Review Practice Exercise 5

Maternal Risk Factors > Maternal Newborn

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Practice Exercise 5

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Total Questions : 5

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Question 1:

A nurse is conducting a psychosocial assessment. Which condition is a significant psychosocial risk factor for poor pregnancy outcomes?

A. Gestational diabetes B. Intimate partner violence C. Placental abruption D. Multiple gestation

Answer and Explanation

Choice A:

Gestational diabetes is a medical, not psychosocial, condition. It is associated with fetal macrosomia (>4000 g), neonatal hypoglycemia (normal 40–60 mg/dL), and polyhydramnios. However, it does not represent a psychosocial factor, and thus it is not the correct answer to this question.

Choice B:

Intimate partner violence is a psychosocial condition that significantly increases the risk of poor pregnancy outcomes. It causes maternal stress, depression, inadequate prenatal care, and substance use, all of which increase fetal morbidity and mortality. The question specifically asks for a psychosocial factor, making this the correct choice.

Choice C:

Placental abruption is a direct obstetric complication caused by premature separation of the placenta, leading to hemorrhage and fetal distress. It presents with abdominal pain, vaginal bleeding, and non-reassuring fetal heart tones (normal baseline 110–160 bpm). It is a physical complication, not a psychosocial risk factor.

Choice D:

Multiple gestation is a biological condition that increases obstetric risk such as preterm birth, preeclampsia, and intrauterine growth restriction. It does not fall under psychosocial factors, which relate to social, emotional, or behavioral conditions affecting pregnancy outcomes.

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Question 2:

What is a key nursing intervention for a patient with suspected intimate partner violence during pregnancy?

A. Administering magnesium sulfate B. Conducting private, sensitive screening C. Ordering a non-stress test D. Monitoring blood glucose levels

Answer and Explanation

Choice A:

Administering magnesium sulfate is indicated for preeclampsia or eclampsia to prevent seizures. It has no role in identifying or addressing intimate partner violence, which requires psychosocial screening and intervention.

Choice B:

Conducting private, sensitive screening is the essential nursing intervention for suspected intimate partner violence. Asking nonjudgmental questions in a safe, confidential environment allows accurate identification of abuse and timely referral to resources, thereby reducing maternal and fetal morbidity.

Choice C:

Ordering a non-stress test evaluates fetal well-being by monitoring fetal heart rate (normal baseline 110–160 bpm). While useful in obstetric complications, it does not address the underlying psychosocial risk factor of intimate partner violence.

Choice D:

Monitoring blood glucose levels is appropriate for gestational diabetes management. Normal fasting glucose in pregnancy is <95 mg/dL, but this is unrelated to psychosocial risk factors such as intimate partner violence.

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Question 3:

A nurse is monitoring a patient with multiple gestation. What is a common complication associated with twin pregnancies?

A. Postpartum depression B. Preterm birth C. Neural tube defects D. Congenital rubella syndrome

Answer and Explanation

Choice A:

Postpartum depression is a psychosocial condition associated with hormonal shifts, lack of support, and stress. While it may occur after any pregnancy, it is not a direct obstetric complication unique to multiple gestation.

Choice B:

Preterm birth is the most common complication of multiple gestation. Uterine overdistension, hormonal changes, and increased uteroplacental insufficiency lead to early labor, often before 37 weeks, making this the correct answer.

Choice C:

Neural tube defects such as spina bifida occur due to folate deficiency and genetic predisposition. They are not more common specifically because of multiple gestation, though nutritional demands are higher in twin pregnancies.

Choice D:

Congenital rubella syndrome results from maternal rubella infection during pregnancy. It is unrelated to multiple gestation and presents with deafness, cataracts, and congenital heart disease, not a complication caused by twin pregnancy.

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Question 4:

Which of the following are potential consequences of intimate partner violence during pregnancy? Select all that apply.

A. Miscarriage B. Preterm labor C. Placental abruption D. Fetal macrosomia E. Neonatal hypoglycemia

Answer and Explanation

Choice A:

Miscarriage can occur from direct abdominal trauma or severe maternal stress. Disruption of placental attachment and uterine perfusion contributes to early pregnancy loss.

Choice B:

Preterm labor is strongly associated with intimate partner violence. Stress hormones and trauma can trigger uterine contractions, leading to delivery before 37 weeks gestation.

Choice C:

Placental abruption results from trauma to the abdomen or chronic vascular stress, leading to premature placental separation. This causes vaginal bleeding, abdominal pain, and compromised fetal oxygenation.

Choice D:

Fetal macrosomia (>4000 g) is usually associated with gestational diabetes due to maternal hyperglycemia and increased fetal insulin production. It is not a complication of intimate partner violence.

Choice E:

Neonatal hypoglycemia (plasma glucose <40 mg/dL in the first 24 hours) is also linked to infants of diabetic mothers due to excess insulin production in utero. It does not result from intimate partner violence.

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Question 5:

Which of the following are obstetric complications associated with placental abnormalities? Select all that apply.

A. Maternal hemorrhage B. Fetal hypoxia C. Neonatal hypoglycemia D. Preterm birth E. Congenital heart defects

Answer and Explanation

Choice A:

Maternal hemorrhage occurs with placental abruption and placenta previa, where separation or abnormal implantation of the placenta leads to severe bleeding.

Choice B:

Fetal hypoxia results from impaired maternal-fetal oxygen transfer when the placenta detaches or is compromised, leading to abnormal fetal heart rate patterns.

Choice C:

Neonatal hypoglycemia (plasma glucose <40 mg/dL in first 24 hours) is most commonly seen in infants of diabetic mothers or those with intrauterine growth restriction. It is not directly caused by placental abnormalities.

Choice D:

Preterm birth is common with placental abnormalities, often due to bleeding, uteroplacental insufficiency, or iatrogenic delivery to save maternal or fetal life.

Choice E:

Congenital heart defects are structural anomalies from abnormal embryonic development, often linked to genetic syndromes or teratogens like rubella. They are not a complication of placental pathology.

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Practice Exercise 5

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