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Which factor is known to increase the risk of gestational diabetes mellitus?
- A. Previous birth of large infant
- B. Maternal age younger than 25 years
- C. Underweight prior to pregnancy
- D. Previous diagnosis of type 2 diabetes mellitus
Correct Answer: A
Rationale: The correct answer is A: Previous birth of large infant. This factor increases the risk of gestational diabetes mellitus due to the association with maternal insulin resistance. Large infants may have been exposed to higher glucose levels in utero, leading to increased risk in subsequent pregnancies. Maternal age younger than 25 years (B) is not a known risk factor. Being underweight prior to pregnancy (C) is actually associated with a lower risk of gestational diabetes. Previous diagnosis of type 2 diabetes mellitus (D) is a separate condition and not a risk factor for gestational diabetes.
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Which cardiac disease has the lowest risk for maternal mortality?
- A. Endocarditis
- B. Aortic stenosis
- C. Patent ductus arteriosus
- D. Pulmonary hypertension
Correct Answer: C
Rationale: The correct answer is C: Patent ductus arteriosus. This condition typically does not pose a significant risk for maternal mortality because it is a relatively benign cardiac defect that does not significantly impact maternal health during pregnancy. Other choices, such as endocarditis, aortic stenosis, and pulmonary hypertension, have higher risks for maternal mortality due to complications like heart failure, arrhythmias, and increased risk of thromboembolic events. Therefore, patent ductus arteriosus is the lowest risk for maternal mortality among the given options.
Which finding in the exam of a patient with a diagnosis of threatened abortion would change the diagnosis to inevitable abortion?
- A. Presence of backache
- B. Rise in hCG level
- C. Clear fluid from vagina
- D. Pelvic pressure
Correct Answer: C
Rationale: The correct answer is C: Clear fluid from vagina. In threatened abortion, the pregnancy is at risk but the fetus is still viable. In inevitable abortion, there is no chance of continuation. Clear fluid from the vagina indicates rupture of membranes, leading to inevitable abortion due to the loss of amniotic fluid. Backache, rise in hCG levels, and pelvic pressure are common symptoms in threatened abortion but do not definitively indicate progression to inevitable abortion.
The labor and birth nurse is reviewing the risk factors for placenta previa with a group of nursing students. The nurse determines that the students understood the discussion when they identify which patient being at the highest risk for developing a placenta previa?
- A. Female fetus, Mexican-American, primigravida
- B. Male fetus, Asian-American, previous preterm birth
- C. Male fetus, African-American, previous cesarean birth
- D. Female fetus, European-American, previous spontaneous abortion
Correct Answer: C
Rationale: The correct answer is C: Male fetus, African-American, previous cesarean birth. Placenta previa occurs when the placenta partially or completely covers the cervix. African-American women have a higher incidence of placenta previa. Previous cesarean birth is a risk factor due to possible scarring on the uterine wall, increasing the likelihood of placenta implantation issues. Male fetuses are associated with a higher risk of placenta previa, possibly due to a larger placental size. The other choices do not align with known risk factors for placenta previa, such as the ethnicity, fetal gender, and obstetric history mentioned.
What virus is highly contagious, spread through airborne particles, and can cause intrauterine fetal demise, skin scarring, eye, limb or neurologic abnormalities, anemia, thrombocytopenia, and low birth weight in the fetus?
- A. toxoplasmosis
- B. syphilis
- C. rubella
- D. Varicella (chickenpox)
Correct Answer: D
Rationale: The correct answer is D: Varicella (chickenpox). Varicella virus is highly contagious and spreads through airborne particles. It can cause intrauterine fetal demise, skin scarring, eye, limb, or neurologic abnormalities, anemia, thrombocytopenia, and low birth weight in the fetus. Varicella infection during pregnancy can lead to severe complications for both the mother and the fetus. Toxoplasmosis (A), syphilis (B), and rubella (C) can also cause complications during pregnancy, but they do not match all the characteristics mentioned in the question.
Which finding on a prenatal visit at 10 weeks might suggest a hydatidiform mole?
- A. Blood pressure of 120/80 mm Hg
- B. Complaint of frequent mild nausea
- C. Fundal height measurement of 18 cm
- D. History of bright red spotting for 1 day weeks ago
Correct Answer: C
Rationale: The correct answer is C: Fundal height measurement of 18 cm. At 10 weeks of gestation, the fundal height should typically measure around 10-12 cm. A fundal height measurement of 18 cm would suggest excessive growth, which is a characteristic finding in a hydatidiform mole due to abnormal proliferation of placental tissue.
Incorrect choices:
A: Blood pressure of 120/80 mm Hg is within normal range and not specific to hydatidiform mole.
B: Complaint of frequent mild nausea is a common symptom in early pregnancy and not specific to a mole.
D: History of bright red spotting for 1 day weeks ago is more indicative of a potential previous miscarriage, not necessarily a mole.