Chapter 20 Maternal and Child Health Nursing 7th Edition

Chapter 20  Maternal and Child Health Nursing 7th Edition

Complete Chapter Questions And Answers
 

Sample Questions

1.
A patient with asthma who is 32 weeks pregnant is concerned that the health care provider has reduced the doses of asthma maintenance medications. What should the nurse respond to this patient’s concern?
A)
Asthma medication is teratogenic and should not be taken.
B)
Asthma improves during pregnancy so higher doses are not needed.
C)
Asthma medication may reduce labor contractions and should be reduced.
D)
Asthma medication is ineffective during pregnancy and should be stopped.
Ans:
C

Feedback:

Some asthma maintenance medication such as beta-adrenergic agonists may be taken safely during pregnancy, but they have the potential to reduce labor contractions. The doses of these medications may be reduced as the patient approaches the time of delivery. Not all asthma medication is teratogenic. Asthma can improve during pregnancy because of circulating corticosteroids; however, the doses of the medications should have already been adjusted according to the patient’s symptoms. There is no evidence to support that asthma medication is ineffective during pregnancy.

2.
A patient with type 2 diabetes mellitus is planning to become pregnant within the next several months. What should the nurse instruct the patient to support the 2020 National Health Goals of reducing the complications of pregnancy from diabetes?
A)
Avoid episodes of hyperglycemia.
B)
Reduce the current exercise regimen by half.
C)
Limit the intake of carbohydrates and fats in the diet.
D)
Reduce the use of insulin for blood glucose coverage.
Ans:
A

Feedback:

To support the 2020 National Health Goals, the nurse should instruct the patient to enter pregnancy without hyperglycemia. This action helps reduce congenital anomalies in newborns. Reducing exercise, limiting carbohydrates and fats, and reducing the use of insulin for blood glucose coverage does not support the 2020 National Health Goals to reduce the complications of pregnancy associated with diabetes.

3.
A patient with diabetes is in the first trimester of pregnancy and is currently having difficulty keeping blood glucose levels within normal limits. The patient explains that she has been “eating for two” so the baby is healthy. What should the nurse respond to the patient?
A)
“Elevated blood glucose levels cause low birth weights in infants.”
B)
“Elevated blood glucose levels ensure the baby has mature lungs at birth.”
C)
“Elevated blood glucose levels hasten the development of the fetus in utero.”
D)
“Elevated blood glucose levels in the first trimester have been linked to congenital anomalies.”
Ans:
D

Feedback:

The first trimester of pregnancy is the most important time for fetal development. If the patient can control hyperglycemia during this time, the chances of a congenital anomaly are greatly reduced. Infants of patients with poorly controlled diabetes tend to be large. At birth, babies born to patients with uncontrolled diabetes are prone to respiratory distress syndrome. Elevated blood glucose levels do not hasten the development of the fetus in utero and can lead to hydramnios.

4.
The nurse determines that a pregnant patient is at risk for developing a deep vein thrombosis. What should the nurse instruct the patient to reduce the risk of this potential complication? (Select all that apply.)
A)
Avoid foods high in calcium.
B)
Take a baby aspirin every day.
C)
Avoid standing in one position.
D)
Do not cross the legs at the knee.
E)
Do not wear knee-high stockings.
Ans:
C, D, E

Feedback:

The risk of thrombus formation can be reduced through measures such as avoiding the use of constrictive knee-high stockings, not sitting with legs crossed at the knee, and avoiding standing in one position for a long period. Calcium restriction does not reduce the risk of thrombus formation and could potentially harm the developing fetus. The nurse cannot prescribe medication, and the patient should not take any medication without direction from the health care provider.

5.
A patient with diabetes who is in the second trimester of pregnancy notes that the usual dose of insulin to maintain blood glucose levels has been increasing over the last few weeks. What should the nurse explain to the patient about insulin during pregnancy?
A)
The fetus is using insulin to maintain blood glucose level in utero.
B)
Insulin resistance develops because of placenta and other hormones.
C)
An increase in circulating blood volume during pregnancy deactivates insulin.
D)
The change in diet causes an increased need for insulin to maintain blood glucose levels.
Ans:
B

Feedback:

Patients with diabetes, who become pregnant, develop insulin resistance as the pregnancy progresses, or insulin does not seem as effective during pregnancy. This phenomenon is believed to be caused by the presence of the hormone human placental lactogen and high levels of cortisol, estrogen, progesterone, and catecholamines. The increased need for insulin is not because of the fetus using insulin to maintain blood glucose level in utero. The patient’s increased circulating blood volume is not deactivating insulin. The patient’s change in diet might necessitate an adjustment in insulin dosage, but this would vary according to blood glucose level.