Obstetrical Nursing – Antepartum – NCLEX Quiz 5

1. The antagonist for magnesium sulfate should be readily available to any client receiving IV magnesium. Which of the following drugs is the antidote for magnesium toxicity?

Calcium gluconate

Hydralazine (Apresoline)

Narcan

RhoGAM

Calcium gluconate is the antidote for magnesium toxicity. Ten ml of 10% calcium gluconate is given IV push over 3-5 minutes. Hydralazine is given for sustained elevated blood pressures in preeclamptic clients.

Explanation

Calcium gluconate is the antidote for magnesium toxicity. Ten ml of 10% calcium gluconate is given IV push over 3-5 minutes. Hydralazine is given for sustained elevated blood pressures in preeclamptic clients.

2. A 21-year old client. 6 weeks' pregnant is diagnosed with hyperemesis gravidarum. This excessive vomiting during pregnancy will often result in which of the following conditions?

Bowel perforation

Electrolyte imbalance

Miscarriage

Pregnancy induced hypertension (PIH)

Excessive vomiting in clients with hyperemesis gravidarum often causes weight loss and fluid. electrolyte. and acid-base imbalances.

Explanation

Excessive vomiting in clients with hyperemesis gravidarum often causes weight loss and fluid. electrolyte. and acid-base imbalances.

3. Gravida refers to which of the following descriptions?

A serious pregnancy

Number of times a female has been pregnant

Number of children a female has delivered

Number of term pregnancies a female has had.

Gravida refers to the number of times a female has been pregnant. regardless of pregnancy outcome or the number of neonates delivered.

Explanation

Gravida refers to the number of times a female has been pregnant. regardless of pregnancy outcome or the number of neonates delivered.

4. Which of the following conditions is common in pregnant women in the 2nd trimester of pregnancy?

Mastitis

Metabolic alkalosis

Physiologic anemia

Respiratory acidosis

Hemoglobin and hematocrit levels decrease during pregnancy as the increase in plasma volume exceeds the increase in red blood cell production.

Explanation

Hemoglobin and hematocrit levels decrease during pregnancy as the increase in plasma volume exceeds the increase in red blood cell production.

5. Which of the following symptoms occurs with a hydatidiform mole?

Heavy. bright red bleeding every 21 days

Fetal cardiac motion after 6 weeks gestation

Benign tumors found in the smooth muscle of the uterus

“Snowstorm” pattern on ultrasound with no fetus or gestational sac

The chorionic villi of a molar pregnancy resemble a snowstorm pattern on ultrasound. Bleeding with a hydatidiform mole is often dark brown and may occur erratically for weeks or months.

Explanation

The chorionic villi of a molar pregnancy resemble a snowstorm pattern on ultrasound. Bleeding with a hydatidiform mole is often dark brown and may occur erratically for weeks or months.

6. A pregnant woman's last menstrual period began on April 8. 2005. and ended on April 13. Using Naegele's rule her estimated date of birth would be:

1/15/2006

1/20/2006

07/01/2006

11/05/2005

Naegele’s rule requires subtracting 3 months and adding 7 days and 1 year if appropriate to the first day of a pregnant woman’s last menstrual period. When this rule is used with April 8. 2005. the estimated date of birth is January 15. 2006.

Explanation

Naegele’s rule requires subtracting 3 months and adding 7 days and 1 year if appropriate to the first day of a pregnant woman’s last menstrual period. When this rule is used with April 8. 2005. the estimated date of birth is January 15. 2006.

7. A pregnant woman at 32 weeks' gestation complains of feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. The nurse's initial response would be to:

Assess the woman’s blood pressure and pulse

Have the woman breathe into a paper bag

Raise the woman’s legs

Turn the woman on her left side.

During a fundal height measurement. the woman is placed in a supine position. This woman is experiencing supine hypotension as a result of uterine compression of the vena cava and abdominal aorta. Turning her on her side will remove the compression and restore cardiac output and blood pressure.Option A: After turning the client on the side. then vital signs can be assessed.Option B: Breathing into a paper bag is the solution for dizziness related to respiratory alkalosis associated with hyperventilation.Option C: Raising her legs will not solve the problem since pressure will remain on the major abdominal blood vessels. thereby continuing to impede cardiac output.

Explanation

During a fundal height measurement. the woman is placed in a supine position. This woman is experiencing supine hypotension as a result of uterine compression of the vena cava and abdominal aorta. Turning her on her side will remove the compression and restore cardiac output and blood pressure.Option A: After turning the client on the side. then vital signs can be assessed.Option B: Breathing into a paper bag is the solution for dizziness related to respiratory alkalosis associated with hyperventilation.Option C: Raising her legs will not solve the problem since pressure will remain on the major abdominal blood vessels. thereby continuing to impede cardiac output.

8. Clients with gestational diabetes are usually managed by which of the following therapies?

Diet

NPH insulin (long-acting)

Oral hypoglycemic drugs

Oral hypoglycemic drugs and insulin

Clients with gestational diabetes are usually managed by diet alone to control their glucose intolerance. Oral hypoglycemic agents are contraindicated in pregnancy. NPH isn’t usually needed for blood glucose control for GDM.

Explanation

Clients with gestational diabetes are usually managed by diet alone to control their glucose intolerance. Oral hypoglycemic agents are contraindicated in pregnancy. NPH isn’t usually needed for blood glucose control for GDM.

9. Which of the following answers best describes the stage of pregnancy in which maternal and fetal blood are exchanged?

Conception

9 weeks’ gestation. when the fetal heart is well developed

32-34 weeks gestation

Maternal and fetal blood are never exchanged

Only nutrients and waste products are transferred across the placenta. Blood exchange only occurs in complications and some medical procedures accidentally.

Explanation

Only nutrients and waste products are transferred across the placenta. Blood exchange only occurs in complications and some medical procedures accidentally.

10. Which of the following terms applies to the tiny. blanched. slightly raised end arterioles found on the face. neck. arms. and chest during pregnancy?

Epulis

Linea nigra

Striae gravidarum

Telangiectasias

The dilated arterioles that occur during pregnancy are due to the elevated level of circulating estrogen. The linea nigra is a pigmented line extending from the symphysis pubis to the top of the fundus during pregnancy.

Explanation

The dilated arterioles that occur during pregnancy are due to the elevated level of circulating estrogen. The linea nigra is a pigmented line extending from the symphysis pubis to the top of the fundus during pregnancy.