Obstetric Nursing CEUS Practice Test
71.A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement, if made by the client, indicates a need for further teaching?
a) I should stay on the diabetic diet
b) I should perform glucose monitoring at home
c) I should avoid exercise because of the negative effects on insulin production
d) I should be aware of any infections and report signs of infection immediately to my health care provider
72. A client has just had surgery to deliver a nonviable fetus resulting from abruptio placentae. As a result of abruptio placentae, the client develops disseminated intravascular coagulation (DIC) and is told about the complication. The client begins to cry and screams, "God, just let me die now!" Which nursing diagnosis should direct care for this client at time?
a) grieving related to the loss of the baby
b) situational low self-esteem related to being ill
c) deficient knowledge related to the disease process
d) hopelessness related to the loss of the baby and personal health
73. A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client for:
a) enlargement of the breast
b) complaints of feeling hot when the room is cool
c) periods of fetal movement followed by quiet periods
d) evidence of bleeding, such as in the gums, petechia, and purpura
74. A nurse in a maternity unit is reviewing the records of the clients on the unit. Which client would the nurse identify as being at the greatest risk for developing disseminated intravascular coagulation (DIC)?
a) a primigravida with mild preeclampsia
b) a primigravida who delivered a 10-lb baby 3 hours ago
c) a gravida II who has just been diagnosed with dead fetus syndrome
d) a gravida IV who delivered 8 hours ago and has lost 500 ml of blood
75. A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement, if made by the client, indicates a need for further instructions.
a) I will watch for the evidence of the passage of tissue
b) I will maintain strict bed rest throughout the remainder of the pregnancy
c) I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad
d) I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding
Obstetric Nursing CEUS Practice Test:
ANSWERS AND RATIONALE
71) C
- exercise is safe for the client with gestational diabetes mellitus and is helpful in lowering the blood glucose level. Dietary modifications are the mainstay of treatment, and the client is placed on a standard diabetic diet. Many client are taught to perform blood glucose monitoring. If the client is not performing the blood glucose monitoring at home, then it will be performed at the clinic or health care provider's office. Signs of infection need to be reported to the health care provider.
72) D
- by seeing no way out of the situation except for death, the client meets the criteria for hopelessness. A person who lacks hope thinks that life is too much to handle. Option A is a possible nursing diagnosis at a later time; however, at this time, the diagnosis of hopelessness should take precedence. Option C is a possible nursing diagnosis later, but not enough data support it at this point. The data given do not support the nursing diagnosis of situational self-esteem.
73) D
- severe preeclampsia can trigger disseminated intravascular coagulation (DIC) because of the widespread damage to vascular integrity. Bleeding is an early sign of DIC and should be reported to the health care provider if noted on assessment. Option A, B, and C are normal occurrences in the last trimester of pregnancy.
74) C
- dead fetus syndrome is considered a risk factor for DIC. Sever preeclampsia is considered a risk factor for DIC; a mild case is not. Delivering a large baby is not considered a risk factor for DIC. Hemorrhage is a risk factor with DIC; however, a loss of 500 ml is not considered hemorrhage.
75) B
- strict bed rest throughout the remainder of the pregnancy is not required. The client is advised to curtail sexual activities until bleeding has ceased, and for 2 weeks following the last evidence of bleeding or as recommended by the physician or other health care provider. The client is instructed to count the number of perineal pads used daily and to note the quantity and color of blood on the pad. The client also should watch for the evidence of the passage of tissue.
Or go back to Obstetric Nursing CEUS Practice Test (1-5) to start the practice test from the beginning.
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