Chapter 21 Maternal and Child Health Nursing 7th Edition

Chapter 21  Maternal and Child Health Nursing 7th Edition

Complete Chapter Questions And Answers
 

Sample Questions

1.
A pregnant patient is diagnosed with placenta previa. Which action should the nurse implement immediately for this patient?
A)
Assess fetal heart sounds with an external monitor.
B)
Help the patient remain ambulatory to reduce bleeding.
C)
Assess uterine contractions by an internal pressure gauge.
D)
Prepare for a vaginal examination to assess the extent of bleeding.
Ans:
A

Feedback:

For placenta previa, the nurse should attach external monitoring equipment to record fetal heart sounds and uterine contractions. Internal pressure gauges to measure uterine contractions are contraindicated. A pelvic or rectal examination should never be done with painless bleeding late in pregnancy because any agitation of the cervix when there is a placenta previa might tear the placenta further and initiate massive hemorrhage, which could be fatal to both mother and child. To ensure an adequate blood supply to the patient and fetus, the patient should be placed immediately on bed rest in a side-lying position.

2.
The nurse is preparing an education session on the 2020 National Health Goals to prevent complications of pregnancy. What should the nurse include as the best preventive measure to eliminate complications of pregnancy?
A)
Encourage all pregnant patients to have prenatal care.
B)
Suggest all pregnant patients keep weight gain to a minimum.
C)
Recommend all pregnant patients engage in exercise most days of the week.
D)
Counsel all pregnant patients to select low-fat dairy products rich in calcium.
Ans:
A

Feedback:

Encouraging all women to come for prenatal care is the best preventive measure for eliminating complications of pregnancy. Weight gain, exercise, and calcium intake are not identified as specific measures to prevent complications of pregnancy.

3.
The nurse is concerned that a pregnant patient is experiencing abruptio placentae. What did the nurse assess in this patient?
A)
Increased blood pressure and oliguria
B)
Pain in a lower quadrant and increased pulse rate
C)
Painless vaginal bleeding and a fall in blood pressure
D)
Sharp fundal pain and discomfort between contractions
Ans:
D

Feedback:

Abruptio placentae is characterized by a sharp, stabbing pain high in the uterine fundus as the initial separation occurs. Manifestations of abruptio placentae do not include increased blood pressure, oliguria, pain in the lower quadrant, increased pule rate, painless vaginal bleeding, or a fall in blood pressure.

4.
A patient who is 16 weeks pregnant is passing pieces of body tissue along with blood clots and dark red blood from the vagina. What should the nurse direct the patient to do at this time?
A)
Begin immediate bed rest.
B)
Count the number of perineal pads that are saturated with blood.
C)
Continue with normal daily activity and monitor pulse rate every hour.
D)
Seek immediate medical attention and bring the expressed vaginal material.
Ans:
D

Feedback:

Gestational trophoblastic disease is abnormal proliferation and then degeneration of the trophoblastic villi. The embryo fails to develop beyond a primitive start. At approximately week 16 of pregnancy, vaginal bleeding will begin as spotting of dark-brown blood accompanied by discharge of the clear fluid-filled vesicles. The pregnant patient who begins to miscarry at home needs to bring any clots or tissue passed to the hospital because the presence of clear fluid-filled cysts identifies gestational trophoblastic disease. The patient needs to seek immediate medical attention and not stay at home on bed rest, count perineal pads, or continue with normal activity and count pulse rates every hour.

5.
The nurse is reviewing the plan of care for a pregnant patient experiencing a threatened miscarriage. Which outcome would be appropriate for this patient?
A)
Bed rest is maintained until all bleeding stops.
B)
Less than one perineal pad is saturated per hour.
C)
Bleeding spontaneously stops within 24 to 48 hours.
D)
Normal coitus is resumed 1 week after the episode.
Ans:
C

Feedback:

For a threatened miscarriage, an outcome for care would be that all bleeding would spontaneously stop within 24 to 48 hours. Bed rest is not recommended for a threatened miscarriage because blood will pool in the vagina. Vaginal bleeding that saturates a perineal pad in 1 hour is an emergency and could indicate an incomplete or complete miscarriage. Normal coitus should be withheld for 2 weeks after a threatened miscarriage.