ATI RN
Common Complications in Early Pregnancy Questions
Question 1 of 5
A woman was administered misoprostol (Cytotec) in an effort to induce labor, but the care team is unsatisfied with the results. Consequently, oxytocin will be used. Prior to administering oxytocin, what must occur?
Correct Answer: A
Rationale: A: The correct answer is A. Four hours must elapse after the last dose of misoprostol before administering oxytocin. Misoprostol is a prostaglandin E1 analog used to ripen the cervix and induce labor. Oxytocin, on the other hand, is a hormone that stimulates uterine contractions. The care team must wait at least four hours after administering misoprostol to avoid the risk of uterine hyperstimulation when oxytocin is subsequently administered. This timing ensures that the uterus has had time to recover from the effects of misoprostol, reducing the likelihood of complications during labor induction. B: The incorrect answer is B. The woman having a type and cross-match performed is not a necessary step prior to administering oxytocin. Type and cross-match are typically done to determine the patient's blood type and screen for any antibodies that may cause transfusion reactions. While it is important to know the patient's blood type in case a blood transfusion is needed during labor, it is not directly related to the administration of oxytocin. C: The incorrect answer is C. The woman receiving a bolus of 500-mL normal saline is not a required step before administering oxytocin. Normal saline may be used during labor to maintain hydration and electrolyte balance, but it is not specifically needed before starting oxytocin. It is essential to monitor the woman's fluid status and provide hydration as needed, but a bolus of normal saline is not a prerequisite for oxytocin administration. D: The incorrect answer is D. The woman having her electrolytes measured is not a mandatory step before administering oxytocin. While monitoring electrolyte levels is important during labor, especially if oxytocin is being used, checking electrolytes before starting oxytocin is not a standard requirement. It is crucial to monitor electrolytes throughout labor to ensure proper hydration and prevent complications, but it does not need to be done immediately before oxytocin administration.
Question 2 of 5
A primiparous woman was vigilant in avoiding medications and herbs during her pregnancy and states that she is similarly committed to protecting her baby's health now that she is breast-feeding. What principle should guide the woman's use of medications while breast-feeding?
Correct Answer: D
Rationale: Choice A is incorrect because while it is true that very few medications are explicitly contraindicated while breastfeeding, it does not mean that most medications are safe to use. It is essential for the woman to consult with her healthcare provider before taking any medication while breastfeeding to ensure the safety of the baby. Choice B is also incorrect because the safety of herbs during breastfeeding is not well-studied, and some herbs can have adverse effects on the baby. It is generally recommended to avoid using herbs while breastfeeding unless approved by a healthcare provider. Choice C is incorrect because not all women can resume their prepregnancy medication regimen after delivery. Some medications can pass into breast milk and potentially harm the baby. It is crucial for the woman to discuss with her healthcare provider about the safety of continuing any medications while breastfeeding. The correct answer is D because most medications are not safe to use while a woman is breastfeeding. Many medications can pass into breast milk and have harmful effects on the baby. It is essential for the woman to be cautious and consult with her healthcare provider before taking any medication while breastfeeding to ensure the safety of her baby.
Question 3 of 5
Which of these statements best describes the action of the hormone progesterone during pregnancy?
Correct Answer: D
Rationale: Progesterone plays a crucial role in maintaining pregnancy by supporting the endometrium, the lining of the uterus, where the fertilized egg implants and the fetus develops. This hormone is produced by the corpus luteum in the ovaries during the early stages of pregnancy and later by the placenta. Choice A is incorrect because progesterone does not produce human chorionic gonadotropin (hCG). hCG is produced by the developing placenta and is responsible for maintaining the corpus luteum to continue producing progesterone until the placenta takes over. Choice B is incorrect because duct formation in the breast is actually stimulated by estrogen, not progesterone. Estrogen is responsible for the development of breast tissue and ductal growth. Choice C is incorrect because progesterone does not promote sloughing of the endometrial wall during pregnancy. In fact, progesterone helps prevent the shedding of the endometrium by maintaining its thickness and vascularity to support the growing fetus. Therefore, the correct answer is D because progesterone plays a crucial role in maintaining the endometrium around the fetus during pregnancy to provide a suitable environment for fetal development.
Question 4 of 5
The nurse auscultates a functional systolic murmur, grade II/IV, on a woman in week 30 of her pregnancy. The remainder of her physical assessment is within normal limits. The nurse would:
Correct Answer: C
Rationale: Option C is the correct answer because during pregnancy, there is a physiological increase in blood volume to support the growing fetus and meet the demands of the maternal body. This increase in blood volume can lead to the development of innocent or functional murmurs, which are common and typically benign in pregnant women. The grade II/IV systolic murmur heard by the nurse is likely due to the increased blood flow through the heart and is not indicative of any underlying pathology. Therefore, it is important for the nurse to recognize this finding as a normal physiological response to pregnancy. Option A is incorrect because referring the woman for additional consultation is unnecessary in this situation. The grade II/IV systolic murmur is likely innocent and related to the increased blood volume during pregnancy, so there is no need for further investigation or intervention. Option B is incorrect because asking the woman to run briefly in place to assess for an increase in intensity of the murmur is not necessary. Innocent murmurs in pregnancy are typically not affected by physical activity and do not change in intensity based on exercise. This action may cause unnecessary stress and anxiety for the woman without providing any valuable information. Option D is incorrect because restricting the woman's activities and asking her to return for re-evaluation in 1 week is not warranted. As mentioned earlier, innocent murmurs in pregnancy are common and benign, so there is no need for restrictions or frequent follow-up visits for this finding. The nurse should educate the woman about the normal physiological changes in pregnancy and reassure her that the murmur is likely harmless.
Question 5 of 5
Which finding is considered normal and expected when the nurse is performing a physical examination on a pregnant woman?
Correct Answer: A
Rationale: The correct answer is A because a palpable, full thyroid is a normal finding during pregnancy. Significant diffuse enlargement of the thyroid is abnormal and indicates various conditions. Pale mucous membranes may suggest anemia, and edema in one lower leg with pain could indicate deep vein thrombosis.