Question

A woman who is 34 weeks pregnant is admitted with contractions every 2 minutes, lasting 60 seconds. She says she had some vaginal bleeding at home, and there is a small amount of blood on her perineal pad. The priority action of the nurse is to:

Answer 1

Correct Answers:

evaluate the maternal and fetal circulation and oxygenation

Rationale :

🫀Maternal circulation must be assessed first because bleeding in pregnancy can quickly threaten maternal perfusion and shock.

👶Fetal oxygenation can drop fast if the cause is placental abruption/previa, so continuous fetal monitoring is a priority.

🩸A vaginal exam can worsen bleeding if placenta previa is present, so assessment comes before invasive checks.

🚑Prioritizing ABC-style stabilization (oxygenation/perfusion) protects both clients (mother and fetus) in an obstetric emergency.

📌Core Message

Prioritize maternal-fetal oxygenation and perfusion first because antepartum bleeding can rapidly compromise both.

Answer 2

Correct Answers:

Glyburide (Glynase)

Rationale :

💉When diet therapy fails in gestational diabetes, medication is used to improve glucose control and protect the fetus.

🍬Glyburide is an oral hypoglycemic sometimes prescribed in pregnancy to reduce maternal hyperglycemia when diet alone isn’t enough.

🧠Controlling maternal blood glucose lowers risks like macrosomia and neonatal hypoglycemia after delivery.

🧩This choice fits because it directly targets elevated glucose, unlike drugs used for hypertension or seizure prevention.

📌Core Message

If diet doesn’t control gestational diabetes, start medication aimed at lowering maternal glucose to reduce maternal-fetal complications.

Answer 3

Correct Answers:

should come to the hospital for further evaluation

Rationale :

📞At 32 weeks, symptoms like backache plus GI changes can be early signs of preterm labor, needing assessment.

🧷Preterm labor may start subtly, so evaluation for cervical change and uterine activity is important.

🩺Early triage allows timely interventions like hydration, monitoring, and tocolysis/steroids if indicated.

⏳Delaying care risks progression to preterm birth, so the safest advice is immediate evaluation.

📌Core Message

Possible preterm labor signs at 32 weeks require hospital evaluation to prevent or prepare for early delivery.

Answer 4

Correct Answers:

Nifedipine (Procardia)

Rationale :

💊In pregnancy, safe antihypertensives are chosen to reduce maternal stroke risk while protecting uteroplacental blood flow.

🧠Nifedipine is a commonly used pregnancy-compatible medication for hypertension management.

🚫Medications like ACE inhibitors/ARBs are avoided because they can harm fetal kidney development and amniotic fluid levels.

🌿Treating sustained hypertension helps prevent worsening into preeclampsia and improves overall pregnancy outcomes.

📌Core Message

Use pregnancy-safe antihypertensives (like nifedipine) and avoid agents that can injure fetal development.

Answer 5

Correct Answers:

Applying a fetal scalp electrode

Rationale :

🦠A fetal scalp electrode creates a break in the skin, increasing exposure to maternal blood.

🧤Avoiding invasive monitoring reduces the risk of vertical transmission when blood-to-blood contact is increased.

🧼Limiting procedures that cause microabrasions supports safer intrapartum management for the newborn.

🧷This aligns with the principle of minimizing invasive fetal instrumentation in maternal infections.

📌Core Message

Avoid invasive fetal monitoring that increases blood exposure to reduce HIV transmission risk.

Answer 6

Correct Answers

Blank 1 Correct Option: Absent deep tendon reflexes
Blank 2 Correct Option: Calcium gluconate

Rationale :

🧠Magnesium sulfate depresses the nervous system, so loss of deep tendon reflexes is an early toxicity warning.

🫁Progressing toxicity can depress respirations, making early detection of reflex changes critical.

💉Calcium gluconate directly counteracts magnesium’s effects and is the standard antidote.

📋Frequent checks of reflexes, respirations, and urine output help prevent severe complications.

📌Core Message

Monitor for neuromuscular depression (like absent reflexes) and treat magnesium toxicity with calcium gluconate.

Answer 7

Correct Answers:

Ectopic pregnancy

Rationale :

🧨Unilateral stabbing abdominal pain in early pregnancy strongly suggests tubal implantation.

🩸Pale and clammy appearance signals possible internal bleeding and hemodynamic instability.

🧷Referred shoulder pain is classic for diaphragmatic irritation from intra-abdominal bleeding.

🚑This is an obstetric emergency requiring rapid evaluation to prevent shock and protect the patient’s life.

📌Core Message

Early pregnancy bleeding with unilateral pain and shoulder pain suggests ectopic pregnancy with possible internal hemorrhage.

Answer 8

Correct Answers

Blank 1 Correct Option: Cocaine use
Blank 2 Correct Option: Uterine hypertonicity

Rationale :

🧯Cocaine use causes intense vasoconstriction, increasing risk of placental separation.

🪨Abruption often triggers a rigid, tender uterus due to uterine irritability and trapped blood.

📉This condition can reduce placental perfusion, leading to fetal distress even with limited external bleeding.

🚨Recognizing hypertonicity supports rapid escalation for maternal stabilization and fetal monitoring.

📌Core Message

Placental abruption is linked to vasoconstrictive risks (like cocaine) and presents with uterine hypertonicity/tenderness.

Answer 9

Correct Answers:

hypertension diagnosed after 20 weeks

Rationale :

📅Gestational hypertension is defined by new-onset hypertension after 20 weeks of pregnancy.

🧾The diagnosis depends on blood pressure timing and readings, not on seizures as a defining feature.

🔍Early identification allows monitoring for progression to preeclampsia and protects maternal-fetal outcomes.

🩺Correct classification guides safe surveillance and treatment to reduce maternal complications.

📌Core Message

Gestational hypertension is new-onset high BP after 20 weeks, requiring monitoring for progression.

Answer 10

Correct Answers:

Macrosomia leading to birth complications

Rationale :

🍯Maternal hyperglycemia increases fetal insulin and growth, causing macrosomia.

👶A larger fetus raises the risk of shoulder dystocia and birth trauma during delivery.

🏥Macrosomia can lead to higher rates of operative delivery and maternal complications like perineal injury.

📉Tight glucose control reduces the risk of excess fetal growth and improves delivery safety.

📌Core Message

Gestational diabetes can cause macrosomia, increasing delivery complications like difficult birth and injury risks.

1 :
A woman who is 34 weeks pregnant is admitted with contractions every 2 minutes, lasting 60 seconds. She says she had some vaginal bleeding at home, and there is a small amount of blood on her perineal pad. The priority action of the nurse is to:

2 :
A woman with gestational diabetes has continued high blood glucose levels even after adjusting her diet. Which of the following medications would the nurse anticipate being ordered at this time?

3 :
A patient telephones the labor unit and says that she is 32 weeks gestation and reports having a back ache and diarrhea all day. The nurse should advise the woman that she:

4 :
A woman who is 22 weeks pregnant has a blood pressure of 148/100, but states she has not been having headaches or blurred vision and her urine is negative for protein. The nurse anticipates which of the following antihypertensives to be prescribed at this time?

5 :
A nurse is caring for a client who is HIV-positive and in labor. Which of the following interventions should the nurse avoid?

6 :
Complete the sentence by choosing the correct options.

Correct Answers

7 :
A nurse is assessing a pregnant client in the first trimester who presents with vaginal bleeding, pallor, clammy skin, left lower abdominal pain, and referred shoulder pain. Which of the following conditions should the nurse suspect?

8 :
Complete the sentence by choosing the correct options.

Correct Answers

9 :
Which of the below symptoms are common in patients diagnosed with gestational hypertension?

10 :
A nurse is teaching about the effects of gestational diabetes. Which of the following complications can occur in the newborn?

1 : A woman who is 34 weeks pregnant is admitted with contractions every 2 minutes, lasting 60 seconds. She says she had some vaginal bleeding at home, and there is a small amount of blood on her perineal pad. The priority action of the nurse is to:

2 : A woman with gestational diabetes has continued high blood glucose levels even after adjusting her diet. Which of the following medications would the nurse anticipate being ordered at this time?

3 : A patient telephones the labor unit and says that she is 32 weeks gestation and reports having a back ache and diarrhea all day. The nurse should advise the woman that she:

4 : A woman who is 22 weeks pregnant has a blood pressure of 148/100, but states she has not been having headaches or blurred vision and her urine is negative for protein. The nurse anticipates which of the following antihypertensives to be prescribed at this time?

5 : A nurse is caring for a client who is HIV-positive and in labor. Which of the following interventions should the nurse avoid?

6 : Complete the sentence by choosing the correct options.

Correct Answers

7 : A nurse is assessing a pregnant client in the first trimester who presents with vaginal bleeding, pallor, clammy skin, left lower abdominal pain, and referred shoulder pain. Which of the following conditions should the nurse suspect?

8 : Complete the sentence by choosing the correct options.

Correct Answers

9 : Which of the below symptoms are common in patients diagnosed with gestational hypertension?

10 : A nurse is teaching about the effects of gestational diabetes. Which of the following complications can occur in the newborn?

1 :
A woman who is 34 weeks pregnant is admitted with contractions every 2 minutes, lasting 60 seconds. She says she had some vaginal bleeding at home, and there is a small amount of blood on her perineal pad. The priority action of the nurse is to:

2 :
A woman with gestational diabetes has continued high blood glucose levels even after adjusting her diet. Which of the following medications would the nurse anticipate being ordered at this time?

3 :
A patient telephones the labor unit and says that she is 32 weeks gestation and reports having a back ache and diarrhea all day. The nurse should advise the woman that she:

4 :
A woman who is 22 weeks pregnant has a blood pressure of 148/100, but states she has not been having headaches or blurred vision and her urine is negative for protein. The nurse anticipates which of the following antihypertensives to be prescribed at this time?

5 :
A nurse is caring for a client who is HIV-positive and in labor. Which of the following interventions should the nurse avoid?

6 :
Complete the sentence by choosing the correct options.

7 :
A nurse is assessing a pregnant client in the first trimester who presents with vaginal bleeding, pallor, clammy skin, left lower abdominal pain, and referred shoulder pain. Which of the following conditions should the nurse suspect?

8 :
Complete the sentence by choosing the correct options.

9 :
Which of the below symptoms are common in patients diagnosed with gestational hypertension?

10 :
A nurse is teaching about the effects of gestational diabetes. Which of the following complications can occur in the newborn?