STgBANK
Maternity,gNewborn,gandgWomen'sgHealthgNursinggAgCase-
BasedgApproachgbygDr.gAmygO'Meara
2ndgEdition
TEST BANK!!!
g
, MaternitygNewborngandgWomen’sgHealthgNursinggAgCase-BasedgApproachg2nd
EditiongO’MearagTest
BankChapterg1gImmediategPostpartumgHemorrhagegMULTIP
LEgCHOICE
1. Agpregnantgwomangisgbeinggdischargedgfromgtheghospitalgaftergthegplacementgofgagcervicalg
cerclagegbecausegofgaghistorygofgrecurrentgpregnancygloss,gsecondarygtogangincompetentgcervi
x.gWhichginformationgregardinggpostproceduralgcaregshouldgthegnursegemphasizegingthegdisch
argegteaching?
a. Anygvaginalgdischargegshouldgbegimmediatelygreportedgtogherghealthgcaregprovider.
b. Thegpresencegofganygcontractions,grupturegofgmembranesg(ROM),gorgseveregperinealgpressuregsho
d
c. Thegclientgwillgneedgtogmakegarrangementsgforgcaregatghome,gbecauseghergactivityglevelgwillgbegr
ri
d. Thegclientgwillgbegscheduledgforgagcesareangbirth
.gANS:gB
Nursinggcaregshouldgstressgthegimportancegofgmonitoringgforgthegsignsgandgsymptomsgofgpreterm
labor.gVaginalgbleedinggneedsgtogbegreportedgtoghergprimaryghealthgcaregprovider.gBedgrestgisgang
elementgofgcare.gHowever,gthegwomangmaygstandgforgperiodsgofgupgtog90gminutes,gwhichgallows
ghergthegfreedomgtogseeghergphysician.gHomeguterinegactivitygmonitoringgmaygbegusedgtoglimitgth
egwomansgneedgforgvisitsgandgtogmonitorghergstatusgsafelygatghome.gThegcerclagegcangbegremoved
gatg37gweeksgofggestationg(togpreparegforgagvaginalgbirth),gorgagcesareangbirthgcangbegplanned.
DIF:gCognitivegLevel:gApplygREF:gdm.g675
TOP:gNursinggProcess:gPlanningg|gNursinggProcess:gImplementatio
ngMSC:gClientgNeeds:gHealthgPromotiongandgMaintenance
2. Agperinatalgnursegisggivinggdischargeginstructionsgtogagwoman,gstatusgpostsuction,gandgcurettag
egsecondarygtogaghydatidiformgmole.gThegwomangasksgwhygshegmustgtakegoralgcontraceptivesgfo
rgthegnextg12gmonths.gWhatgisgthegbestresponsegbygthegnurse?
Ifgyouggetgpregnantgwithing1gyear,gthegchancegofgagsuccessfulgpregnancygisgverygsmall.gTherefore
a. pregnancy,gitgwouldgbegbettergforgyougtogusegthegmostgreliablegmethodgofgcontraceptiongavailable
Thegmajorgriskgtogyougaftergagmolargpregnancygisgagtypegofgcancergthatgcangbegdiagnosedgonlygby
meghormonegthatgyourgbodygproducesgduringgpregnancy.gIfg yougweregtoggetgpregnant,gthengitgwo
dgmak
b. thisgcancergmoregdifficult.
Ifgyougcangavoidgagpregnancygforgthegnextgyear,gthegchancegofgdevelopinggagsecondgmolargpregna
y
c. improvegyourgchancegofgagsuccessfulgpregnancy,gnotggettinggpregnantgatgthisgtimegisgbest.
d. Oralgcontraceptivesgaregthegonlygformgofgbirthgcontrolgthatgwillgpreventgagrecurrencegofgagmolargp
eggANS:gB
Betahumangchorionicggonadotroping(beta-hCG)ghormoneglevelsgaregdrawngforg1g yeargtogensure
thatgthegmolegisgcompletelyggone.gThegchancegofgdevelopinggchoriocarcinomagaftergthegdevelop
mentgofgaghydatidiformgmolegisgincreased.gTherefore,gtheggoalgisgtogachievegagzeroghumangchorio
nicggonadotroping(hCG)glevel.gIfgthegwomangweregtogbecomegpregnant,gthengitgmaygobscuregthegp
resencegofgthegpotentiallygcarcinogenicgcells.gWomengshouldgbeginstructedgtogusegbirthgcontrolgf
MedgC
,org1gyeargaftergtreatmentgforgaghydatidiformgmole.gThegrationalegforgavoidinggpregnancy
MedgC
, forg1gyeargisgtogensuregthatgcarcinogenicgcellsgaregnotgpresent.gAnygcontraceptivegmethodgexcep
tgangintrauterinegdeviceg(IUD)gisgacceptable.
DIF:gCognitivegLevel:gApplygREF:gdm.g679
TOP:gNursinggProcess:gPlanningg|gNursinggProcess:gImplementatio
ngMSC:gClientgNeeds:gPhysiologicgIntegrity
3. Thegnursegisgpreparinggtogadministergmethotrexategtogthegclient.gThisghazardousgdru
ggisgmostgoftengusedgforgwhichgobstetricgcomplication?
a. Completeghydatidiformgmole
b. Missedgabortion
c. Unrupturedgectopicgpregnancy
d. Abruptiogplacentae
gANS:gC
Methotrexategisgangeffectivegnonsurgicalgtreatmentgoptiongforgaghemodynamicallygstablegwoman
whosegectopicgpregnancygisgunrupturedgandgmeasuresglessgthang4gcmgingdiameter.gMethotrexategi
sgnotgindicatedgorgrecommendedgasgagtreatmentgoptiongforgagcompleteghydatidiformgmole,gforgag
missedgabortion,gorgforgabruptiogplacentae.
DIF:gCognitivegLevel:gApplygREF:gdm.g677gTOP:gNursinggProcess:gPlanninggMS
C:gClientgNeeds:gPhysiologicgIntegrity
4. Ag26-year-oldgpregnantgwoman,ggravidag2,gparag1-0-0-
1,gisg28gweeksgpregnantgwhengshegexperiencesgbrightgred,gpainlessgvaginalgbleeding.gOnghergarri
valgatgtheghospital,gwhichgdiagnosticgproceduregwillgthegclientgmostglikelyghavegperformed?
a. Amniocentesisgforgfetalglunggmaturity
b. Transvaginalgultrasoundgforgplacentalglocation
c. Contractiongstressgtestg(CST)
d. Internalgfetalgmonitoring
gANS:gB
Thegpresencegofgpainlessg bleedinggshouldgalwaysgalertgtheghealthgcaregteamgtogthegpossibilitygof
placentagprevia,gwhichgcangbegconfirmedgthroughgultrasonography.gAmniocentesisgisgnotgperfor
medgongagwomangwhogisgexperiencinggbleeding.gIngthegeventgofgangimminentgdelivery,gthegfetusg
isgpresumedgtoghavegimmatureglungsgatgthisggestationalgage,gandgthegmothergisggivengcorticostero
idsgtogaidgingfetalglunggmaturity.gAgCSTgisgnotgperformedgatgagpretermggestationalgage.gFurtherm
ore,gbleedinggisgagcontraindicationgtogagCST.gInternalgfetalgmonitoringgisgalsogcontraindicatedging
thegpresencegofgbleeding.
DIF:gCognitivegLevel:gApplygREF:gdm.g680
TOP:gNursinggProcess:gAssessmentgMSC:gClientgNeeds:gHealthgPromotiongandgMaintenance
5. AglaboringgwomangwithgnogknowngriskgfactorsgsuddenlygexperiencesgspontaneousgROM.gTh
egfluidgconsistsgofgbrightgredgblood.gHergcontractionsgaregconsistentgwithghergcurrentgstagegofgla
bor.gNogchangeginguterinegrestinggtoneghasgoccurred.gThegfetalgheartgrateg(FHR)gbeginsgtogdecli
negrapidlygaftergthegROM.gThegnursegshouldgsuspectgthegpossibilitygofgwhatgcondition?
a. Placentagprevia
b. Vasagprevia
c. Severegabruptiogplacentae
MedgC
Maternity,gNewborn,gandgWomen'sgHealthgNursinggAgCase-
BasedgApproachgbygDr.gAmygO'Meara
2ndgEdition
TEST BANK!!!
g
, MaternitygNewborngandgWomen’sgHealthgNursinggAgCase-BasedgApproachg2nd
EditiongO’MearagTest
BankChapterg1gImmediategPostpartumgHemorrhagegMULTIP
LEgCHOICE
1. Agpregnantgwomangisgbeinggdischargedgfromgtheghospitalgaftergthegplacementgofgagcervicalg
cerclagegbecausegofgaghistorygofgrecurrentgpregnancygloss,gsecondarygtogangincompetentgcervi
x.gWhichginformationgregardinggpostproceduralgcaregshouldgthegnursegemphasizegingthegdisch
argegteaching?
a. Anygvaginalgdischargegshouldgbegimmediatelygreportedgtogherghealthgcaregprovider.
b. Thegpresencegofganygcontractions,grupturegofgmembranesg(ROM),gorgseveregperinealgpressuregsho
d
c. Thegclientgwillgneedgtogmakegarrangementsgforgcaregatghome,gbecauseghergactivityglevelgwillgbegr
ri
d. Thegclientgwillgbegscheduledgforgagcesareangbirth
.gANS:gB
Nursinggcaregshouldgstressgthegimportancegofgmonitoringgforgthegsignsgandgsymptomsgofgpreterm
labor.gVaginalgbleedinggneedsgtogbegreportedgtoghergprimaryghealthgcaregprovider.gBedgrestgisgang
elementgofgcare.gHowever,gthegwomangmaygstandgforgperiodsgofgupgtog90gminutes,gwhichgallows
ghergthegfreedomgtogseeghergphysician.gHomeguterinegactivitygmonitoringgmaygbegusedgtoglimitgth
egwomansgneedgforgvisitsgandgtogmonitorghergstatusgsafelygatghome.gThegcerclagegcangbegremoved
gatg37gweeksgofggestationg(togpreparegforgagvaginalgbirth),gorgagcesareangbirthgcangbegplanned.
DIF:gCognitivegLevel:gApplygREF:gdm.g675
TOP:gNursinggProcess:gPlanningg|gNursinggProcess:gImplementatio
ngMSC:gClientgNeeds:gHealthgPromotiongandgMaintenance
2. Agperinatalgnursegisggivinggdischargeginstructionsgtogagwoman,gstatusgpostsuction,gandgcurettag
egsecondarygtogaghydatidiformgmole.gThegwomangasksgwhygshegmustgtakegoralgcontraceptivesgfo
rgthegnextg12gmonths.gWhatgisgthegbestresponsegbygthegnurse?
Ifgyouggetgpregnantgwithing1gyear,gthegchancegofgagsuccessfulgpregnancygisgverygsmall.gTherefore
a. pregnancy,gitgwouldgbegbettergforgyougtogusegthegmostgreliablegmethodgofgcontraceptiongavailable
Thegmajorgriskgtogyougaftergagmolargpregnancygisgagtypegofgcancergthatgcangbegdiagnosedgonlygby
meghormonegthatgyourgbodygproducesgduringgpregnancy.gIfg yougweregtoggetgpregnant,gthengitgwo
dgmak
b. thisgcancergmoregdifficult.
Ifgyougcangavoidgagpregnancygforgthegnextgyear,gthegchancegofgdevelopinggagsecondgmolargpregna
y
c. improvegyourgchancegofgagsuccessfulgpregnancy,gnotggettinggpregnantgatgthisgtimegisgbest.
d. Oralgcontraceptivesgaregthegonlygformgofgbirthgcontrolgthatgwillgpreventgagrecurrencegofgagmolargp
eggANS:gB
Betahumangchorionicggonadotroping(beta-hCG)ghormoneglevelsgaregdrawngforg1g yeargtogensure
thatgthegmolegisgcompletelyggone.gThegchancegofgdevelopinggchoriocarcinomagaftergthegdevelop
mentgofgaghydatidiformgmolegisgincreased.gTherefore,gtheggoalgisgtogachievegagzeroghumangchorio
nicggonadotroping(hCG)glevel.gIfgthegwomangweregtogbecomegpregnant,gthengitgmaygobscuregthegp
resencegofgthegpotentiallygcarcinogenicgcells.gWomengshouldgbeginstructedgtogusegbirthgcontrolgf
MedgC
,org1gyeargaftergtreatmentgforgaghydatidiformgmole.gThegrationalegforgavoidinggpregnancy
MedgC
, forg1gyeargisgtogensuregthatgcarcinogenicgcellsgaregnotgpresent.gAnygcontraceptivegmethodgexcep
tgangintrauterinegdeviceg(IUD)gisgacceptable.
DIF:gCognitivegLevel:gApplygREF:gdm.g679
TOP:gNursinggProcess:gPlanningg|gNursinggProcess:gImplementatio
ngMSC:gClientgNeeds:gPhysiologicgIntegrity
3. Thegnursegisgpreparinggtogadministergmethotrexategtogthegclient.gThisghazardousgdru
ggisgmostgoftengusedgforgwhichgobstetricgcomplication?
a. Completeghydatidiformgmole
b. Missedgabortion
c. Unrupturedgectopicgpregnancy
d. Abruptiogplacentae
gANS:gC
Methotrexategisgangeffectivegnonsurgicalgtreatmentgoptiongforgaghemodynamicallygstablegwoman
whosegectopicgpregnancygisgunrupturedgandgmeasuresglessgthang4gcmgingdiameter.gMethotrexategi
sgnotgindicatedgorgrecommendedgasgagtreatmentgoptiongforgagcompleteghydatidiformgmole,gforgag
missedgabortion,gorgforgabruptiogplacentae.
DIF:gCognitivegLevel:gApplygREF:gdm.g677gTOP:gNursinggProcess:gPlanninggMS
C:gClientgNeeds:gPhysiologicgIntegrity
4. Ag26-year-oldgpregnantgwoman,ggravidag2,gparag1-0-0-
1,gisg28gweeksgpregnantgwhengshegexperiencesgbrightgred,gpainlessgvaginalgbleeding.gOnghergarri
valgatgtheghospital,gwhichgdiagnosticgproceduregwillgthegclientgmostglikelyghavegperformed?
a. Amniocentesisgforgfetalglunggmaturity
b. Transvaginalgultrasoundgforgplacentalglocation
c. Contractiongstressgtestg(CST)
d. Internalgfetalgmonitoring
gANS:gB
Thegpresencegofgpainlessg bleedinggshouldgalwaysgalertgtheghealthgcaregteamgtogthegpossibilitygof
placentagprevia,gwhichgcangbegconfirmedgthroughgultrasonography.gAmniocentesisgisgnotgperfor
medgongagwomangwhogisgexperiencinggbleeding.gIngthegeventgofgangimminentgdelivery,gthegfetusg
isgpresumedgtoghavegimmatureglungsgatgthisggestationalgage,gandgthegmothergisggivengcorticostero
idsgtogaidgingfetalglunggmaturity.gAgCSTgisgnotgperformedgatgagpretermggestationalgage.gFurtherm
ore,gbleedinggisgagcontraindicationgtogagCST.gInternalgfetalgmonitoringgisgalsogcontraindicatedging
thegpresencegofgbleeding.
DIF:gCognitivegLevel:gApplygREF:gdm.g680
TOP:gNursinggProcess:gAssessmentgMSC:gClientgNeeds:gHealthgPromotiongandgMaintenance
5. AglaboringgwomangwithgnogknowngriskgfactorsgsuddenlygexperiencesgspontaneousgROM.gTh
egfluidgconsistsgofgbrightgredgblood.gHergcontractionsgaregconsistentgwithghergcurrentgstagegofgla
bor.gNogchangeginguterinegrestinggtoneghasgoccurred.gThegfetalgheartgrateg(FHR)gbeginsgtogdecli
negrapidlygaftergthegROM.gThegnursegshouldgsuspectgthegpossibilitygofgwhatgcondition?
a. Placentagprevia
b. Vasagprevia
c. Severegabruptiogplacentae
MedgC
