Test Bank for Maternity Newborn and Women’s Health Nursing: A Case-Based Approach 2nd Edition O’Meara||ISBN NO-10,1975209028||ISBN NO-13,978-1975209025||Complete Chapters||Latest Guide

MATERNITY NEWBORN AND WOMEN’S HEALTH
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NURSING A CASE-BASED APPROACH 2ND
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EDITIONO’MEARA’S TEST BANK
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Chapter: 1 Immediate Postpartum Hemorrhage
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MULTIPLE CHOICE n7

,1. An expectant woman is being discharged from the health center after the
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placementof a cervical cerclage because of a history of recurrent
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gestation/pregnancy loss, secondary to an incompetent cervix. Which information
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regarding post procedural care should the nursing attendantemphasize in the
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discharge teaching?
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a. Any vaginal discharge should be immediately reported to her health care
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provider.b. The presence of any contractions, rupture of membranes (ROM), or severe
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perineal pressure should be reported
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c. The client will need to make arrangements for care at home, because her
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activitylevel will be restricted
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d. The client will be scheduled for a cesarean
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birth.ACCURATE CHOICE:-B
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Reasoning:->>>>Nursing care should stress the importance of monitoring for the n7 n7 n7 n7 n7 n7 n7 n7 n7


signs and symptoms of preterm labor. Vaginal bleeding needs to be reported to her
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primary health care provider. Bed rest is an element of care. However, the woman
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may stand for periods of up to 90 minutes, which allows her the freedom to see
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her physician. Home uterine activity monitoring may be used to limit the womans
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need for visits and to monitor her status safely at home. The cerclage can be
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removed at 37 weeks of gestation (to prepare for a vaginal birth), or a cesarean
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birth can be planned.
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DIF: Cognitive Level: Apply REF: dm. 675
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TOPIC Nursing Process: Planning | Nursing Process: Implementation MSC: Client
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Needs:HealthPromotion and Maintenance
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2. A perinatal nursing attendant is giving discharge instructions to a woman,
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n7status postsuction,and curettage secondary to a hydatidiform mole. The woman asks
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why she must take oral contraceptives for the next 12 months. What is the best
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response by the nursing attendant?
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a. If you get expectant within 1 year, the chance of a successful
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n 7gestation/pregnancy is very small. Therefore, if gestation/pregnancy, it would n7 n 7 n7 n7 n7 n7 n7 n7


be better for you to use the most reliable methodof contraception available.
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b. The major risk to you after a molar gestation/pregnancy is a type of cancer that
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can be diagnosed only by me hormone that your body produces during
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gestation/pregnancy. If you were to get expectant, then itwould make this cancer
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more difficult.
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c. If you can avoid a gestation/pregnancy for the next year, the chance of
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developing a second molar gestation/pregnancy improve your chance of a successful
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gestation/pregnancy, not getting expectant at this timeisbest.
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d. Oral contraceptives are the only form of birth control that will prevent a
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recurrence of amolar gestation/pregnancy
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ACCURATE CHOICE:-B n7


Reasoning:->>>>Betahuman chorionic gonadotropin (beta-hCG) hormone levels are n7 n7 n7 n7 n7 n7


n7drawn for1 year to ensure that the mole is completely gone. The chance of
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developing choriocarcinomaafter the development of a hydatidiform mole is
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increased. Therefore, the goal is to achieve azero
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,human chorionic gonadotropin (hCG) level. If the woman were to become expectant,
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then it may obscure the presence of the potentially carcinogenic cells. Women
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should be instructed to use birth control for 1 year after treatment for a hydatidiform
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mole. The rationale for avoiding gestation/pregnancy for 1 year is to ensure that
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carcinogenic cells are not present. Any contraceptive method except an intrauterine
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device (IUD) is acceptable.
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DIF: Cognitive Level: Apply REF: dm. 679
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TOPIC Nursing Process: Planning | Nursing Process: Implementation MSC: Client
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Needs:Physiologic Integrity
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3. The nursing attendant is preparing to administer methotrexate to the client.
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This hazardousdrug is most often used for which obstetric complication?
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a. Complete hydatidiform mole n7 n7


b. Missed abortion n7


c. Unruptured ectopic gestation/pregnancy n7 n7


d. Abruptio
placentaeACCURATE
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CHOICE:-C
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Reasoning:->>>>Methotrexate is an effective nonsurgical treatment option for a n7 n7 n7 n7 n7 n7 n7 n7


hemodynamically stable woman whose ectopic gestation/pregnancy is unruptured and
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n7measures less than 4 cm in diameter. Methotrexate is not indicated or recommended as
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a treatment option for a complete hydatidiform mole, for amissed abortion, or for
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abruptio placentae.
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DIF: Cognitive Level: Apply REF: dm. 677 TOPIC Nursing Process: Planning MSC:
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Client Needs: Physiologic Integrity
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4. A 26-year-old expectant woman, gravida 2, para 1-0-0-1, is 28 weeks
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n7expectant whenshe experiences bright red, painless vaginal bleeding. On her
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arrival at the health center, which diagnostic procedure will the client most
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likely have performed?
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a. Amniocentesis for fetal lung maturity n7 n7 n7 n7


b. Transvaginal ultrasound for placental location n7 n7 n7 n7


c. Contraction stress test (CST) n7 n7 n7


d. Internal fetal n7


monitoringACCURATE
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CHOICE:-B
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Reasoning:->>>>The presence of painless bleeding should always alert the health n7 n7 n7 n7 n7 n7 n7 n7 n7


care teamto the possibility ofplacenta previa, which can be confirmed through
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ultrasonography.
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Amniocentesis is not performed on a woman who is experiencing bleeding. In the event
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of animminent delivery, the fetus is presumed to have immature lungs at this
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gestational age, andthe mother is given corticosteroids to aid in fetal lung maturity.
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A CST is not performed at a preterm gestational age. Furthermore, bleeding is a
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contraindication to a CST. Internal fetal monitoring is also contraindicated in the
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presence of bleeding.
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DIF: Cognitive Level: Apply REF: dm. 680
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TOPIC Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
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5. A laboring woman with no known risk factors suddenly experiences spontaneous
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ROM. The fluid consists of bright red blood. Her contractions are consistent with her
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current stage oflabor. No change in uterine resting tone has occurred. The fetal heart
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rate (FHR) begins to decline rapidly after the ROM. The nursing attendant should
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suspect the possibility of what condition?
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, a. Placenta previa
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