Foundations of Nursing 8th Edition Cooper Test Bank
Chapter 29: Care of the High-Risk Mother, Newborn, and Family With Special Needs
Cooper: Foundations of Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient is admitted to the hospital with hyperemesis gravidarum. The patient is
malnourished and severely dehydrated. The care plan should be altered to include which
interventions?
a. Hyperalimentation
b. IV fluids and electrolyte replacement
c. Hormone replacement therapy
d. Vitamin supplements
ANS: B
Medical treatment is aimed at meeting fluid and electrolyte replacement.
DIF: Cognitive Level: Application REF: 910 OBJ: 1
TOP: Hyperemesis gravidarum KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity
2. A patient with hyperemesis gravidarum asks the nurse what would have happened if she had
not come to the hospital. What result is the best response by the nurse?
a. A large for gestational age infant
b. Anorexia nervosa
c. Preterm delivery
d. Maternal or fetal death N R I G B.C M
U S N T O
ANS: D
If untreated, hyperemesis gravidarum can result in maternal or fetal death.
DIF: Cognitive Level: Application REF: 879 OBJ: 1
TOP: Hyperemesis gravidarum KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
3. How should twins who share a placenta and come from one fertilized ovum be identified?
a. Dizygotic
b. Trizygotic
c. Genetically different
d. Monozygotic
ANS: D
Monozygotic twins, also known as identical twins, originate from one fertilized ovum and
share a placenta. Monozygotic twins carry the same genetic code. Dizygotic twins are the
result of two separate ova being fertilized at the same time.
DIF: Cognitive Level: Comprehension REF: 879 OBJ: 1
TOP: Multifetal pregnancy KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
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Foundations of Nursing 8th Edition Cooper Test Bank
4. What complication of delivery should the nurse expect with the birth of multiple fetuses?
a. An ectopic tendency
b. Difficulty with breast-feeding
c. A vaginal delivery
d. Loss of uterine tone
ANS: D
Delivery of multiple fetuses is often complicated by loss of uterine tone. Oftentimes
multiple fetuses are delivered by cesarean. An ectopic tendency would present before
delivery. While it can be difficult to breastfeed multiple infants, this does not relate to the
delivery.
DIF: Cognitive Level: Application REF: 879 OBJ: 1
TOP: High-risk pregnancy KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
5. A patient is admitted to the hospital with signs of an ectopic pregnancy. What should the
plan of care include for the patient?
a. Long-term bed rest
b. Episodes of extreme hypertension
c. Surgery to remove the embryo/fetus
d. Treatment for dehydration
ANS: C
An ectopic implantation occurs somewhere outside the uterus and either resolves itself in a
spontaneous abortion or requires surgical intervention.
N R I G B.C
U S N T
DIF: Cognitive Level: Application OM 880
REF: OBJ: 1
TOP: Ectopic pregnancy KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity
6. What percent of first-trimester pregnancies spontaneously abort?
a. 5% to 10%
b. 10% to15%
c. 20% to 25%
d. 40% to 50%
ANS: B
It is estimated that 10% to 15% of first-trimester pregnancies end in spontaneous abortion.
DIF: Cognitive Level: Knowledge REF: 882 OBJ: 1
TOP: Abortions KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
7. What symptom, no matter what stage of pregnancy, should be reported immediately?
a. Backache
b. Urinary frequency
c. Vaginal bleeding
d. Uterine tightening
ANS: C
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Foundations of Nursing 8th Edition Cooper Test Bank
Women should be instructed to contact their health care provider if any bleeding occurs
during pregnancy.
DIF: Cognitive Level: Comprehension REF: 883 OBJ: 2
TOP: Vaginal bleeding KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
8. A patient in her second trimester of pregnancy arrives at the hospital complaining of bright
red, painless vaginal bleeding. What condition should the nurse immediately suspect?
a. Abruptio placentae
b. Hemorrhage
c. Placenta previa
d. Placentitis
ANS: C
Placenta previa is a serious condition that consists of bright red painless vaginal bleeding
occurring after 20 weeks of pregnancy. The major symptoms of abruptio placentae are
severe abdominal pain and uterine rigidity.
DIF: Cognitive Level: Application REF: 885 OBJ: 2
TOP: Placenta previa KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
9. A pregnant woman comes to the hospital 3 weeks before her estimated date of birth (EDB)
complaining of severe pain and a rigid abdomen. What should the nurse immediately
suspect as the cause of the pain?
a. Placenta previa NURSINGTB.COM
b. Appendicitis
c. Ectopic pregnancy
d. Abruptio placentae
ANS: D
The major symptoms of abruptio placentae are severe pain and a rigid abdomen. Placenta
previa consists of painless bleeding. Appendicitis is not usually accompanied by a rigid
abdomen. Symptoms of an ectopic pregnancy would usually occur in the first trimester.
DIF: Cognitive Level: Application REF: 887 OBJ: 2
TOP: Abruptio placentae KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
10. A patient presents with symptoms of abruptio placentae. To facilitate uterine-placental
perfusion, in what position would the nurse place the patient?
a. Prone position
b. Trendelenburg’s position
c. Supine position
d. Modified side-lying position
ANS: D
A modified side-lying position facilitates uterine-placental perfusion.
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Foundations of Nursing 8th Edition Cooper Test Bank
DIF: Cognitive Level: Application REF: 888 OBJ: 2
TOP: Abruptio placentae KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
11. A pregnant woman visits a clinic visit during her 21st week of pregnancy. The nurse
identifies edema, hypertension, and proteinuria. What condition does the nurse suspect?
a. Allergy
b. Protein deficiency
c. Circulatory problem
d. Gestational hypertension
ANS: D
Gestational hypertension (GH), formerly referred to as pregnancy-induced hypertension
(PIH), is a disease encountered during pregnancy or early in the puerperium, characterized
by increasing hypertension, proteinuria, and generalized edema. These signs generally
appear after the 20th week of pregnancy.
DIF: Cognitive Level: Analysis REF: 890 OBJ: 4
TOP: Pregnancy-induced hypertension (PIH)
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
12. What condition is a possible cause of gestational hypertension?
a. Too much salt
b. A toxin
c. Renal disease
d. Diabetes
ANS: C
N R I G B.C M
U S N T O
Gestational hypertension may be caused by other existing conditions, such as renal disease.
DIF: Cognitive Level: Knowledge REF: 890 OBJ: 4
TOP: Pregnancy-induced hypertension (PIH)
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
13. What should the nurse hope to identify by keeping a record of a patient’s blood pressure
during prenatal visits?
a. Ketoacidosis
b. Placenta previa
c. Gestational diabetes
d. Gestational hypertension
ANS: D
Blood pressure should be assessed routinely during pregnancy, because symptoms of
gestational hypertension include hypertension.
DIF: Cognitive Level: Comprehension REF: 890 OBJ: 4
TOP: Pregnancy-induced hypertension (PIH)
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
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Foundations of Nursing 8th Edition Cooper Test Bank
14. The nurse is assessing a “kick count” for a patient with gestational hypertension. What
result should be a cause for concern?
a. Less than three kicks per hour
b. Less than five kicks per hour
c. Less than seven kicks per hour
d. Less than nine kicks per hour
ANS: A
A kick count of fewer than three per hour is considered serious and a cause for concern.
DIF: Cognitive Level: Application REF: 892 OBJ: 3
TOP: Pregnancy-induced hypertension (PIH)
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
15. When discussing toxoplasmosis infection during pregnancy, what should the nurse caution
the patient to avoid?
a. Contacting with an infected person
b. Emptying cat litter boxes bare-handed
c. Having unprotected sex
d. Eating excessive amounts of shellfish
ANS: B
A pregnant woman should wear gloves whenever having contact with cat feces as this is a
possible source of toxoplasmosis infection.
DIF: Cognitive Level: Application REF: 897 OBJ: 6
TOP: Infection KEY: Nursing Process Step: Implementation
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MSC: NCLEX: Health Promotion NGTB.COM
Maintenance
16. What is a major complication of gestational diabetes that affects the infant?
a. Lack of nutrition
b. Dehydration
c. Hypoglycemia
d. Hyperglycemia
ANS: C
A result of gestational diabetes is neonatal hypoglycemia.
DIF: Cognitive Level: Comprehension REF: 897 OBJ: 1
TOP: Diabetes KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
17. A pregnant patient who has type 2 diabetes (NIDDM) may require insulin. Why is the
insulin necessary?
a. The growing baby will require more glucose.
b. Oral hypoglycemic agents may be teratogenic.
c. Increased hormone levels raise blood glucose.
d. Oral hypoglycemics do not reach the fetus.
ANS: B
Oral hypoglycemics are discontinued because of teratogenic effects.
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Foundations of Nursing 8th Edition Cooper Test Bank
DIF: Cognitive Level: Comprehension REF: 898 OBJ: 5
TOP: Diabetes KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
18. Why is the fetus dependent on the mother for glucose control?
a. The insulin requirements are higher.
b. Insulin is destroyed by the placenta.
c. Insulin does not cross the placenta.
d. Insulin is absorbed by the fetus.
ANS: C
Insulin will not cross the placenta, but high glucose levels do. Therefore, it is imperative that
the mother control glucose levels.
DIF: Cognitive Level: Analysis REF: 901 OBJ: 5
TOP: Diabetes KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
19. A patient with a history of rheumatic heart disease is being admitted to the labor and
delivery unit. To prevent further stress on the heart, what should the nurse anticipate to be
ordered?
a. Oxygen administration
b. Administering large amount of IV fluids
c. Positioning the patient on her back
d. Encouraging activity between contractions
ANS: A
N R I G B.C M
U S N T O
Oxygen is administered to increase blood oxygen saturation and decrease the stress on the
heart. IV fluid administration is kept to a minimum to prevent fluid overload. The patient
would be positioned in a semi-Fowler’s position to improve circulation. The patient should
be encouraged to rest between contractions to conserve energy.
DIF: Cognitive Level: Application REF: 901 OBJ: 12
TOP: Cardiovascular defects KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance
20. A 14-year-old pregnant adolescent arrives at the hospital in early labor. The nurse should
recognize that the adolescent is at a greater risk for which problem?
a. Calcium deficit
b. Cephalopelvic disproportion
c. Bleeding tendency
d. Low hemoglobin levels
ANS: B
There are several physiologic concerns for pregnant adolescents, including cephalopelvic
disproportion.
DIF: Cognitive Level: Analysis REF: 903 OBJ: 7
TOP: Adolescent pregnancy KEY: Nursing Process Step:
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Foundations of Nursing 8th Edition Cooper Test Bank
Assessment
MSC: NCLEX: Physiological Integrity
21. When should the gestational age of the infant be determined?
a. Within 5 to 10 minutes of delivery
b. Within 1 to 2 hours of delivery
c. Within 2 to 8 hours of delivery
d. Within 12 to 24 hours of delivery
ANS: C
The gestational age tests are done within 2 to 8 hours of delivery.
DIF: Cognitive Level: Comprehension REF: 908 OBJ: 9
TOP: Gestational age KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
22. The newborn infant has oxygenation problems and a lack of subcutaneous fat. What should
the nurse determine as the gestational age of this infant?
a. 20 to 37 completed weeks of pregnancy
b. 38 to 41 completed weeks of pregnancy
c. 14 to 36 completed weeks of pregnancy
d. 42 or more completed weeks of pregnancy
ANS: A
The lungs of preterm infants have not fully developed; therefore, they have problems with
oxygenation. Preterm infants also lack subcutaneous fat. The gestational age of the preterm
is classified as 20 to 37 complete weeks of pregnancy.
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DIF: Cognitive Level: Analysis REF: 909 OBJ: 9
TOP: Preterm KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance
23. Compared to older infants of comparable weight, how much higher is the morbidity and
mortality rate for preterm infants?
a. One to two times
b. Two to three times
c. Three to four times
d. Four to five times
ANS: C
The morbidity and mortality rate for preterm infants is higher by three to four times that of
an older infant of similar weight.
DIF: Cognitive Level: Comprehension REF: 907-908 OBJ: 9
TOP: Preterm KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
24. A neonate is born with weak muscle tone, froglike extremities, and ears that fold easily.
From these observations, what gestational age should the nurse give this infant?
a. Full term
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Foundations of Nursing 8th Edition Cooper Test Bank
b. Small for gestational age
c. Preterm
d. Postterm
ANS: C
Preterm infant posture is froglike, the muscle tone is weak, and the ears are easily folded.
DIF: Cognitive Level: Analysis REF: 910 OBJ: 9
TOP: Preterm KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
25. A primigravida is Rh negative and her husband is Rh positive. She is concerned about the
health of the fetus. The nurse explains that there is little danger to the fetus if it is Rh
positive; however, the mother would become sensitized during delivery. If this were the
case, the mother would produce what in subsequent pregnancies?
a. Rh-negative blood cells
b. Rh-positive blood cells
c. Rh-negative antibodies
d. Rh-positive antibodies
ANS: D
If the mother is exposed to the Rh antigen, Rh-positive antibodies will be produced after
delivery of an Rh-positive baby. If the baby is Rh negative, no antibodies will be produced.
DIF: Cognitive Level: Analysis REF: 912 OBJ: 10
TOP: Hemolytic disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
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26. The nurse assures a patient who has become sensitized to the Rh antigen that she can be
protected for future pregnancies by receiving what injection?
a. Iron
b. Vitamin B12
c. RhoGAM
d. Type O blood
ANS: C
RhoGAM prevents the development of naturally occurring maternal antibodies.
DIF: Cognitive Level: Comprehension REF: 912 OBJ: 10
TOP: Hemolytic disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
27. The nurse is assessing the newborn and discovers a yellowing of the skin. What is true for
jaundice that appears at birth?
a. Within normal limits
b. Pathologic
c. A result of iron deficiency
d. Indicating possible hepatitis
ANS: B
NURSINGTB.COM
Foundations of Nursing 8th Edition Cooper Test Bank
Jaundice observed at birth is considered an indicator of a pathologic condition,
erythroblastosis fetalis. It is considered abnormal.
DIF: Cognitive Level: Comprehension REF: 911-912 OBJ: 10
TOP: Hemolytic disease KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
28. What test is used to identify the maternal level of Rh antibodies in the mother’s blood?
a. Indirect Coombs’ test
b. Hemolytic test
c. Rh antibody test
d. Direct Coombs’ test
ANS: A
The indirect Coombs’ test measures the maternal level of antibodies.
DIF: Cognitive Level: Knowledge REF: 912 OBJ: 3
TOP: Hemolytic disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
29. A nursery nurse is implementing phototherapy for a jaundiced infant. What is the purpose of
the phototherapy?
a. It is initiated when the bilirubin level reaches 5 mg/dL.
b. It converts bilirubin to a water-soluble form to be excreted in the urine.
c. It changes bilirubin to a bile salt to be excreted through the bowel.
d. It requires eye patches to remain in place 24 hours a day.
ANS: B
N R I G B.C M
U S N T O
Phototherapy converts the bilirubin into a water-soluble form to be excreted by the kidneys.
It is initiated when the bilirubin level reaches 12 to 15 mg/dL. The eye patches are worn
during therapy, but removed for feeding, bathing, and socialization.
DIF: Cognitive Level: Analysis REF: 912 OBJ: 10
TOP: Hemolytic disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
30. Why do alcohol and illegal drugs endanger the fetus?
a. Both are absorbed into the bloodstream.
b. Both affect the mother.
c. Both cross the placental barrier.
d. Both increase the heart rate of the fetus.
ANS: C
Alcohol and illicit drugs cross the placental barrier and affect the fetus.
DIF: Cognitive Level: Application REF: 876 | 913 OBJ: 8
TOP: Fetal risk from drugs KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
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Foundations of Nursing 8th Edition Cooper Test Bank
31. Cognitive impairment, facial abnormalities, and growth retardation are characteristics of
which abnormality in a fetus?
a. Fetal dependency
b. Fetal immaturity
c. Malnutrition dependency
d. Fetal alcohol syndrome
ANS: D
Use of alcohol may result in multiple anomalies called fetal alcohol syndrome. The fetus
may also be born with alcohol dependency and immaturity, but the characteristics noted are
specific for fetal alcohol syndrome.
DIF: Cognitive Level: Application REF: 876 OBJ: 8
TOP: Fetal risk KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
32. What should be specifically monitored in a patient who is hospitalized with gestational
hypertension?
a. Blood sugar
b. Temperature
c. Level of consciousness
d. Deep tendon reflexes
ANS: D
If the patient is hospitalized for gestational hypertension, deep tendon reflexes are
monitored. The blood sugar, temperature, and LOC will also be monitored, but they are not
the priority in the hypertensive patient.
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DIF: Cognitive Level: Application REF: 891 OBJ: 4
TOP: Eclampsia KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity
33. What is the antidote for magnesium sulfate toxicity?
a. Vitamin K
b. Calcium gluconate
c. Potassium sulfate
d. Calcium carbonate
ANS: B
The antidote for magnesium sulfate toxicity is calcium gluconate.
DIF: Cognitive Level: Knowledge REF: 892 OBJ: 11
TOP: Maternal risk KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment
34. What is a prominent feature of postpartum depression?
a. Failure to thrive
b. Rejection of the infant
c. Inability to care for the baby
d. Problems with the baby’s father
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Foundations of Nursing 8th Edition Cooper Test Bank
ANS: B
A prominent feature of PPD is rejection of the infant.
DIF: Cognitive Level: Comprehension REF: 916 OBJ: 1
TOP: Postpartum depression (PPD) KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity
35. What is the usual treatment for severe postpartum depression?
a. Improved nutrition
b. Vitamin therapy
c. Pharmacologic interventions
d. Support group therapy
ANS: C
Support therapy is not enough for major PPD. Pharmacologic interventions are needed in
most instances.
DIF: Cognitive Level: Comprehension REF: 878 OBJ: 1
TOP: Postpartum depression (PPD) KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity
MULTIPLE RESPONSE
1. A pregnant patient with tuberculosis asks the nurse how the disease will affect her
pregnancy and her newborn. What statements by the nurse are most appropriate? (Select all
that apply.)
NURS
a. “You have nothing to worry
INGYou
about. TB.C M
willObe disease free before you deliver.”
b. “The tuberculosis can be transmitted to the fetus in rare occurrences.”
c. “Your newborn will be tested for tuberculosis after delivery.”
d. “There is no approved treatment for the infant if she tests positive for the disease.”
e. “You will not be able to hold your newborn until you have been cleared according
to the health department guidelines.”
ANS: B, C, E
TB can be transmitted to a fetus in the womb. Newborns of infected mothers are skin tested
for TB after birth and treated if the skin test is positive. Mothers who have TB are not
allowed to have exposure to their newborn until they have been cleared according to the
health department standards.
DIF: Cognitive Level: Application REF: 894 OBJ: 13
TOP: Pulmonary tuberculosis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
COMPLETION
1. Following an abruptio placentae, the patient suddenly becomes dyspneic, complains of chest
pain, and begins to ooze blood from her IV insertion site. The nurse assesses these as
indicators of disseminated ______________ coagulation.
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Foundations of Nursing 8th Edition Cooper Test Bank
ANS:
intravascular
DIC is characterized by dyspnea, chest pain, and uncontrolled bleeding.
DIF: Cognitive Level: Application REF: 887 OBJ: 2
TOP: Disseminated intravascular coagulation (DIC)
KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity
2. The nurse reports to the charge nurse that the 3-hour postpartum patient is bleeding
excessively as she has saturated one peripad in less than ______ minutes.
ANS:
15
fifteen
The saturation of one peripad within 15 minutes is considered to be excessive bleeding.
DIF: Cognitive Level: Comprehension REF: 889 OBJ: 3
TOP: Postpartum hemorrhage KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
3. The nurse explains that severe _________________ needs to be controlled because it can
develop into another syndrome called HELLP (Hypertension, Elevated Liver enzymes, and
Low Platelets).
ANS: NURSINGTB.COM
preeclampsia
Progressive preeclampsia can develop into HELLP syndrome.
DIF: Cognitive Level: Comprehension REF: 890 OBJ: 4
TOP: Hypertension | Elevated Liver enzymes, and Low Platelets (HELLP)
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance
4. The patient who has taken the ovulation stimulant clomiphene (Clomid), and who has been
determined to be pregnant, calls the clinic nurse to report that she is bleeding and has passed
a small grapelike object. From this information the nurse suspects a hydatidiform
____________.
ANS:
mole
Hydatidiform moles occur frequently in people who have taken Clomid. The physical
changes are similar to a real pregnancy until bleeding occurs and some grapelike clusters are
passed.
DIF: Cognitive Level: Application REF: 880 OBJ: 3
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Foundations of Nursing 8th Edition Cooper Test Bank
TOP: Hydatidiform mole KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
5. A woman who is 14 weeks’ pregnant calls the clinic nurse to report that after a brief
bleeding episode a week ago, her uterus seems to have gotten smaller, but her periods have
not begun. The nurse assesses the indicators for a _____________ abortion.
ANS:
missed
A missed abortion is initiated by a bleeding episode in which the fetus is not expelled. The
uterus begins to shrink, but periods do not resume.
DIF: Cognitive Level: Application REF: 880 OBJ: 3
TOP: Missed abortion KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity
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