Question 139540 Id: 139540 Question Title: Type: MCSA Difficulty Level: Calcula tor: false Question Stem The nurse is caring for a patient at 30 weeks’ gestation who is experiencing preterm premature rupture of membranes (PPROM). Which statement indicates that the patient needs additional teaching? “If I: Stimulus Answer Choice 1 “Were having a singleton pregnancy instead of twins, my membranes would probably not have ruptured.” Rationale 1 Multifetal gestation increases the risk for PPROM. Answer 1 false Choice 2 “Develop a urinary tract infection in my next pregnancy, I might rupture membranes early again.” Rationale 2 A UTI increases the risk for PPROM. Answer 2 false Choice 3 “Want to become pregnant again, I will have to plan on being on bed rest for the whole pregnancy.”
Transcript
Question 139540Id: 139540
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
The nurse is caring for a patient at 30 weeks’ gestation who is experiencing preterm premature rupture of membranes (PPROM). Which statement indicates that the patient needs additional teaching? “If I:
Stimulus
Answer
Choice 1“Were having a singleton pregnancy instead of twins, my membranes would probably not have ruptured.”
Rationale 1 Multifetal gestation increases the risk for PPROM.
Answer 1 false
Choice 2“Develop a urinary tract infection in my next pregnancy, I might rupture membranes early again.”
Rationale 2 A UTI increases the risk for PPROM.
Answer 2 false
Choice 3“Want to become pregnant again, I will have to plan on being on bed rest for the whole pregnancy.”
Rationale 3There is no evidence indicating that bed rest in a subsequent pregnancy decreases the risk for PPROM.
Answer 3 true
Choice 4“Have bleeding in the third trimester of my next pregnancy, I might rupture membranes again.”
Rationale 4 Second- and third-trimester bleeding increases the risk for PPROM.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Evaluation
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO01_Q01
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO01 - Explain the possible causes, risk factors, and clinical therapy for premature rupture of the membranes or preterm labor in determining the nursing care management of the woman and her fetus-newborn.
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Question 139541Id: 139541
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
A clinical nurse coordinator is teaching a class of nursing students about surgical and postoperative care of the woman who undergoes cerclage. Which nursing student’s statement indicates the need for further clarification of the teaching?
Stimulus
Answer
Choice 1 “Sometimes cerclage can be performed on an outpatient basis.”
Rationale 1
An uncomplicated elective cerclage may be done on an outpatient basis or the woman may be hospitalized and discharged after 24 to 48 hours. An emergency cerclage, however, requires hospitalization for 5 to 7 days or longer.
Answer 1 false
Choice 2“If cerclage is performed emergently, the woman will usually be hospitalized for at least five days.”
Rationale 2
An uncomplicated elective cerclage may be done on an outpatient basis or the woman may be hospitalized and discharged after 24 to 48 hours. An emergency cerclage, however, requires hospitalization for 5 to 7 days or longer.
Answer 2 false
Choice 3“If the woman’s amniotic sac is bulging, the cerclage is contraindicated and the procedure cannot be performed.”
Rationale 3Decompression of a bulging amniotic sac is not a contraindication to cerclage; rather, the amniotic sac must be decompressed immediately before the procedure.
Answer 3 true
Choice 4“After 37 weeks’ gestation, the woman’s cerclage may be cut in order to allow for vaginal delivery.”
Rationale 4After 37 completed weeks’ gestation, the suture may be cut and vaginal birth permitted, or the suture may be left in place and a cesarean birth performed.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Evaluating
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Evaluation
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO03_Q02
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1: LO03 – Explain cervical insufficiency and describe its clinical therapy.
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Question 139542Id: 139542
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
A 26-year-old woman who is pregnant with her first child is admitted to the obstetrics unit with a diagnosis of cervical insufficiency. Based upon the patient’s diagnosis, how is she most likely to describe her symptoms?
Stimulus
Answer
Choice 1 “I’ve been having contractions every four hours.”
Rationale 1Cervical insufficiency (formerly called incompetent cervix) is painless dilatation of the cervix without contractions due to a structural or functional defect of the cervix.
Answer 1 false
Choice 2 “My cervical pain has gotten much worse over the past two days.”
Rationale 2Cervical insufficiency (formerly called incompetent cervix) is painless dilatation of the cervix without contractions due to a structural or functional defect of the cervix.
Answer 2 false
Choice 3 “I’m not having any pain, but my contractions are getting stronger.”
Rationale 3Cervical insufficiency (formerly called incompetent cervix) is painless dilatation of the cervix without contractions due to a structural or functional defect of the cervix.
Answer 3 false
Choice 4 “I’m not having any pain and I don’t feel any contractions.”
Rationale 4Cervical insufficiency (formerly called incompetent cervix) is painless dilatation of the cervix without contractions due to a structural or functional defect of the cervix.
Answer 4 true
Global Rationale
Meta 1
Cognitive Level: Evaluating
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Assessment
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO03 _Q03
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1: LO03 – Explain cervical insufficiency and describe its clinical therapy.
Learning Outcome 2:
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Question 139543Id: 139543
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
The nurse has received an end of shift report in the high-risk maternity unit. Which patient should the nurse see first?
Stimulus
Answer
Choice 126 weeks’ gestation with placenta previa experiencing blood on toilet tissue after a bowel movement
Rationale 1Bleeding with a placenta previa is a complication that can be life-threatening to both the mother and baby. This patient is the highest priority.
Answer 1 true
Choice 230 weeks’ gestation with placenta previa whose fetal monitor strip shows late decelerations
Rationale 2Late decelerations are an abnormal finding, but put only the fetus at risk. This patient is not the highest priority.
Answer 2 false
Choice 335 weeks’ gestation with grade I abruptio placentae in labor who has a strong urge to push
Rationale 3Grade I abruptio placentae creates slight vaginal bleeding. The urge to push indicates that delivery is near. This patient is not the highest priority.
Rationale 4Although pregnancy-induced hypertension puts a woman at risk for developing abruptio placentae, there is no indication that this patient is experiencing this complication. This patient is not the highest priority.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Planning
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO02 _Q04
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO02 - Compare placenta previa and abruptio placentae, including implications for the mother and fetus, as well as nursing care.
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Question 139544Id: 139544
Question Title:
Type: MCMADifficulty Level:
Calculator:
false
Question Stem
The nurse is planning an in-service educational program to talk about disseminating intravascular coagulation (DIC). The nurse should identify which of the following as risk factors for developing DIC?
Standard Text Select all that apply.
Stimulus
Answer
Choice 1 Diabetes mellitus
Rationale 1Diabetes, multiparity, and preterm labor do not cause the same release of thromboplastin that triggers DIC.
Answer 1 false
Choice 2 Abruptio placentae
Rationale 2
Abruptio placentae leave intrauterine arteries open and bleeding. This results in release of thromboplastin into the maternal blood supply and triggers the development of DIC. In prolonged retention of the fetus after demise, thromboplastin is released from the degenerating fetal tissues into the maternal bloodstream, which activates the extrinsic clotting system. This triggers the formation of multiple tiny clots, which deplete the fibrinogen and factors V and VII, and result in DIC.
Answer 2 true
Choice 3 Prolonged retention of a fetus after demise
Rationale 3 Abruptio placentae leave intrauterine arteries open and bleeding. This results in release of thromboplastin into the maternal blood supply and triggers the development of DIC. In prolonged retention of the fetus after demise, thromboplastin is released from the degenerating fetal tissues into the maternal bloodstream, which activates the extrinsic clotting system. This
triggers the formation of multiple tiny clots, which deplete the fibrinogen and factors V and VII, and result in DIC.
Answer 3 true
Choice 4 Multiparity
Rationale 4Diabetes, multiparity, and preterm labor do not cause the same release of thromboplastin that triggers DIC.
Answer 4 false
Choice 5 Preterm labor
Rationale 5Diabetes, multiparity, and preterm labor do not cause the same release of thromboplastin that triggers DIC.
Answer 5 false
Global Rationale
Meta 1
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Planning
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO02 _Q05
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO02 - Compare placenta previa and abruptio placentae, including implications for the mother and fetus, as well as nursing care.
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Question 139545Id: 139545
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
The patient at 30 weeks’ gestation is admitted with painless late vaginal bleeding. The nurse understands that expectant management includes:
Stimulus
Answer
Choice 1 Limiting vaginal exams to only one per 24-hour period.
Rationale 1 Vaginal exams are contraindicated because the exam can stimulate bleeding.
Answer 1 false
Choice 2 Evaluating the fetal heart rate with an internal monitor.
Rationale 2Fetal heart rate monitoring will be done with an external fetal monitor. The placenta is covering the cervical os, and therefore the fetal scalp cannot be accessed to apply an internal monitor.
Answer 2 false
Choice 3 Monitoring for blood loss, pain, and uterine contractibility.
Rationale 3Blood loss, pain, and uterine contractibility need to be assessed for patient comfort and safety.
Answer 3 true
Choice 4 Assessing blood pressure every 2 hours.
Rationale 4Blood pressure measurements every 2 hours are unnecessary. They can be done on a routine basis or p.r.n.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Planning
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO02 _Q06
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO02 - Compare placenta previa and abruptio placentae, including implications for the mother and fetus, as well as nursing care.
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Question 139546Id: 139546
Question Title:
Type: MCMADifficulty Level:
Calculator:
false
Question Stem
A multigravida patient is admitted to labor and delivery in active labor. Nursing diagnoses that might apply to the patient with suspected abruptio placentae include:
Standard Text Select all that apply.
Stimulus
Answer
Choice 1 Fluid volume, risk for deficit related to hypovolemia.
Rationale 1Maternal and perinatal fetal mortality are concerns due to blood loss and hypoxia.
Answer 1 true
Choice 2 Tissue perfusion, risk for altered related to blood loss.
Rationale 2Maternal and perinatal fetal mortality are concerns due to blood loss and hypoxia.
Answer 2 true
Choice 3 Anxiety related to concern for own safety.
Rationale 3Maternal and perinatal fetal mortality are concerns due to blood loss and hypoxia.
Answer 3 true
Choice 4Knowledge deficit related to lack of information about inherited genetic defects.
Rationale 4Abruptio placentae is a premature separation of the placenta, not a genetic abnormality.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
Nursing/Integrated Concepts:
Nursing Process: Diagnosis
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO02 _Q07
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO02 - Compare placenta previa and abruptio placentae, including implications for the mother and fetus, as well as nursing care.
Learning Outcome 2:
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Question 139547Id: 139547
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
The charge nurse is reviewing the physician’s notes describing the diagnosis of abruptio placentae in a patient who is currently admitted. The physician describes the woman’s placental separation as being “central.” Based upon this description, what can the nurse infer about the woman’s condition?
Stimulus
Answer
Choice 1Blood is trapped between the woman’s placenta and the uterine wall, and she may have concealed bleeding.
Rationale 1With the central type of placental separation, blood is trapped between the placenta and uterine wall with concealed bleeding.
Answer 1 true
Choice 2The total separation of the woman’s placenta from the uterine wall will lead to massive hemorrhage.
Rationale 2
With marginal placental separation, blood passes between the fetal membranes and the uterine wall and escapes vaginally. With central placental separation, blood is trapped between the placenta and uterine wall, and bleeding is concealed. With complete separation, there is total separation of the placenta from the uterine wall, and massive bleeding ensues.
Answer 2 false
Choice 3Blood is passing between the fetal membranes and the woman’s uterine wall, which will lead to some vaginal bleeding.
Rationale 3
With marginal placental separation, blood passes between the fetal membranes and the uterine wall and escapes vaginally. With central placental separation, blood is trapped between the placenta and uterine wall, and bleeding is concealed. With complete separation, there is total separation of the placenta from the uterine wall, and massive bleeding ensues.
Answer 3 false
Choice 4 The slight separation of the woman’s placenta from the uterine wall will not
produce any bleeding.
Rationale 4
With marginal placental separation, blood passes between the fetal membranes and the uterine wall and escapes vaginally. With central placental separation, blood is trapped between the placenta and uterine wall, and bleeding is concealed. With complete separation, there is total separation of the placenta from the uterine wall, and massive bleeding ensues.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Evaluating
Client Need: Physiological Integrity
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Assessment
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO02 _Q08
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO02 - Compare placenta previa and abruptio placentae, including implications for the mother and fetus, as well as nursing care.
Learning Outcome 2:
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Question 139548Id: 139548
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
The home health nurse is admitting a patient at 18 weeks who is pregnant with twins. Which nursing action is most important?
Stimulus
Answer
Choice 1 Teach the patient about foods that are good sources of protein.
Rationale 1A diet containing 3,500 kcal (minimum) and 175 g protein is recommended for a woman with normal-weight twins. Teaching about protein sources facilitates adequate fetal growth.
Answer 1 true
Choice 2 Assess the patient’s blood pressure in her upper right arm.
Rationale 2
Pre-eclampsia is not diagnosed until the 20th week of gestation. This patient is only at 18 weeks. Further, blood pressure can be assessed in either arm when the patient is in a sitting position; in a side-lying position, the blood pressure should be assessed in the upper arm.
Answer 2 false
Choice 3 Determine whether the pregnancy is a result of infertility treatment.
Rationale 3
Although the incidence of multifetal pregnancy is higher in pregnancies resulting from infertility treatment than in those resulting from spontaneous pregnancies, the cause of the multifetal pregnancy does not impact nursing care.
Answer 3 false
Choice 4 Collect a cervicovaginal fetal fibronectin (fFN) specimen.
Rationale 4Preterm labor is not diagnosed until 20 weeks. This patient is only at 18 weeks. Fetal fibronectin (fFN) testing is not indicated at this time.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Implementation
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO04 _Q09
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO04 - Explain the maternal and fetal-neonatal implications and the clinical therapy in determining the nursing care management of the woman with multiple gestation.
Learning Outcome 2:
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Question 139549Id: 139549
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
In counseling a newly pregnant gravida 1 at 8 weeks’ twin gestation, the nurse teaches the woman about the need for increased caloric intake. The nurse would tell the woman that the minimum recommended intake should be:
Stimulus
Answer
Choice 1 2,500 kcal and 120 grams protein.
Rationale 1 This is less than recommended for a twin-gestation pregnancy.
Answer 1 false
Choice 2 3,000 kcal and 150 grams protein.
Rationale 2 This is less than recommended for a twin-gestation pregnancy.
Answer 2 false
Choice 3 3,500 kcal and 175 grams protein.
Rationale 3This is the recommended caloric and protein intake in a twin-gestation pregnancy.
Answer 3 true
Choice 4 4,000 kcal and 190 grams protein.
Rationale 4 This is more than recommended for a twin-gestation pregnancy.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Implementation
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21 LO04 Q10
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO04 - Explain the maternal and fetal-neonatal implications and the clinical therapy in determining the nursing care management of the woman with multiple gestation.
Learning Outcome 2:
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Standard 6:
Question 139550Id: 139550
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
When a woman who is experiencing a multiple fetal pregnancy asks, “What are the chances of having an uncomplicated pregnancy?” the nurse answers with which statement?
Stimulus
Answer
Choice 1 The perinatal mortality rate for monoamniotic siblings is 50%.
Rationale 1 The perinatal mortality rate for monoamniotic siblings is 10–32%.
Answer 1 false
Choice 2 Twins are less likely to have complications than are singleton births.
Rationale 2 Twins are more likely to have complications than are singleton births.
Answer 2 false
Choice 3Primiparous women pregnant with twins are less likely to develop complications.
Rationale 3Primiparous women with twin pregnancies are more likely to develop complications.
Answer 3 false
Choice 4 Spontaneously conceived twins are less likely to develop complications.
Rationale 4This is true. Spontaneously conceived twins are less likely to develop complications.
Answer 4 true
Global Rationale
Meta 1
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Planning
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21 LO04 Q11
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO04 - Explain the maternal and fetal-neonatal implications and the clinical therapy in determining the nursing care management of the woman with multiple gestation.
Learning Outcome 2:
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Standard 6:
Question 139551Id: 139551
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
The patient at 38 weeks’ gestation has been diagnosed with oligohydramnios. Which statement indicates that teaching has been effective?
Stimulus
Answer
Choice 1 “My gestational diabetes may have caused this problem to develop.”
Rationale 1Gestational diabetes can lead to polyhydramnios but does not cause oligohydramnios.
Answer 1 false
Choice 2 “When I go into labor, I should come to the hospital right away.”
Rationale 2
The incidence of cord compression and resulting fetal distress is high when there is an inadequate amount of amniotic fluid to cushion the umbilical cord. Thus, the patient with oligohydramnios should come to the hospital in early labor to detect any fetal intolerance of labor that might develop.
Answer 2 true
Choice 3 “This problem is common and will likely occur with my next pregnancy.”
Rationale 3Oligohydramnios occurs in 1–3% of pregnancies. It rarely recurs in subsequent pregnancies.
Answer 3 false
Choice 4 “Women with this condition usually go into labor after their due date.”
Rationale 4The risk of fetal demise is increased with oligohydramnios. Labor is usually induced when the patient reaches term pregnancy to prevent fetal demise.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Evaluation
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21_LO05_Q12
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO05 - Compare the identification, maternal and fetal-neonatal implications, clinical therapy, and nursing care management of women with hydramnios and oligohydramnios.
Learning Outcome 2:
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Question 139552Id: 139552
Question Title:
Type: MCMADifficulty Level:
Calculator:
false
Question Stem
The nurse is admitting a patient who was diagnosed with hydramnios. The patient asks why she has developed this condition. The nurse should explain that hydramnios is sometimes associated with:
Standard Text Select all that apply.
Stimulus
Answer
Choice 1 Chest pain, dyspnea, tachycardia, and hypotension.
Rationale 1Chest pain, dyspnea, tachycardia, and hypotension are symptoms of amniotic embolism, which occurs more commonly with hydramnios. Hydramnios occurs in 10–20% of pregnant diabetics.
Answer 1 true
Choice 2 Postmaturity syndrome.
Rationale 2Renal malformation or dysfunction and postmaturity can cause oligohydramnios.
Answer 2 true
Choice 3 Renal malformation or dysfunction.
Rationale 3Renal malformation or dysfunction and postmaturity can cause oligohydramnios.
Answer 3 false
Choice 4 Maternal diabetes.
Rationale 4 Hydramnios is not associated with maternal diabetes.
Answer 4 true
Choice 5 Large-for-gestational-age infants.
Rationale 5Large-for-gestational-age infants and placenta previa are not associated with hydramnios.
Answer 5 false
Global Rationale
Meta 1
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
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Nursing/Integrated Concepts:
Nursing Process: Implementation
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Reference:
Source Id: Chapter 21_LO05_Q13
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Source Au Title Ed:
Source Usage:
Writer First Name: admin
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Meta 4
Learning Outcome 1:LO05 - Compare the identification, maternal and fetal-neonatal implications, clinical therapy, and nursing care management of women with hydramnios and oligohydramnios.
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Question 139553Id: 139553
Question Title:
Type: MCMADifficulty Level:
Calculator:
false
Question Stem
When caring for a laboring patient with oligohydramnios, the nurse should be aware that:
Standard Text Select all that apply.
Stimulus
Answer
Choice 1 There is an increased risk of cord compression.
Rationale 1Less amniotic fluid lessens the cushioning effect, and cord compression is more likely.
Answer 1 true
Choice 2There is less fluid available for the fetus to use during fetal breathing movements; therefore, pulmonary hypoplasia can develop, which could cause respiratory difficulties at birth.
Rationale 2
Answer 2 true
Choice 3 Labor progress is often more rapid than average.
Rationale 3 Labor progress is slower than average due to the decreased fluid volume.
Answer 3 false
Choice 4 Early decelerations are more likely.
Rationale 4Decreased amniotic fluid can contribute to fetal head compression, which manifests itself in early decelerations.
Answer 4 true
Global Rationale
Meta 1
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Planning
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21 LO05 Q14
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO05 - Compare the identification, maternal and fetal-neonatal implications, clinical therapy, and nursing care management of women with hydramnios and oligohydramnios.
Learning Outcome 2: Health Promotion and Maintenance
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Question 139554Id: 139554
Question Title:
Type: MCSADifficulty Level:
Calculator:
false
Question Stem
Hydramnios most likely would be suspected when:
Stimulus
Answer
Choice 1 There is less amniotic fluid than normal for gestation.
Rationale 1Hydramnios occurs when there is more amniotic fluid than normal for gestation.
Answer 1 false
Choice 2 The fundal height increases disproportionately to the gestation.
Rationale 2The increased amount of amniotic fluid will increase the fundal height disproportionately to the gestation.
Answer 2 true
Choice 3 The woman has a twin gestation.
Rationale 3 Hydramnios is not suspected simply by virtue of a twin gestation.
Answer 3 false
Choice 4 The quadruple screen comes back positive.
Rationale 4 A positive quadruple screen is not indicative of hydramnios.
Answer 4 false
Global Rationale
Meta 1
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
Nursing/Integrated Concepts:
Nursing Process: Assessment
Content Area:
Content Area Sub:
Meta 2
Clinical Domain:
Topical Category:
Topical SubCategory:
Pearson Nursing Taxonomy #:
Taxonomy Category Comments:
Key Terms:
Strategy:
Meta 3
Reference:
Source Id: Chapter 21 LO05 Q15
Source Chapter Number:
Source Chapter Title:
Source Au Title Ed:
Source Usage:
Writer First Name: admin
Writer Last Name:
Royalty:
Stakes:
Special Handling:
Comments:
Meta 4
Learning Outcome 1:LO05 - Compare the identification, maternal and fetal-neonatal implications, clinical therapy, and nursing care management of women with hydramnios and oligohydramnios.
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