Review Questions
1
.
The nurse is caring for a patient with a spontaneous abortion at 8 weeks’ gestation. What is the most common cause of first trimester loss?
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ectopic pregnancy
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spontaneous abortion
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cervical insufficiency
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stillbirth
2
.
A 29-year-old Chinese American patient is admitted for IUFD. Her blood pressure (BP) is 90/60, body mass index (BMI) is 41, and the medical and surgical history is noncontributory. She does not smoke or have substance use disorder. What part of her history places her at risk for IUFD?
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age
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obesity
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hypotension
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ethnicity
3
.
What type of testing should be offered to a patient who has had a stillbirth?
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NIPTs
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ultrasound
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placental pathology
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blood crossmatch
4
.
The nurse is providing bereavement care to a family after a stillbirth. What is an example of communication with a patient that demonstrates effective bereavement care?
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“It is so sad that you never became a parent.”
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“Don’t worry. We will take good care of the fetus.”
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“Are there any religious ceremonies you would like for us to coordinate for you?”
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“I know you are grieving. I will take care of all of the decisions for you.”
5
.
The nurse provides education on care after a first trimester loss. What is an example of communication with a patient that demonstrates effective aftercare education?
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“You will need to follow up with us in several weeks. We want to make sure you are doing well.”
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“You should call us if you are bleeding and soaking 4 maxi pads in a day.”
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“Your period will return in 2 weeks.”
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“You should wait 2 months before having intercourse.”
6
.
The nurse provides education on care after a second trimester loss. What is an example of a topic of effective discharge education?
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list of local perinatal support groups
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consent for manual removal of placenta
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signs and symptoms of chorioamnionitis
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how to donate breast milk
7
.
The nurse is caring for a patient who has been diagnosed as having a fetal death. The nurse is aware of the possible causes of intrapartum fetal death. How can the nurse explain the potential causes of IPFD to the patient?
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“We will always find the cause of fetal death with an autopsy.”
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“Infection is never a cause of fetal death.”
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“Umbilical cord entanglement can cause fetal death.”
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“Congenital anomalies cause growth restriction, not fetal death.”
8
.
After reviewing a patient’s history, what does nurse recognize as a risk factor for IPFD?
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chronic hypertension
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hypothyroidism
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depression
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asthma
9
.
The nurse manager is planning a debriefing for several of the nurses after an IPFD. What should the manager expect?
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The nurses will need to discuss fault in order to alleviate feelings of guilt.
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During the debriefing, some nurses will complain of physical tension, headache, and insomnia.
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The nurse caring for the patient will need to defend herself to the health-care provider.
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The charge nurse will discuss the nurse’s documentation to prevent a lawsuit.
10
.
Postpartum depression and anxiety are prevalent among parents experiencing an IPFD. What is an example of a statement by the parent that would alert the nurse to signs of depression?
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“I really miss feeling the baby move in my belly.”
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“My family is supportive, but my partner and I just need a few hours to ourselves.”
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“Before the baby died, I really enjoyed spending time with friends. Now nothing I do brings me joy, and I hate leaving the house.”
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“I feel very sad about not becoming a parent. I really need my support group right now.”
11
.
How can the nurse explain the complications of preterm birth?
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Intraventricular hemorrhage is not a serious complication of prematurity.
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Necrotizing enterocolitis is a condition of prematurity that causes constipation.
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Respiratory distress is a cause of death related to prematurity.
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Surfactant causes premature lungs to be overly pliable and opens the lungs too quickly.
12
.
How can the nurse caring for a patient with a neonatal loss practice self-care?
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Refrain from discussing her feelings at work.
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Understand that depression is normal after neonatal loss.
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Take off work for a week.
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Debrief with manager and colleagues.
13
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How can the nurse be culturally sensitive after a neonatal death?
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Call a priest for all families during this time of grief.
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Recognize that most religions have traditions surrounding death.
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Encourage families to have an open casket to help them deal with the death.
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Discuss cremation, as it is the best process for a neonatal death.
14
.
Supporting siblings through grief after a neonatal loss is difficult. What suggestions should the nurse give parents?
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Try not to discuss your grief with siblings.
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Wait until children are older to be honest about their sibling’s death.
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Give them permission to cry and grieve.
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Avoid displaying pictures of the newborn until the sibling is older.