ATI RN
Antenatal care for complicated pregnancies Questions
Question 1 of 5
Anti-infective prophylaxis is indicated for a pregnant patient with a history of mitral valve stenosis related to rheumatic heart disease because the patient is at risk of developing
Correct Answer: C
Rationale: The correct answer is C: bacterial endocarditis. Pregnant patients with mitral valve stenosis are at increased risk for developing bacterial endocarditis due to the presence of abnormal valve structures. This condition can lead to serious complications including septic emboli and heart failure. Hypertension (choice A) is not directly related to mitral valve stenosis. Postpartum infection (choice B) is not a primary concern in this scenario. Upper respiratory infections (choice D) are not specifically associated with mitral valve stenosis. In summary, anti-infective prophylaxis is indicated to prevent bacterial endocarditis in pregnant patients with a history of mitral valve stenosis.
Question 2 of 5
Between which weeks of gestation would a client with type 1 diabetes expect to increase her insulin dosage?
Correct Answer: C
Rationale: The correct answer is C (24th and 28th weeks of gestation) because during the second and third trimesters of pregnancy, insulin needs typically increase due to hormonal changes causing insulin resistance. This is when the placenta produces hormones that interfere with insulin, leading to higher blood sugar levels. Choices A, B, and D are incorrect because they do not align with the typical pattern of insulin dosage adjustments during pregnancy for clients with type 1 diabetes.
Question 3 of 5
A pregnant client with a history of preterm labor is at home on bed rest. Which instruction would be included in this client's teaching plan?
Correct Answer: C
Rationale: The correct answer is C: Lie on the side with the head raised on a small pillow. This position helps improve circulation to the uterus and placenta, reducing the risk of preterm labor. Lying on the left side also promotes optimal blood flow. Option A is incorrect as elevating the foot of the bed can decrease blood flow to the placenta. Option B may cause discomfort and increase pressure on the cervix. Option D is not suitable for bed rest as it involves being on all fours, which is not conducive to rest and relaxation.
Question 4 of 5
A pregnant client is admitted with abdominal pain and heavy vaginal bleeding. Which is the immediate nursing action?
Correct Answer: A
Rationale: The correct immediate nursing action is to administer oxygen (Choice A) to ensure adequate oxygenation for both the mother and the fetus. Oxygen is crucial in cases of vaginal bleeding as it helps maintain tissue perfusion and prevent hypoxia. Elevating the head of the bed (Choice B) is not the priority as oxygenation should be addressed first. Drawing blood for a hematocrit level (Choice C) may provide valuable information but does not address the immediate need for oxygen. Giving an intramuscular analgesic (Choice D) is not appropriate without knowing the cause of the pain and bleeding.
Question 5 of 5
Which position increases cardiac output in the obstetrical client with cardiac disease?
Correct Answer: C
Rationale: The correct answer is C: Lateral positioning. This position increases cardiac output in obstetrical clients with cardiac disease by improving venous return to the heart, reducing pressure on the vena cava, and optimizing uteroplacental perfusion. The other choices are incorrect because Trendelenburg can worsen cardiac function by increasing venous return and intracardiac volume, low semi-Fowler does not optimize venous return and may decrease preload, and supine positioning with legs elevated can compress the vena cava, leading to decreased cardiac output and potential hypotension.