Maternal Adaptations And Complications Quiz

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Maternal Adaptations And Complications Quiz - Quiz

Pregnancy is a wonderful time in a woman's life. Unfortunately, it's bridled with complications. How aware are you of maternal adaptation and complications? Why not take this informative quiz and find it out yourself? Please make sure to read all the questions very carefully before answering. All the questions must be answered. You are given four choices out of which only one is correct, make sure to pick the correct answer. There is no time limit on the quiz, hence you can take the quiz whenever you may need to refresh your knowledge. Good luck & keep learning!


Questions and Answers
  • 1. 

    A client in the 28th week of gestation comes to the emergency department because she thinks that she's in labor. To confirm the diagnosis of PRETERM LABOR, the nurse would expect the physical examinations to reveal: Client's needs category: Physiological integrity Client's need subcategory: Physiological adaptation Cognitive level: Knowledge

    • A.

      Irregular uterine contractions with no cervical dilation

    • B.

      Painful contractions with cervical dilation

    • C.

      Regular uterine dilation with cervical dilation

    • D.

      Regular uterine contractions without cervical dilation

    Correct Answer
    C. Regular uterine dilation with cervical dilation
    Explanation
    Regular uterine contractions (every 10 minutes or more) along with cervical dilation before 36 weeks' gestation or rupture of fluids indicates preterm labor.

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  • 2. 

    A client in the active phase of labor has a reactive fetal monitor strip and has been encouraged to walk. When she returns to bed for a monitor check, she complains for an urge to push. The nurse notes that the amniotic membranes have ruptured and she can visualize the umbilical cord. What should the nurse do next? Client's needs category: Physiological Integrity Client's needs subcategory: Reduction of risk potential Cognitive level: Analysis

    • A.

      Put the client in a knee-to-chest position

    • B.

      Call the physician or midwife because it is emergent

    • C.

      Push down on the uterine fundus

    • D.

      Arrange for fetal blood sampling to assess for fetal acidosis

    Correct Answer
    A. Put the client in a knee-to-chest position
    Explanation
    The knee to chest position gets the weight off the baby and umbilical cord, which would prevent blood flow. Calling the physician or midwife, and arranging for blood sampling are IMPORTANT, but they have a lower priority than getting the baby off the cord.

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  • 3. 

    A client is attempting to deliver vaginally despite the fact that her previous delivery was by cesarean delivery. Her contractions are 2 to 3 minutes apart, lasting from 75 to 100 seconds. Suddenly, the client complains of intense abdominal pain, and the fetal monitor stops picking up contractions. The nurse recognizes that which of the following events may have occured? Client's needs category: Physiological Integrity Cognitive level: Application

    • A.

      Abruptio placentae

    • B.

      Prolapsed cord

    • C.

      Partial placenta previa

    • D.

      Complete uterine rupture

    Correct Answer
    D. Complete uterine rupture
    Explanation
    With complete uterine contraction, the client would feel a sharp pain in the lower abdomen and contractions would cease. FHR would also cease within a few minutes.

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  • 4. 

    A client with gravida 3 para 2 at 40 weeks' gestation is admitted with spontaneous contractions. The physician performs an amniotomy to augment her labor. The PRIORITY nursing action is to: Client's needs category: Physiological Integrity Cognitive level: Knowledge

    • A.

      Explain the rationale for the amniotomy to the patient

    • B.

      Monitor fetal heart tones after the amniotomy

    • C.

      Ambulate the client to strengthen the contraction pattern

    • D.

      Position the client in a lithotomy position to administer perineal care

    Correct Answer
    B. Monitor fetal heart tones after the amniotomy
    Explanation
    The nurse should first monitor fetal heart tone. After an amniotomy is performed, the umbilical cord may be washed down below the presenting part and cause umbilical cord compression, which would indicate by vitiable deceleration on the fetal heart tracing.

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  • 5. 

    The characteristics of the HELLP syndrome are: Select all that apply. Cognitive level: Analysis and Knowledge

    • A.

      Hemolysis (blood destruction)

    • B.

      Elevated liver enzyme

    • C.

      Hypertension and generalized edema

    • D.

      Low platelet count

    • E.

      Proteinuria

    • F.

      It is usually occurring before the 37th weeks' gestation

    Correct Answer(s)
    A. Hemolysis (blood destruction)
    B. Elevated liver enzyme
    D. Low platelet count
    F. It is usually occurring before the 37th weeks' gestation
    Explanation
    HELLP syndrome is characterized by:
    1. Hemolysis
    2. Elevated liver enzyme
    3. Low platelet count
    4. usually occurring before the 37th weeks' gestation

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  • 6. 

    What are the manifestations of Hypertension in pregnancy (Preeclampsia)? Select all that apply.

    • A.

      Systolic blood pressure greater than 140 or diastolic blood pressure greater than 90

    • B.

      Proteinuria

    • C.

      Weight gain

    • D.

      Decreased urine output

    • E.

      Presence of HELLP syndrome

    • F.

      Headaches, blurred vision, hyperreflexia, nausea, vomiting

    Correct Answer(s)
    A. Systolic blood pressure greater than 140 or diastolic blood pressure greater than 90
    B. Proteinuria
    C. Weight gain
    D. Decreased urine output
    E. Presence of HELLP syndrome
    F. Headaches, blurred vision, hyperreflexia, nausea, vomiting
    Explanation
    The manifestations of hypertension in pregnancy (preeclampsia) include systolic blood pressure greater than 140 or diastolic blood pressure greater than 90, proteinuria, weight gain, decreased urine output, presence of HELLP syndrome, and symptoms such as headaches, blurred vision, hyperreflexia, nausea, and vomiting. These symptoms and signs are indicative of the development of preeclampsia, a condition characterized by high blood pressure and organ damage during pregnancy.

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  • 7. 

    A 36 years old pregnant patient (is on her 36th weeks of gestation) has been diagnosed with hypertension with a blood pressure of 140/90 for the past two weeks has been admitted to the labor and delivery department. Suddenly within the first 24 hours of her stay, the patient described a bright red bleeding on her drape. The nurse ask about her pain level, the patient rated her pain as 1 out of 10. What are the necessary nursing intervention you need to provide for this patient? Select all that apply. 

    • A.

      Monitor maternal Vital Signs, including uterine activity

    • B.

      Monitor signs of infection

    • C.

      Monitor fetal heart rate

    • D.

      Obtain a blood glucose from the patient

    • E.

      Provide vitamin K because the patient is bleeding severely

    • F.

      Administer 2 Tylenol as needed order

    Correct Answer(s)
    A. Monitor maternal Vital Signs, including uterine activity
    B. Monitor signs of infection
    C. Monitor fetal heart rate
    Explanation
    To evaluate maternal well-being, we need to monitor maternal vital signs, including uterine activity. Patients with placenta previa are at increased risk for infection. We need to monitor fetal heart rate to detect complications. You don't need to take her blood glucose, administer vitamin K and tylenol to the patient which will further compromised the condition of the patient.

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  • 8. 

    What is the condition called whereby the placenta is implanted in the lower uterine segment. It can be classified as partially, totally, or marginal.?

    Correct Answer(s)
    placenta previa
    Placenta previa
    Explanation
    Placenta previa is the condition where the placenta is implanted in the lower uterine segment. It can be classified as partially, totally, or marginal.

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  • 9. 

    It is th partial or complete premature detachment of the placenta from its site of implantation in the uterus. It is usually occuring in the late third trimester or in labor.

    Correct Answer(s)
    abruptio placentae
    Abruptio placentae
    Explanation
    Abruptio placentae refers to the partial or complete premature detachment of the placenta from its site of implantation in the uterus. It typically occurs in the late third trimester of pregnancy or during labor.

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  • 10. 

    What the do you call the procedure whereby the OB/GYN physician removes amniotic fluid sample from the uterus during 14th to 16 th weeks of gestation?

    Correct Answer(s)
    amniocentesis
    Amniocentesis
    Explanation
    Amniocentesis is the procedure in which an OB/GYN physician removes a sample of amniotic fluid from the uterus during the 14th to 16th weeks of gestation. This procedure is performed to diagnose genetic abnormalities or fetal infections. It involves inserting a thin needle through the abdomen into the uterus to collect the fluid. The fluid is then analyzed to provide information about the baby's health and development.

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  • 11. 

    What is the procedure called whereby the physician removes a small piece of villi between 8 to 12 weeks' gestation under ultrasound guidance?

    Correct Answer(s)
    Chorionic villi sampling
    chorionic villi sampling
    Explanation
    Chorionic villi sampling is a procedure in which a small piece of villi, which are finger-like projections in the placenta, is removed between 8 to 12 weeks' gestation under ultrasound guidance. This procedure is used to diagnose genetic disorders and chromosomal abnormalities in the fetus. It involves inserting a thin tube or needle through the cervix or abdomen to collect a sample of the chorionic villi. The sample is then analyzed in a laboratory to provide information about the baby's health.

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  • 12. 

    The LPN is helping the RN to complete the necessary assessment data on the Biophysical Profile (BPP) to detect if the fetus is healthy and well. What are the necessary components of this profile?

    • A.

      Fetal breathing movement

    • B.

      Fetal tone

    • C.

      Gross body movement

    • D.

      L/S ratio

    • E.

      Reactivity of fetal heart rate

    • F.

      Amniotic fluid volume

    • G.

      Presence of alpha-fetoprotein

    Correct Answer(s)
    A. Fetal breathing movement
    B. Fetal tone
    C. Gross body movement
    E. Reactivity of fetal heart rate
    F. Amniotic fluid volume
    Explanation
    There are five components of the biophysical profile
    a. fetal breathing movement
    b. fetal tone
    c. gross body movement
    d. reactivity of FHR
    e. amniotic fluid volume

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  • 13. 

    Infection that occurs during pregnancy is very compromising for the fetus. A 12 weeks pregant Asian female is asking the LPN what TORCH disease is. As a knowledgable LPN, you know that TORCH disease includes:  

    • A.

      Rubella

    • B.

      Cytomegalovirus

    • C.

      Tuberculosis

    • D.

      Influenza

    • E.

      Chlamydia

    • F.

      Human papilloma virus

    • G.

      Herpes Simplex

    Correct Answer(s)
    A. Rubella
    B. Cytomegalovirus
    G. Herpes Simplex
    Explanation
    TORCH (Toxoplasmosis and other infections: rubella, cytomegalovirus, herpes simplex)

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  • 14. 

    What are the normal physical responses of a pregnant woman who is on a Latent Phase of the First Stage of Labor?

    • A.

      Able to continue usual activities

    • B.

      Contractions mild, initially 10 to 20 minutes apart

    • C.

      Contractions moderate to severe, 2 to 3 minutes apart

    • D.

      Nausea, hiccups

    Correct Answer(s)
    A. Able to continue usual activities
    B. Contractions mild, initially 10 to 20 minutes apart
    Explanation
    During the Latent Phase of the First Stage of Labor, a pregnant woman will typically experience mild contractions that are initially 10 to 20 minutes apart. At this stage, the woman is usually able to continue her usual activities as the contractions are not yet intense or frequent. The presence of nausea and hiccups are not mentioned as normal physical responses in this phase of labor.

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  • 15. 

    An LPN is watching a nurse practitioner performs an abdominal palpation that is used to determine fetal presentatio, lie, postion, and engagement. As an LPN, you know that this is procedure is called:

    Correct Answer(s)
    leopold maneuvers
    Leopold Maneuvers
    Leopold maneuvers
    Explanation
    The correct answer is "Leopold maneuvers" because this procedure is named after Dr. Christian Gerhard Leopold, who developed a systematic approach to assess the position and presentation of the fetus through abdominal palpation. The term "maneuvers" signifies the different steps involved in the assessment process. The capitalization of the words does not affect the correctness of the answer, as it is still referring to the same procedure.

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  • 16. 

    A nursing student is discussing the normal findings in labor to a 39 weeks pregnant patient. What are the normal findings common to laboring client and the fetus? Select all that apply.

    • A.

      FHR of 130

    • B.

      maternal blood pressure of 139/89

    • C.

      Maternal pulse of 100

    • D.

      Maternal temperature of 100.4

    • E.

      Dehydration due to work of labor

    • F.

      Leukorrhea

    Correct Answer(s)
    A. FHR of 130
    B. maternal blood pressure of 139/89
    C. Maternal pulse of 100
    D. Maternal temperature of 100.4
    E. Dehydration due to work of labor
    Explanation
    The normal findings common to a laboring client and the fetus include a FHR (fetal heart rate) of 130, maternal blood pressure of 139/89, maternal pulse of 100, and maternal temperature of 100.4. Dehydration due to the work of labor is not a normal finding, as it can be a sign of inadequate fluid intake or excessive fluid loss. Leukorrhea, which is an increase in vaginal discharge, is a normal finding during pregnancy but not specifically related to labor.

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  • 17. 

    Which of the following characteristics of contractions would the nurse expect to find in a client experiencing true labor?

    • A.

      Occurring at irregular intervals

    • B.

      Starting mainly in the abdomen

    • C.

      Gradually increasing intervals

    • D.

      Increasing intensity with walking

    Correct Answer
    D. Increasing intensity with walking
    Explanation
    With true labor, contractions increase in intensity with walking. In addition, true labor contractions occur at regular intervals, usually starting in the back and sweeping around to the abdomen. The interval of
    true labor contractions gradually shortens.

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  • 18. 

    During which of the following stages of labor would the nurse assess “crowning”?

    • A.

      First stage

    • B.

      Second stage

    • C.

      Third stage

    • D.

      Fourth stage

    Correct Answer
    B. Second stage
    Explanation
    Crowing, which occurs when the newborn’s head
    or presenting part appears at the vaginal opening, occurs during the second stage of labor. During the first stage of labor, cervical dilation and effacement occur. During the third stage of labor, the newborn and placenta are delivered. The fourth stage of labor lasts from 1 to 4 hours after birth, during which time the mother and newborn recover from the physical process of birth and the mother’s organs undergo the initial readjustment to the nonpregnant state.

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  • 19. 

    Barbiturates are usually not given for pain relief during active labor for which of the following reasons?

    • A.

      The neonatal effects include hypotonia, hypothermia, generalized drowsiness, and reluctance to feed for the first few days.

    • B.

      These drugs readily cross the placental barrier, causing depressive effects in the newborn 2 to 3 hours after intramuscular injection.

    • C.

      They rapidly transfer across the placenta, and lack of an antagonist make them generally inappropriate during labor.

    • D.

      Adverse reactions may include maternal hypotension, allergic or toxic reaction or partial or total respiratory failure

    Correct Answer
    C. They rapidly transfer across the placenta, and lack of an antagonist make them generally inappropriate during labor.
    Explanation
    Barbiturates are rapidly transferred across the placental barrier, and lack of an antagonist makes them generally inappropriate during active labor. Neonatal side effects of barbiturates include central nervous system depression, prolonged drowsiness, delayed establishment of feeding (e.g. due to poor sucking reflex or poor sucking pressure). Tranquilizers are associated with neonatal effects such as hypotonia, hypothermia, generalized drowsiness, and reluctance to feed for the first few days. Narcotic analgesic readily cross the placental barrier, causing depressive effects in the newborn 2 to 3 hours afterintramuscular injection. Regional anesthesia is associated with adverse reactions such as maternal hypotension, allergic or toxic reaction, or partial or total respiratory failure.

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  • 20. 

    Which of the following nursing interventions would the nurse perform during the third stage of labor?

    • A.

      Obtain a urine specimen and other laboratory tests.

    • B.

      Assess uterine contractions every 30 minutes.

    • C.

      Coach for effective client pushing

    • D.

      Promote parent-newborn interaction.

    Correct Answer
    D. Promote parent-newborn interaction.
    Explanation
    During the third stage of labor, which begins with the delivery of the newborn, the nurse would promote parent-newborn interaction by placing the newborn on the mother’s abdomen and encouraging the parents to touch the newborn. Collecting a urine specimen and other laboratory tests is done on admission during the first stage of labor. Assessing uterine contractions every 30 minutes is performed during the latent phase of the first stage of labor. Coaching the client to push effectively is appropriate during the second stage of labor.

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  • 21. 

    Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage?

    • A.

      Placenta previa

    • B.

      Ectopic pregnancy

    • C.

      Incompetent cervix

    • D.

      Abruptio placentae

    Correct Answer
    D. Abruptio placentae
    Explanation
    Abruptio placentae is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severehemorrhage. Placenta previa refers to implantation of the placenta in the lower uterine segment, causing painless bleeding in the third trimester of pregnancy. Ectopic pregnancy refers to the implantation of the products of conception in a site other than the endometrium. Incompetent cervix is a conduction characterized by painful dilation of the cervical os without uterine contractions.

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  • 22. 

    Which of the following would the nurse assess in a client experiencing abruptio placenta?

    • A.

      Bright red, painless vaginal bleeding

    • B.

      Concealed or external dark red bleeding

    • C.

      Palpable fetal outline

    • D.

      Soft and nontender abdomen

    Correct Answer
    B. Concealed or external dark red bleeding
    Explanation
    A client with abruptio placentae may exhibit concealed or dark red bleeding, possibly reporting sudden intense localized uterine pain. The uterus is typically firm to boardlike, and the fetal presenting part may be engaged. Bright red, painless vaginal bleeding, a palpable fetal outline and a soft nontender abdomen are manifestations of placenta previa.

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  • 23. 

    Which of the following best describes preterm labor?    

    • A.

      Labor that begins after 20 weeks gestation and before 37 weeks gestation

    • B.

      Labor that begins after 15 weeks gestation and before 37 weeks gestation

    • C.

      Labor that begins after 24 weeks gestation and before 28 weeks gestation

    • D.

      Labor that begins after 28 weeks gestation and before 40 weeks gestation

    Correct Answer
    A. Labor that begins after 20 weeks gestation and before 37 weeks gestation
    Explanation
    Preterm labor is best described as labor that begins after 20 weeks’ gestation and before 37 weeks’ gestation. The other time periods are inaccurate.

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  • 24. 

    A patient with pregnancy-induced hypertension is most likely to exhibit which of the following symptoms? 

    • A.

      Headaches, double vision, vaginal bleeding

    • B.

       Proteinuria, headaches, double vision

    • C.

      Proteinuria, double vision, uterine contractions

    • D.

      Proteinuria, headaches, vaginal bleeding

    Correct Answer
    B.  Proteinuria, headaches, double vision
    Explanation
    Pregnancy-induced hypertension, also known as preeclampsia, is a condition characterized by high blood pressure and damage to organs such as the liver and kidneys. One of the hallmark symptoms of preeclampsia is proteinuria, which is the presence of excess protein in the urine. This is due to the impaired function of the kidneys. Headaches are another common symptom, often caused by the increased blood pressure. Double vision can occur as a result of the damage to the organs, including the eyes. Vaginal bleeding and uterine contractions are not typically associated with pregnancy-induced hypertension.

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  • 25. 

     A patient is in the first stage of labor, What is the shortest but most difficult part of this stage?

    • A.

      Transitional phase

    • B.

      Complete phase

    • C.

      Latent phase

    • D.

      Active phase

    Correct Answer
    A. Transitional phase
    Explanation
    The transitional phase is the shortest but most difficult part of the first stage of labor. This phase occurs when the cervix is dilated from 8 to 10 centimeters and contractions become stronger and more frequent. During this phase, the woman may experience intense pain, increased pressure, and a strong urge to push. It is considered the most challenging part of labor because it marks the transition from the early stages of labor to the active pushing stage.

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  • 26. 

    Which of the is most likely to be found when assessing a pregnant client with an abruption placenta?

    • A.

      Premature rupture of membranes

    • B.

      Rigid, board-like abdomen

    • C.

      Tetanic uterine contractions

    • D.

      Excessive vaginal bleeding

    Correct Answer
    B. Rigid, board-like abdomen
    Explanation
    When assessing a pregnant client with an abruption placenta, a rigid, board-like abdomen is most likely to be found. This is because an abruption placenta occurs when the placenta separates from the uterus before the baby is born. This separation can cause internal bleeding and lead to the accumulation of blood in the abdomen. As a result, the abdomen becomes rigid and board-like to the touch. This is a concerning sign and requires immediate medical attention.

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  • 27. 

    Which of the following is the usual treatment for partial placenta previa?

    • A.

      Labor induction with oxytocin

    • B.

      Platelet infusion

    • C.

      Immediate cesarean delivery

    • D.

      Activity limited to bed rest

    Correct Answer
    D. Activity limited to bed rest
    Explanation
    The usual treatment for partial placenta previa is activity limited to bed rest. This is because bed rest helps to reduce the risk of bleeding and complications associated with partial placenta previa. It allows the placenta to heal and prevents further damage or detachment. Other options such as labor induction with oxytocin, platelet infusion, and immediate cesarean delivery may be considered in cases of complete placenta previa or if there is severe bleeding or fetal distress. However, for partial placenta previa, bed rest is the preferred treatment option.

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  • 28. 

     Progestin use may increase the risk for:

    • A.

      Female hypogonadism

    • B.

      Premenstrual syndrome

    • C.

      Tubal or ectopic pregnancy

    • D.

      None of the above

    Correct Answer
    C. Tubal or ectopic pregnancy
    Explanation
    Progestin use may increase the risk for tubal or ectopic pregnancy. Progestins are synthetic hormones that mimic the effects of progesterone in the body. They are commonly used in hormonal contraceptives and hormone replacement therapy. While progestins are effective in preventing pregnancy when used correctly, there is a small risk of ectopic pregnancy, which occurs when a fertilized egg implants outside the uterus, usually in the fallopian tubes. This can be a serious medical condition that requires immediate attention and treatment. Therefore, it is important for individuals using progestin-based contraceptives to be aware of this potential risk.

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