Chapter 17 Pregnancy at Risk: Pregestational Problems

Chapter 17   Pregnancy at Risk: Pregestational Problems

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) The nurse is caring for a pregnant woman who admits to using cocaine and ecstasy on a regular basis. The client states, “Everybody knows that alcohol is bad during pregnancy, but what’s the big deal about ecstasy?” What is the nurse’s best response?

1. “Ecstasy can cause a high fever in you and therefore cause the baby harm.”
2. “Ecstasy leads to deficiencies of thiamine and folic acid, which help the baby develop.”
3. “Ecstasy produces babies with small heads and short bodies with brain function alterations.”
4. “Ecstasy produces intrauterine growth restriction and meconium aspiration.”

Answer:  1

Explanation:  1. Hyperthermia (elevated temperature) is a side effect of MDMA (ecstasy).

Page Ref: 355

Cognitive Level:  Applying

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: V. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the health care team. | AACN Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  1 Summarize the effects of alcohol and illicit drugs on the childbearing woman and her fetus/newborn.

MNL LO:  2.6.3 Determine strategies for managing the care of the pregnant woman who abuses substances.

 

 

2) The nurse is doing preconception counseling with a 28-year-old woman with no prior pregnancies. Which statement made by the client indicates to the nurse that the client has understood the teaching?

1. “I can continue to drink alcohol until I am diagnosed as pregnant.”
2. “I need to stop drinking alcohol completely when I start trying to get pregnant.”
3. “A beer once a week will not damage the fetus.”
4. “I can drink alcohol while breastfeeding because it doesn’t pass into breast milk.”

Answer:  2

Explanation:  2. Women should discontinue drinking alcohol when they start to attempt to become pregnant due to possible effects of alcohol on the fetus.

Page Ref: 354

Cognitive Level:  Understanding

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome:  1 Summarize the effects of alcohol and illicit drugs on the childbearing woman and her fetus/newborn.

MNL LO:  2.6.3 Determine strategies for managing the care of the pregnant woman who abuses substances.

3) A woman’s history and appearance suggest drug abuse. What is the nurse’s best approach?

1. Ask the woman directly, “Do you use any street drugs?”
2. Ask the woman whether she would like to talk to a counselor.
3. Ask some questions about over-the-counter medications and avoid mention of illicit drugs.
4. Explain how harmful drugs can be for her baby.

Answer:  1

Explanation:  1. If drug abuse is suspected, the nurse should ask direct questions and be matter-of-fact and nonjudgmental to elicit honest responses.

Page Ref: 356

Cognitive Level:  Applying

Client Need/Sub:  Health Promotion and Maintenance: Lifestyle Choices

Standards:  QSEN Competencies: I. C. 13. Acknowledge the tension that may exist between patient rights and the organizational responsibility for professional, ethical care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  1 Summarize the effects of alcohol and illicit drugs on the childbearing woman and her fetus/newborn.

MNL LO:  2.6.3 Determine strategies for managing the care of the pregnant woman who abuses substances.

 

4) A 20-year-old woman is at 28 weeks’ gestation. Her prenatal history reveals past drug abuse, and urine screening indicates that she has recently used heroin. The nurse should recognize that the woman is at increased risk for which condition?

1. Erythroblastosis fetalis
2. Diabetes mellitus
3. Abruptio placentae
4. Pregnancy-induced hypertension

Answer:  4

Explanation:  4. Women who use heroin are at risk for poor nutrition, anemia, and pregnancy-induced hypertension (or preeclampsia-eclampsia).

Page Ref: 356

Cognitive Level:  Understanding

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: V. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the health care team. | AACN Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  1 Summarize the effects of alcohol and illicit drugs on the childbearing woman and her fetus/newborn.

MNL LO:  2.6.3 Determine strategies for managing the care of the pregnant woman who abuses substances.

 

5) The nurse is working with a woman who abuses stimulants. The nurse is aware that the fetus is at risk for which of the following?

Note: Credit will be given only if all correct and no incorrect choices are selected.

Select all that apply.

1. Withdrawal symptoms
2. Cardiac anomalies
3. Sudden infant death syndrome
4. Being small for gestational age
5. Fetal alcohol syndrome

Answer:  1, 2, 3, 4

Explanation:  1. Infants born to mothers who abuse stimulants such as amphetamines can have withdrawal symptoms.

2. Infants born to mothers who abuse stimulants such as cocaine can be born with cardiac anomalies.
3. Infants born to mothers who abuse stimulants such as cocaine can have sudden infant death syndrome.
4. Infants born to mothers who abuse stimulants such as nicotine can be small for gestational age.

Page Ref: 354

Cognitive Level:  Understanding

Client Need/Sub:  Physiological Integrity: Reduction of Risk Potential

Standards:  QSEN Competencies: V. B. 4. Communicate observations of concerns related to hazards and errors to patients, families, and the health care team. | AACN Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient outcomes. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  1 Summarize the effects of alcohol and illicit drugs on the childbearing woman and her fetus/newborn.

MNL LO:  2.6.3 Determine strategies for managing the care of the pregnant woman who abuses substances.