Chapter 17 Pregnancy at Risk: Pregestational
Problems
1) 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 whats the big deal about ecstasy? What is the
nurses 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: 1
Explanation: 1. Hyperthermia (elevated temperature) is a side effect of
MDMA (ecstasy).
Page Ref: 355
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: V. B. 4. Communicate observations or
concerns related to hazards and errors to patients, families, and the health
care team. | AACN Essentials Competencies: IX. 12. Create a safe environment
that results in high quality patient outcomes. | NLN Competencies: Quality and
Safety: Communicate potential risk factors and actual errors. |
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1 Summarize the effects of alcohol and illicit drugs on
the childbearing woman and her fetus/newborn.
MNL LO: 2.6.3 Determine strategies for managing the care of the pregnant
woman who abuses substances.
1
Copyright 2016 Pearson Education, Inc.
,2) 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 doesnt pass into breast
milk.
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.
Page Ref: 354
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, culture,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
Centered Care: Communicate information effectively; listen openly and
cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 1 Summarize the effects of alcohol and illicit drugs on
the childbearing woman and her fetus/newborn.
MNL LO: 2.6.3 Determine strategies for managing the care of the pregnant
woman who abuses substances.
3) A womans history and appearance suggest drug abuse. What is the nurses
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: 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.
Problems
1) 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 whats the big deal about ecstasy? What is the
nurses 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: 1
Explanation: 1. Hyperthermia (elevated temperature) is a side effect of
MDMA (ecstasy).
Page Ref: 355
Cognitive Level: Applying
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: V. B. 4. Communicate observations or
concerns related to hazards and errors to patients, families, and the health
care team. | AACN Essentials Competencies: IX. 12. Create a safe environment
that results in high quality patient outcomes. | NLN Competencies: Quality and
Safety: Communicate potential risk factors and actual errors. |
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 1 Summarize the effects of alcohol and illicit drugs on
the childbearing woman and her fetus/newborn.
MNL LO: 2.6.3 Determine strategies for managing the care of the pregnant
woman who abuses substances.
1
Copyright 2016 Pearson Education, Inc.
,2) 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 doesnt pass into breast
milk.
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.
Page Ref: 354
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum
and Newborn Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated
surrogates in active partnerships that promote health, safety and well-being, and
self-care management. | AACN Essentials Competencies: IX. 7. Provide
appropriate patient teaching that reflects developmental stage, age, culture,
spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-
Centered Care: Communicate information effectively; listen openly and
cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 1 Summarize the effects of alcohol and illicit drugs on
the childbearing woman and her fetus/newborn.
MNL LO: 2.6.3 Determine strategies for managing the care of the pregnant
woman who abuses substances.
3) A womans history and appearance suggest drug abuse. What is the nurses
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: 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.
