Chapter 18 Pregnancy at Risk: Gestational Onset
1) The nurse is caring for a client who was just admitted to rule out ectopic
pregnancy. Which orders are the most important for the nurse to perform?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected. Select all that apply.
1. Assess the clients temperature.
2. Document the time of the clients last meal.
3. Obtain urine for urinalysis and culture.
4. Report complaints of dizziness or weakness.
5. Have the lab draw blood for B-hCG level every 48 hours.
Answer: 4, 5
Explanation: 4. Reporting complaints of dizziness and weakness is important,
as it can indicate hypovolemia from internal bleeding.
5. Having the lab draw blood for B-hCG levels every 48 hours is important,
as the level rises much more slowly in ectopic pregnancy than in normal
pregnancy.
Page Ref: 376, 377
Cognitive Level: Analyzing
Client Need/Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: V. B. 2. Demonstrate effective use of
strategies to reduce risk of harm to self or others. | 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: Implementation
Learning Outcome: 2 Contrast the etiology, medical therapy, and nursing
interventions for the various bleeding problems associated with pregnancy.
MNL LO: 2.7.2 Describe the causes of bleeding in early pregnancy and their
implications for nursing care.
1
Copyright 2016 Pearson Education, Inc.
,2) The nurse educator is presenting a class on the different kinds of
miscarriages. Miscarriages, or spontaneous abortions, are classified clinically
into which of the following different categories?
Note: Credit will be given only if all correct and no incorrect choices are
,selected.
Select all that apply.
1. Threatened abortion
2. Incomplete abortion
3. Complete abortion
4. Missed abortion
5. Acute abortion
Answer: 1, 2, 3, 4
Explanation: 1. Unexplained cramping, bleeding, or backache indicates the
fetus might be in jeopardy. This is a threatened abortion.
2. In an incomplete abortion, parts of the products of conception are retained,
most often the placenta.
3. In a complete abortion, all the products of conception are expelled. The
uterus is contracted and the cervical os may be closed.
4. In a missed abortion, the fetus dies in utero but is not expelled.
Page Ref: 374
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Management of Care
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3. Use
skills of inquiry, analysis, and information literacy to address practice issues. |
NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and (a) quality and safe patient care, (b) excellence in
nursing, and (c) advancement of the profession. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 1 Delineate the bleeding problems associated with
pregnancy.
MNL LO: 2.7.2 Describe the causes of bleeding in early pregnancy and their
implications for nursing care.
2
Copyright 2016 Pearson Education, Inc.
, 3) The nurse is presenting a class on the pathophysiology of the different
abortions. Some of the causes are which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Chromosomal abnormalities
2. Insufficient or excessive hormonal levels
3. Sexual intercourse in the first trimester
4. Infections in the first trimester
5. Cervical insufficiency
Answer: 1, 2, 4, 5
Explanation: 1. Chromosomal defects are generally seen as spontaneous
abortions during weeks 4 to 8.
2. Insufficient or excessive hormonal levels usually will result in spontaneous
abortion by 10 weeks gestation.
4. Infectious and environmental factors may also be seen in first trimester
pregnancy loss.
5. In late spontaneous abortion, the cause is usually a maternal factor, for
example, cervical insufficiency or maternal disease, and fetal death may not
precede the onset of abortion.
Page Ref: 373
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Safety and Infection
Control
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of
human growth and development, pathophysiology, pharmacology, medical
management, and nursing management across the health-illness continuum,
across lifespan and in all health care settings. | NLN Competencies: Quality and
Safety: Communicate potential risk factors and actual errors. |
Nursing/Integrated Concepts: Nursing Process: Assessment
1) The nurse is caring for a client who was just admitted to rule out ectopic
pregnancy. Which orders are the most important for the nurse to perform?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected. Select all that apply.
1. Assess the clients temperature.
2. Document the time of the clients last meal.
3. Obtain urine for urinalysis and culture.
4. Report complaints of dizziness or weakness.
5. Have the lab draw blood for B-hCG level every 48 hours.
Answer: 4, 5
Explanation: 4. Reporting complaints of dizziness and weakness is important,
as it can indicate hypovolemia from internal bleeding.
5. Having the lab draw blood for B-hCG levels every 48 hours is important,
as the level rises much more slowly in ectopic pregnancy than in normal
pregnancy.
Page Ref: 376, 377
Cognitive Level: Analyzing
Client Need/Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: V. B. 2. Demonstrate effective use of
strategies to reduce risk of harm to self or others. | 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: Implementation
Learning Outcome: 2 Contrast the etiology, medical therapy, and nursing
interventions for the various bleeding problems associated with pregnancy.
MNL LO: 2.7.2 Describe the causes of bleeding in early pregnancy and their
implications for nursing care.
1
Copyright 2016 Pearson Education, Inc.
,2) The nurse educator is presenting a class on the different kinds of
miscarriages. Miscarriages, or spontaneous abortions, are classified clinically
into which of the following different categories?
Note: Credit will be given only if all correct and no incorrect choices are
,selected.
Select all that apply.
1. Threatened abortion
2. Incomplete abortion
3. Complete abortion
4. Missed abortion
5. Acute abortion
Answer: 1, 2, 3, 4
Explanation: 1. Unexplained cramping, bleeding, or backache indicates the
fetus might be in jeopardy. This is a threatened abortion.
2. In an incomplete abortion, parts of the products of conception are retained,
most often the placenta.
3. In a complete abortion, all the products of conception are expelled. The
uterus is contracted and the cervical os may be closed.
4. In a missed abortion, the fetus dies in utero but is not expelled.
Page Ref: 374
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Management of Care
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: I. 3. Use
skills of inquiry, analysis, and information literacy to address practice issues. |
NLN Competencies: Knowledge and Science: Relationships between
knowledge/science and (a) quality and safe patient care, (b) excellence in
nursing, and (c) advancement of the profession. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 1 Delineate the bleeding problems associated with
pregnancy.
MNL LO: 2.7.2 Describe the causes of bleeding in early pregnancy and their
implications for nursing care.
2
Copyright 2016 Pearson Education, Inc.
, 3) The nurse is presenting a class on the pathophysiology of the different
abortions. Some of the causes are which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices
are selected.
Select all that apply.
1. Chromosomal abnormalities
2. Insufficient or excessive hormonal levels
3. Sexual intercourse in the first trimester
4. Infections in the first trimester
5. Cervical insufficiency
Answer: 1, 2, 4, 5
Explanation: 1. Chromosomal defects are generally seen as spontaneous
abortions during weeks 4 to 8.
2. Insufficient or excessive hormonal levels usually will result in spontaneous
abortion by 10 weeks gestation.
4. Infectious and environmental factors may also be seen in first trimester
pregnancy loss.
5. In late spontaneous abortion, the cause is usually a maternal factor, for
example, cervical insufficiency or maternal disease, and fetal death may not
precede the onset of abortion.
Page Ref: 373
Cognitive Level: Understanding
Client Need/Sub: Health Promotion and Maintenance: Safety and Infection
Control
Standards: QSEN Competencies: I. A. 1. Integrate understanding of multiple
dimensions of patient-centered care. | AACN Essentials Competencies: IX. 3.
Implement holistic, patient-centered care that reflects an understanding of
human growth and development, pathophysiology, pharmacology, medical
management, and nursing management across the health-illness continuum,
across lifespan and in all health care settings. | NLN Competencies: Quality and
Safety: Communicate potential risk factors and actual errors. |
Nursing/Integrated Concepts: Nursing Process: Assessment
