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ANSWER THE FOLLOWING QUESTION A. After a dilatation and curettage (D&C) to evacuate a molar pregnancy, assessing the client for signs and symptoms of which of the following would be most important? 1. Urinary tract infection 2. Hemorrhage 3.Abdominal distention 4. Chorioamnionitis B. A 28-year-old multipara client is admitted to the hospital for observation during the 10th week of pregnancy. The client has a history of habitual spontaneous abortions. Which findings reported by the client at this time suggest there is a threat of aborting the fetus except? 1. Persistent tachycardia 2. Mild irregular uterine cramping 3. Discomfort in the lower back 4. Vaginal bleeding or spotting C. The physician examines the client and determines that the cervix is dilated but the fetus and placenta are still in the uterus. Which nursing intervention is most appropriate when a spontaneous abortion is inevitable? 1. Prepare the client for dilation and curettage (D&C). 2.Place the client in Trendelenburg’s position 3. Prepare the client for placement of a purse-string stitch 4. Place the client in the side-lying position D. With plans to breast-feed her neonate, a pregnant client with insulin-dependent diabetes asks the nurse about insulin needs during the postpartum period. Which of the following statements about postpartal insulin requirements for breastfeeding mothers should the nurse include in the explanation? 1. They fall significantly in the immediate post-partum period 2.They remain the same as during the labor process 3.They usually increase in the immediate postpartum period 4.They need constant adjustment during the first 24 hours E. The client comments to the nurse, “This is like a recurring nightmare. This same thing happened during my last two pregnancies. I don’t want to lose another baby.” Which response by the nurse is most appropriate at this time? 1. “I know this is disappointing. Would you like to talk about how you are feeling?” 2. “Be positive. You are young enough to have additional pregnancies. 3. “I know you are scared, but stress will only make the situation worse.” 4.”Trust me; everything will work out for the best in the end.” F. A 50-year-old widower is admitted to the hospital with a diagnosis of diabetes mellitus and complaints of rapid-onset weight loss, elevated blood glucose levels, and polyphagia, the gerontology nurse should anticipate which of the following secondary medical diagnoses? 1. Impaired glucose tolerance 2. Gestational diabetes mellitus 3. Pituitary tumor 4. Pancreatic tumor G. A 27-year-old primigravid client with insulin-dependent diabetes at 34 weeks’ gestation undergoes a nonstress test, the results of which are documented as reactive. The nurse should tell the client that the test results indicate which of the following? 1. A contraction stress test is necessary 2. The nonstress test should be repeated 3. Chorionic villus sampling is necessary 4. There is evidence of fetal well-being H. A woman presents to the emergency department complaining of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary health care provider finds that the cervix is closed. The anticipated plan of care for this woman is based on a probable diagnosis of which type of spontaneous abortion? 1. Incomplete 2. Inevitable 3. Threatened 4. Septic I. The client also asks the nurse what kinds of diabetes related complications can be expected during pregnancy. The nurse correctly informs the client that diabetics are at risk for developing which condition? 1. Hyperemesis gravidarum 2. Pre-eclampsia 3. Placenta previa 4. Toxoplasmosis J. A nurse is discussing potential health issues that may affect the fetus of a new mother with gestational diabetes mellitus. Which of the following statements by the nurse is the most accurate pertaining to health issues that affect the fetus with a diabetic mother? 1. “Your baby may have birth defects of the heart. This is caused by high levels of glycogen in your body, which is actually a teratogen.” 2. “Your baby may have birth defects of the heart and brain This is caused by high levels of glycogen in your body, which is actually a teratogen.’ 3. “Your baby may have birth defects of the heart, brain, neural tube, and extremities. This is caused by high levels of glycogen in your 4. None of the Above K. A 30-year-old multigravid client at 8 weeks’ gestation has a history of insulin-dependent diabetes since age 20. When explaining about the importance of blood glucose control during pregnancy, the nurse should tell the client that which of the following will occur regarding the client’s insulin needs during the first trimester? 1. They will increase 2. They will decrease 3. They will remain constant 4. They will be unpredictable L. A 21-year-old multigravid client who is 8 months pregnant is admitted to the obstetric unit for observation. The admission diagnosis is partial placenta previa. The client’s partner asks the nurse, “What is placenta previa?” Which response by the nurse provides the best explanation regarding placenta previa? 1. “The placenta is implanted over or close to the internal cervical opening.” 2. “The placenta isn’t producing the hormones needed to maintain the pregnancy.” 3. “The placenta is invaded by polyps that cause premature uterine contractions.” 4. “The placenta is producing antibodies that are destroying the baby’s red blood cells.” M. After teaching a diabetic primigravida about symptoms of hyperglycemia and hypoglycemia, the nurse determines that the client understands the instruction when she says that hyperglycemia may be manifested by which of the following? 1. Dehydration 2. Pallor 3. Sweating 4. Nervousness N. A primigravida admitted to the hospital with a diagnosis of hyperemesis gravidarum is placed on nothing-by-mouth (NPO) status and is receiving intravenous (IV) fluid replacement therapy. In planning this client’s care, the nurse should collaborate with the health care provider (HCP) to carry out which of the following? 1. Withhold oral fluids indefinitely until acidosis is corrected 2. Give oral fluids in small quantities whenever the client desires 3. Per HCP orders, provide clear liquids by mouth after 24 hours if vomiting subsides 4. Withhold oral fluids until total parenteral nutrition replaces lost electrolytes. O. A multigravid client is admitted at 16 weeks’ gestation with a diagnosis of hyperemesis gravidarum. The nurse should explain to the client that hyperemesis gravidarum is thought to be related to high levels of which of the following hormones? 1. Progesterone 2. HCG 3. Somatotropin 4. Aldosterone

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