Chapter 09 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

Chapter 09 Contemporary Maternal Newborn Nursing Care Maternal Newborn Nursing Care Nurse, Family, 8th Edition

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Question 1

Type: MCSA

The nurse is auscultating fetal heart tones in a patient who is 37 weeks’ gestation. While in a supine position, the patient states, “I’m getting lightheaded and dizzy, and I feel clammy.” Which of the following nursing actions is most appropriate?

1. Place a wedge beneath the patient’s right hip.
2. Prepare for administration of packed red blood cells (PRBCs).
3. Help the patient turn onto her right side.
4. Administer supplemental oxygen.

Correct Answer: 1

Rationale 1: The patient is verbalizing symptoms consistent with supine hypotension syndrome, in which compression of the vena cava by the uterus reduces right atrial blood flow. Signs and symptoms include decreased blood pressure, dizziness, pallor, and clamminess. Appropriate interventions include having the woman lie on her left side, or placing a pillow or wedge under her right hip as she lies in a supine position.

Rationale 2: The patient is verbalizing symptoms consistent with supine hypotension syndrome, in which compression of the vena cava by the uterus reduces right atrial blood flow. Repositioning the patient onto her left side or placing a pillow or wedge under her right hip are appropriate interventions.

Rationale 3: The patient is verbalizing symptoms consistent with supine hypotension syndrome, in which compression of the vena cava by the uterus reduces right atrial blood flow. Positioning the patient on her right side would likely exacerbate the reduction in right atrial blood flow.

Rationale 4: The patient is verbalizing symptoms consistent with supine hypotension syndrome, in which compression of the vena cava by the uterus reduces right atrial blood flow. Priority interventions include repositioning the patient onto her left side, or placing a pillow or wedge under her right hip.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO01 – Identify the anatomic and physiologic changes that occur during pregnancy in providing nursing care to expectant women.

Question 2

Type: MCSA

The patient with a normal pre-pregnancy weight asks why she has been told to gain 25–35 pounds during her pregnancy, but her underweight friend was told to gain more weight. The nurse should tell the patient that recommended weight gain during pregnancy should be:

1. 25–35 pounds, regardless of a patient’s pre-pregnancy weight.
2. More than 25–35 pounds for an overweight patient.
3. More than 25–35 pounds for an underweight woman.
4. The same for a normal-weight woman as for an overweight woman.

Correct Answer: 3

Rationale 1: Pre-pregnancy weight determines the recommended weight gain during pregnancy. Women of normal weight should gain 25–35 pounds during pregnancy for optimal fetal outcome.

Rationale 2: Overweight women should gain 15–25 pounds during pregnancy.

Rationale 3: Underweight women are encouraged to gain 28-40 pounds during pregnancy.

Rationale 4: Overweight women should gain 15–25 pounds during pregnancy.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO01 – Identify the anatomic and physiologic changes that occur during pregnancy in providing nursing care to expectant women.

Question 3

Type: MCSA

The nurse is reviewing the assessment findings of a patient who is 35 weeks’ gestation. Which of the following data suggests the need for further investigation?

1. Melasma gravidarum
2. Pseudoanemia
3. Funic souffle
4. Glycosuria

Correct Answer: 4

Rationale 1: Facial chloasma or melasma gravidarum (also known as the “mask of pregnancy”) is a harmless darkening of the skin over the cheeks, nose, and forehead that sometimes accompanies pregnancy.

Rationale 2: Physiologic anemia of pregnancy or pseudoanemia is common during pregnancy and is an expected finding.

Rationale 3: Funic souffle is a normal assessment finding associated with the pulsing of blood through the umbilical cord.

Rationale 4: Glycosuria (glucose in the urine) during pregnancy may be normal or may indicate gestational diabetes, so it always warrants further testing.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO01 – Identify the anatomic and physiologic changes that occur during pregnancy in providing nursing care to expectant women.

Question 4

Type: MCSA

The patient in the prenatal clinic tells the nurse that she is sure that she is pregnant because she has not had a menstrual cycle for three months, and her breasts are getting bigger. What response by the nurse is best?

1. “Lack of menses and breast enlargement are presumptive signs of pregnancy.”
2. “The changes you are describing are definitely indicators that you are pregnant.”
3. “Lack of menses can be caused by many things. We need to do a pregnancy test.”
4. “Breast and menstrual changes are positive signs of pregnancy. Congratulations.”

Correct Answer: 3

Rationale 1: Although this is true, amenorrhea and breast enlargement also can be caused by weight gain and other conditions. A pregnancy test is needed to determine whether the patient is pregnant.

Rationale 2: This statement is false because amenorrhea and breast enlargement are presumptive signs of pregnancy because they can be caused by other conditions.

Rationale 3: This is a true statement and addresses that these changes could be caused by things other than pregnancy.

Rationale 4: This statement is false because amenorrhea and breast enlargement are presumptive signs. It is too early to determine if congratulations are in order.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO02 – Assess the subjective (presumptive), objective (probable), and diagnostic (positive) changes of pregnancy in patients.