, Nursingmaterials
Table of content
Chapter 1: Bess Gaskell: Immediate Postpartum Hemorrhage
Chapter 2: Tatiana Bennett: Later Postpartum Hemorrhage
Chapter 3: Susan Rockwell: Gestational Diabetes, Deep Vein Thrombosis, and
Postpartum Pulmonary Embolism
Chapter 4: Sophie Bloom: Preeclampsia
Chapter 5: Letitia Richford: Cord Prolapse and Nonreassuring Fetal Status
Chapter 6: Rebecca Sweet: Placental Abruption and Fetal Loss
Chapter 7: Hannah Wilder: Chorioamnionitis and Neonatal Sepsis
Chapter 8: Graciella Muñez: Preterm Premature Rupture of Membranes and
Neonatal Respiratory Distress Syndrome
Chapter 9: Nancy Ng: Gestational Diabetes, Macrosomia, and Neonatal
Cephalohematoma
Chapter 10: Lexi Cowslip: Advanced Maternal Age, HELLP Syndrome, and
Neonatal Necrotizing Enterocolitis
Chapter 11: Edie Wilson: Migraine With Aura, Shoulder Dystocia, and Brachial
Plexus Palsy
Chapter 12: Loretta Hale: Intimate Partner Violence, Formula Feeding, and
Postpartum Depression
Chapter 13: Tanya Green: Gestational Trophoblastic Disease (Molar Pregnancy)
and Advanced Maternal Age
Chapter 14: Before Conception
Chapter 15: Pregnancy
Chapter 16: Labor and Delivery
Chapter 17: After Delivery
Chapter 18: The Newborn
Chapter 19: Conditions Existing Before Conception
Chapter 20: Conditions Occurring During Pregnancy
Chapter 21: Complications Occurring Before Labor and Delivery
Chapter 22: Complications Occurring During Labor and Delivery
Chapter 23: Conditions Occurring After Delivery
Chapter 24: Conditions in the Newborn Related to Gestational Age, Size, Injury,
and Pain
Chapter 25: Acquired Conditions and Congenital Abnormalities in the Newborn
Chapter 26: Wellness and Health Promotion
Chapter 27: Common Gynecological Conditions
Chapter 28: Infections
Chapter 29: Family Planning
Chapter 30: Vulnerable Populations
Nursingmaterials
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Maternity Newborn and Women’s Health Nursing A Case-Based Approach 2nd
EditionO’ Test Bank
Chapter 1 Immediate Postpartum Hemorrhage
MULTIPLE CHOICE
1. A pregnant woman is being discharged from the hospital after the placement of a cervical
cerclage because of a history of recurrent pregnancy loss, secondary to an incompetent cervix.
Which information regarding postprocedural care should the nurse emphasize in the discharge
teaching?
a. Any vaginal discharge should be immediately reported to her health care provider.
b. The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure sho
c. The client will need to make arrangements for care at home, because her activity level will be res
d. The client will be scheduled for a cesarean birth.
ANS: B
Nursing care should stress the importance of monitoring for the signs and symptoms of preterm
labor. Vaginal bleeding needs to be reported to her primary health care provider. Bed rest is an
element of care. However, the woman may stand for periods of up to 90 minutes, which allows
her the freedom to see her physician. Home uterine activity monitoring may be used to limit the
womans need for visits and to monitor her status safely at home. The cerclage can be removed at
37 weeks of gestation (to prepare for a vaginal birth), or a cesarean birth can be planned.
DIF: Cognitive Level: Apply REF: dm. 675
TOP: Nursing Process: Planning | Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
2. A perinatal nurse is giving discharge instructions to a woman, status postsuction, and curettage
secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for
the next 12 months. What is the bestresponse by the nurse?
If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore,
a. pregnancy, it would be better for you to use the most reliable method of contraception available.
The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by m
hormone that your body produces during pregnancy. If you were to get pregnant, then it would m
b. this cancer more difficult.
If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnan
c. improve your chance of a successful pregnancy, not getting pregnant at this time is best.
d. Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar pr
ANS: B
Betahuman chorionic gonadotropin (beta-hCG) hormone levels are drawn for 1 year to ensure
that the mole is completely gone. The chance of developing choriocarcinoma after the
development of a hydatidiform mole is increased. Therefore, the goal is to achieve a zero human
chorionic gonadotropin (hCG) level. If the woman were to become pregnant, then it may obscure
the presence of the potentially carcinogenic cells. Women should be instructed to use birth
control for 1 year after treatment for a hydatidiform mole. The rationale for avoiding pregnancy
Med C
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for 1 year is to ensure that carcinogenic cells are not present. Any contraceptive method except
an intrauterine device (IUD) is acceptable.
DIF: Cognitive Level: Apply REF: dm. 679
TOP: Nursing Process: Planning | Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity
3. The nurse is preparing to administer methotrexate to the client. This hazardous drug
is most often used for which obstetric complication?
a. Complete hydatidiform mole
b. Missed abortion
c. Unruptured ectopic pregnancy
d. Abruptio placentae
ANS: C
Methotrexate is an effective nonsurgical treatment option for a hemodynamically stable woman
whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter. Methotrexate is
not indicated or recommended as a treatment option for a complete hydatidiform mole, for a
missed abortion, or for abruptio placentae.
DIF: Cognitive Level: Apply REF: dm. 677 TOP: Nursing Process: Planning
MSC: Client Needs: Physiologic Integrity
4. A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she
experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic
procedure will the client most likely have performed?
a. Amniocentesis for fetal lung maturity
b. Transvaginal ultrasound for placental location
c. Contraction stress test (CST)
d. Internal fetal monitoring
ANS: B
The presence of painless bleeding should always alert the health care team to the possibility of
placenta previa, which can be confirmed through ultrasonography. Amniocentesis is not
performed on a woman who is experiencing bleeding. In the event of an imminent delivery, the
fetus is presumed to have immature lungs at this gestational age, and the mother is given
corticosteroids to aid in fetal lung maturity. A CST is not performed at a preterm gestational age.
Furthermore, bleeding is a contraindication to a CST. Internal fetal monitoring is also
contraindicated in the presence of bleeding.
DIF: Cognitive Level: Apply REF: dm. 680
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
5. A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The
fluid consists of bright red blood. Her contractions are consistent with her current stage of labor.
No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins to decline
rapidly after the ROM. The nurse should suspect the possibility of what condition?
a. Placenta previa
b. Vasa previa
c. Severe abruptio placentae
Med C
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Table of content
Chapter 1: Bess Gaskell: Immediate Postpartum Hemorrhage
Chapter 2: Tatiana Bennett: Later Postpartum Hemorrhage
Chapter 3: Susan Rockwell: Gestational Diabetes, Deep Vein Thrombosis, and
Postpartum Pulmonary Embolism
Chapter 4: Sophie Bloom: Preeclampsia
Chapter 5: Letitia Richford: Cord Prolapse and Nonreassuring Fetal Status
Chapter 6: Rebecca Sweet: Placental Abruption and Fetal Loss
Chapter 7: Hannah Wilder: Chorioamnionitis and Neonatal Sepsis
Chapter 8: Graciella Muñez: Preterm Premature Rupture of Membranes and
Neonatal Respiratory Distress Syndrome
Chapter 9: Nancy Ng: Gestational Diabetes, Macrosomia, and Neonatal
Cephalohematoma
Chapter 10: Lexi Cowslip: Advanced Maternal Age, HELLP Syndrome, and
Neonatal Necrotizing Enterocolitis
Chapter 11: Edie Wilson: Migraine With Aura, Shoulder Dystocia, and Brachial
Plexus Palsy
Chapter 12: Loretta Hale: Intimate Partner Violence, Formula Feeding, and
Postpartum Depression
Chapter 13: Tanya Green: Gestational Trophoblastic Disease (Molar Pregnancy)
and Advanced Maternal Age
Chapter 14: Before Conception
Chapter 15: Pregnancy
Chapter 16: Labor and Delivery
Chapter 17: After Delivery
Chapter 18: The Newborn
Chapter 19: Conditions Existing Before Conception
Chapter 20: Conditions Occurring During Pregnancy
Chapter 21: Complications Occurring Before Labor and Delivery
Chapter 22: Complications Occurring During Labor and Delivery
Chapter 23: Conditions Occurring After Delivery
Chapter 24: Conditions in the Newborn Related to Gestational Age, Size, Injury,
and Pain
Chapter 25: Acquired Conditions and Congenital Abnormalities in the Newborn
Chapter 26: Wellness and Health Promotion
Chapter 27: Common Gynecological Conditions
Chapter 28: Infections
Chapter 29: Family Planning
Chapter 30: Vulnerable Populations
Nursingmaterials
, Nursingmaterials
Maternity Newborn and Women’s Health Nursing A Case-Based Approach 2nd
EditionO’ Test Bank
Chapter 1 Immediate Postpartum Hemorrhage
MULTIPLE CHOICE
1. A pregnant woman is being discharged from the hospital after the placement of a cervical
cerclage because of a history of recurrent pregnancy loss, secondary to an incompetent cervix.
Which information regarding postprocedural care should the nurse emphasize in the discharge
teaching?
a. Any vaginal discharge should be immediately reported to her health care provider.
b. The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure sho
c. The client will need to make arrangements for care at home, because her activity level will be res
d. The client will be scheduled for a cesarean birth.
ANS: B
Nursing care should stress the importance of monitoring for the signs and symptoms of preterm
labor. Vaginal bleeding needs to be reported to her primary health care provider. Bed rest is an
element of care. However, the woman may stand for periods of up to 90 minutes, which allows
her the freedom to see her physician. Home uterine activity monitoring may be used to limit the
womans need for visits and to monitor her status safely at home. The cerclage can be removed at
37 weeks of gestation (to prepare for a vaginal birth), or a cesarean birth can be planned.
DIF: Cognitive Level: Apply REF: dm. 675
TOP: Nursing Process: Planning | Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance
2. A perinatal nurse is giving discharge instructions to a woman, status postsuction, and curettage
secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for
the next 12 months. What is the bestresponse by the nurse?
If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore,
a. pregnancy, it would be better for you to use the most reliable method of contraception available.
The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by m
hormone that your body produces during pregnancy. If you were to get pregnant, then it would m
b. this cancer more difficult.
If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnan
c. improve your chance of a successful pregnancy, not getting pregnant at this time is best.
d. Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar pr
ANS: B
Betahuman chorionic gonadotropin (beta-hCG) hormone levels are drawn for 1 year to ensure
that the mole is completely gone. The chance of developing choriocarcinoma after the
development of a hydatidiform mole is increased. Therefore, the goal is to achieve a zero human
chorionic gonadotropin (hCG) level. If the woman were to become pregnant, then it may obscure
the presence of the potentially carcinogenic cells. Women should be instructed to use birth
control for 1 year after treatment for a hydatidiform mole. The rationale for avoiding pregnancy
Med C
Nursingmaterials
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extra per year?
, Nursingmaterials
for 1 year is to ensure that carcinogenic cells are not present. Any contraceptive method except
an intrauterine device (IUD) is acceptable.
DIF: Cognitive Level: Apply REF: dm. 679
TOP: Nursing Process: Planning | Nursing Process: Implementation
MSC: Client Needs: Physiologic Integrity
3. The nurse is preparing to administer methotrexate to the client. This hazardous drug
is most often used for which obstetric complication?
a. Complete hydatidiform mole
b. Missed abortion
c. Unruptured ectopic pregnancy
d. Abruptio placentae
ANS: C
Methotrexate is an effective nonsurgical treatment option for a hemodynamically stable woman
whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter. Methotrexate is
not indicated or recommended as a treatment option for a complete hydatidiform mole, for a
missed abortion, or for abruptio placentae.
DIF: Cognitive Level: Apply REF: dm. 677 TOP: Nursing Process: Planning
MSC: Client Needs: Physiologic Integrity
4. A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she
experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic
procedure will the client most likely have performed?
a. Amniocentesis for fetal lung maturity
b. Transvaginal ultrasound for placental location
c. Contraction stress test (CST)
d. Internal fetal monitoring
ANS: B
The presence of painless bleeding should always alert the health care team to the possibility of
placenta previa, which can be confirmed through ultrasonography. Amniocentesis is not
performed on a woman who is experiencing bleeding. In the event of an imminent delivery, the
fetus is presumed to have immature lungs at this gestational age, and the mother is given
corticosteroids to aid in fetal lung maturity. A CST is not performed at a preterm gestational age.
Furthermore, bleeding is a contraindication to a CST. Internal fetal monitoring is also
contraindicated in the presence of bleeding.
DIF: Cognitive Level: Apply REF: dm. 680
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
5. A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The
fluid consists of bright red blood. Her contractions are consistent with her current stage of labor.
No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins to decline
rapidly after the ROM. The nurse should suspect the possibility of what condition?
a. Placenta previa
b. Vasa previa
c. Severe abruptio placentae
Med C
Nursingmaterials
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extra per year?
