glycogen storage by the woman and fetus increase.
A newly diagnosed insulin-dependent type 1 diabetic with good blood sugar control is at 20 weeks'
gestation. She asks the nurse how her diabetes will affect her baby. What would the best explanation
include?
1. "Your baby could be smaller than average at birth."
2. "Your baby will probably be larger than average at birth."
3. "As long as you control your blood sugar, your baby will not be affected at all."
4. "Your baby might have high blood sugar for several days." - ANSWER: Answer: 2
Explanation: 2. Characteristically, infants of mothers with diabetes are large for gestational age (LGA)
as a result of high levels of fetal insulin production stimulated by the high levels of glucose crossing
the placenta from the mother. Sustained fetal hyperinsulinism and hyperglycemia ultimately lead to
excessive growth, called macrosomia, and deposition of fat.
A 26-year-old client is 28 weeks pregnant. She has developed gestational diabetes. She is following a
program of regular exercise, which includes walking, bicycling, and swimming. What instructions
should be included in a teaching plan for this client?
1. "Exercise either just before meals or wait until 2 hours after a meal."
2. "Carry hard candy (or other simple sugar) when exercising."
3. "If your blood sugar is 120 mg/dL, eat 20 g of carbohydrate."
4. "If your blood sugar is more than 120 mg/dL, drink a glass of whole milk." - ANSWER: Answer: 2
