MATERNITY NEWBORN AND WOMEN’S HEALTH
bb bb bb bb
NURSING A CASE-BASED APPROACH 2ND
bb bb bb bb bb
EDITIONO’MEARA’S TEST BANK
bb b bb bb
Chapter: bb1 bbImmediate bbPostpartum bbHemorrhage
MULTIPLE bbCHOICE
,1. An bbexpectant bbwoman bbis bbbeing bbdischarged bbfrom bbthe bbhealth bbcenter bbafter bbthe
bbplacementbof bba bbcervical bbcerclage bbbecause bbof bba bbhistory bbof bbrecurrent
bbgestation/pregnancy bbloss, bbsecondary bbto bban bbincompetent bbcervix. bbWhich bbinformation
bbregarding bbpost bbprocedural bbcare bbshould bbthe bbnursing bbattendantbemphasize bbin bbthe
bb discharge bb teaching?
a. Any bbvaginal bbdischarge bbshould bbbe bbimmediately bbreported bbto bbher bbhealth bbcare
bbprovider.bb. The bbpresence bbof bbany bbcontractions, bbrupture bbof bbmembranes bb(ROM), bbor
bbsevere bbperineal bbpressure bb should bb be bb reported
c. The bbclient bbwill bbneed bbto bbmake bbarrangements bbfor bbcare bbat bbhome, bbbecause bbher
bbactivityblevel bbwill bb be bbrestricted
d. The bbclient bbwill bbbe bbscheduled bbfor bba bbcesarean
bbbirth.bACCURATE bbCHOICE:-B
Reasoning:->>>>Nursing bbcare bbshould bbstress bbthe bbimportance bbof bbmonitoring bbfor bbthe
bbsigns bband bbsymptoms bbof bbpreterm bblabor. bbVaginal bbbleeding bbneeds bbto bbbe bbreported bb to bbher
bbprimary bbhealth bb care bbprovider. bbBed bbrest bbis bban bbelement bbof bbcare. bbHowever, bbthe
bbwoman bbmay bbstand bbfor bbperiods bbof bbup bbto bb90 bbminutes, bbwhich bballows bbher bbthe
bbfreedom bbto bbsee bbher bbphysician. bbHome bbuterine bbactivity bbmonitoring b b may b b be b b used bb to
bb limit b b the b b womans bb need bb for bb visits bb and b b to b b monitor bb her bb status bb safely b b at bbhome. bbThe
bbcerclage bb can b b be bb removed bb at b b 37 bb weeks b b of b b gestation b b (to bb prepare bb for b b a b b vaginal
bb birth), b b or bba bbcesarean b b birth bb can bbbe bb planned.
DIF: bbCognitive bb Level: bb Apply bbREF: bbdm. bb675
TOPIC bb Nursing bbProcess: bbPlanning bb| bbNursing bbProcess: bbImplementation b b MSC: bbClient bbNeeds:
bHealthPromotion bband bbMaintenance
2. A b b perinatal b b nursing bbattendant b b is b b giving b b discharge b b instructions b b to b b a
b b woman, b b status b b postsuction,band bbcurettage bbsecondary bbto bba bbhydatidiform bbmole. bbThe
bbwoman bbasks bbwhy bbshe bbmust bbtake bboral bbcontraceptives bb for bbthe bbnext bb 12 bbmonths. bbWhat
bb is bb the bbbest bb response bbby bb the bbnursing bbattendant?
a. If bbyou bbget bbexpectant bbwithin bb1 bbyear, bbthe bbchance bbof b b a b b successful
b b gestation/pregnancy bbis b b very bbsmall. bbTherefore, bbif bbgestation/pregnancy, bbit
bbwould bbbe bbbetter bbfor bbyou bbto bbuse bbthe bbmost bbreliable bbmethodbof bbcontraception
bb available.
b. The bbmajor bbrisk bbto bbyou bbafter bba bbmolar bbgestation/pregnancy bbis bba bbtype bbof bbcancer bbthat
bbcan bbbe bbdiagnosed bbonly bbby bbme bbhormone bbthat bbyour bbbody bbproduces bbduring
bbgestation/pregnancy. bbIf bbyou bbwere bbto bbget bbexpectant, bbthen bbitwould bb make bb this bbcancer
bb more bb difficult.
c. If bbyou bbcan bbavoid bba bbgestation/pregnancy bbfor bbthe bbnext bbyear, bbthe bbchance bbof
bbdeveloping bba bbsecond bbmolar bbgestation/pregnancy bbimprove bbyour bbchance bbof bba
bbsuccessful bbgestation/pregnancy, bbnot bbgetting bbexpectant bbat bbthis bbtimebisbest.
d. Oral bbcontraceptives bbare bbthe bbonly bbform bbof bbbirth bbcontrol bbthat bbwill bbprevent bba
bbrecurrence bbof bbabmolar bb gestation/pregnancy
ACCURATE bbCHOICE:-B
Reasoning:->>>>Betahuman b b chorionic b b gonadotropin b b (beta-hCG) b b hormone b b levels b b are
b b drawn b b forb1 bb year bb to bb ensure bbthat bbthe bbmole bbis bbcompletely bbgone. bbThe bbchance bbof
bbdeveloping bbchoriocarcinoma bafter bbthe bbdevelopment bbof bba bbhydatidiform bbmole bbis
bbincreased. bbTherefore, bbthe bbgoal bbis bbto bbachieve bbabzero
,human bbchorionic bbgonadotropin bb(hCG) bblevel. bbIf b b the bbwoman bbwere b b to bbbecome
bbexpectant, bbthen b b it bbmay b b obscure b b the b b presence b b of b b the b b potentially b b carcinogenic b b cells.
b b Women b b should b b be b b instructed b b to bbuse bbbirth bbcontrol bbfor bb1 bbyear bbafter bbtreatment bbfor bba
bbhydatidiform bbmole. bbThe bbrationale bbfor bbavoiding bbgestation/pregnancy bb for bb 1 b b year bb is b b to
bb ensure bb that bb carcinogenic b b cells b b are bb not bb present. bb Any bb contraceptive bbmethod bb except
bb an bb intrauterine bb device bb(IUD) b b is bbacceptable.
DIF: bbCognitive bb Level: bbApply bb REF: bbdm. bb 679
TOPIC bb Nursing bbProcess: bbPlanning bb| bbNursing bbProcess: bbImplementation b b MSC: bbClient
bb Needs:bPhysiologic bbIntegrity
3. The bb nursing bbattendant b b is b b preparing b b to b b administer bb methotrexate b b to bb the
b b client. b b This bb hazardousbdrug b b is bbmost bb often bb used bb for bb which bb obstetric bb complication?
a. Complete bbhydatidiform bbmole
b. Missed b b abortion
c. Unruptured bbectopic bbgestation/pregnancy
d. Abruptio
bbplacentaebACCURATE
bbCHOICE:-C
Reasoning:->>>>Methotrexate bbis bban bbeffective bbnonsurgical bbtreatment bboption bbfor bba
bbhemodynamically b b stable b b woman b b whose b b ectopic b b gestation/pregnancy b b is b b unruptured
b b and b b measures b b less b b than bb4 bbcm bbin bbdiameter. bbMethotrexate bbis bbnot bbindicated bbor
bbrecommended bbas bba bbtreatment bboption bbfor bba bbcomplete bbhydatidiform bbmole, bbfor bbamissed
bbabortion, bbor bbfor bbabruptio bb placentae.
DIF: bbCognitive bbLevel: bbApply bbREF: bbdm. bb677 bbTOPIC bbNursing bbProcess: bbPlanning bbMSC:
bbClient bbNeeds: bbPhysiologic bb Integrity
4. A b b 26-year-old b b expectant bb woman, bbgravida b b 2, bb para bb 1-0-0-1, bbis bb 28 bb weeks
b b expectant bb whenbshe bbexperiences bbbright bbred, bbpainless bbvaginal bbbleeding. bbOn bbher
bbarrival bbat bbthe bbhealth bbcenter, bbwhich bbdiagnostic bb procedure bb will bb the bb client bb most
bblikely bb have bb performed?
a. Amniocentesis b b for b b fetal b b lung b b maturity
b. Transvaginal b b ultrasound b b for b b placental b b location
c. Contraction bb stress bb test bb (CST)
d. Internal bbfetal
bbmonitoringbACCURATE
bbCHOICE:-B
Reasoning:->>>>The bbpresence bbof bbpainless bbbleeding bbshould bbalways bbalert bbthe bbhealth
bbcare bbteambto bbthe bbpossibility bbofplacenta bbprevia, bbwhich bbcan bbbe bbconfirmed bbthrough
bb ultrasonography.
Amniocentesis bbis bbnot bbperformed bbon bba bbwoman bbwho bbis bbexperiencing bbbleeding. bbIn bbthe
bbevent bbof bbanbimminent bbdelivery, bbthe bbfetus bbis bbpresumed bbto bbhave bbimmature bblungs bbat
bbthis bbgestational bbage, bbandbthe bbmother bbis bbgiven bbcorticosteroids bbto bbaid bbin bbfetal bblung
bbmaturity. bbA bbCST bbis bbnot bbperformed bbat bba bbpreterm bbgestational bbage. bbFurthermore,
bbbleeding bbis bba bbcontraindication bbto bba bbCST. bbInternal bbfetal bbmonitoring bbis bbalso
bb contraindicated bb in bbthe bb presence bbof bb bleeding.
DIF: bbCognitive bb Level: bb Apply bbREF: bbdm. bb680
TOPIC bbNursing bbProcess: bbAssessment bbMSC: bbClient bbNeeds: bbHealth bbPromotion bband bbMaintenance
5. A bblaboring bbwoman bbwith bbno bbknown bbrisk bbfactors bbsuddenly bbexperiences
bbspontaneous bbROM. bbThe bbfluid bbconsists bbof bbbright bbred bbblood. bbHer bbcontractions bbare
bbconsistent bbwith bbher bbcurrent bbstage bbofblabor. bbNo bbchange bbin bbuterine bbresting bbtone bbhas
bboccurred. bbThe bbfetal bbheart bbrate bb(FHR) bbbegins bbto bb decline bbrapidly bbafter bbthe bbROM. bbThe
bbnursing bbattendant bbshould bbsuspect bbthe bbpossibility bbof bbwhat bbcondition?
, a. Placenta b b previa
bb bb bb bb
NURSING A CASE-BASED APPROACH 2ND
bb bb bb bb bb
EDITIONO’MEARA’S TEST BANK
bb b bb bb
Chapter: bb1 bbImmediate bbPostpartum bbHemorrhage
MULTIPLE bbCHOICE
,1. An bbexpectant bbwoman bbis bbbeing bbdischarged bbfrom bbthe bbhealth bbcenter bbafter bbthe
bbplacementbof bba bbcervical bbcerclage bbbecause bbof bba bbhistory bbof bbrecurrent
bbgestation/pregnancy bbloss, bbsecondary bbto bban bbincompetent bbcervix. bbWhich bbinformation
bbregarding bbpost bbprocedural bbcare bbshould bbthe bbnursing bbattendantbemphasize bbin bbthe
bb discharge bb teaching?
a. Any bbvaginal bbdischarge bbshould bbbe bbimmediately bbreported bbto bbher bbhealth bbcare
bbprovider.bb. The bbpresence bbof bbany bbcontractions, bbrupture bbof bbmembranes bb(ROM), bbor
bbsevere bbperineal bbpressure bb should bb be bb reported
c. The bbclient bbwill bbneed bbto bbmake bbarrangements bbfor bbcare bbat bbhome, bbbecause bbher
bbactivityblevel bbwill bb be bbrestricted
d. The bbclient bbwill bbbe bbscheduled bbfor bba bbcesarean
bbbirth.bACCURATE bbCHOICE:-B
Reasoning:->>>>Nursing bbcare bbshould bbstress bbthe bbimportance bbof bbmonitoring bbfor bbthe
bbsigns bband bbsymptoms bbof bbpreterm bblabor. bbVaginal bbbleeding bbneeds bbto bbbe bbreported bb to bbher
bbprimary bbhealth bb care bbprovider. bbBed bbrest bbis bban bbelement bbof bbcare. bbHowever, bbthe
bbwoman bbmay bbstand bbfor bbperiods bbof bbup bbto bb90 bbminutes, bbwhich bballows bbher bbthe
bbfreedom bbto bbsee bbher bbphysician. bbHome bbuterine bbactivity bbmonitoring b b may b b be b b used bb to
bb limit b b the b b womans bb need bb for bb visits bb and b b to b b monitor bb her bb status bb safely b b at bbhome. bbThe
bbcerclage bb can b b be bb removed bb at b b 37 bb weeks b b of b b gestation b b (to bb prepare bb for b b a b b vaginal
bb birth), b b or bba bbcesarean b b birth bb can bbbe bb planned.
DIF: bbCognitive bb Level: bb Apply bbREF: bbdm. bb675
TOPIC bb Nursing bbProcess: bbPlanning bb| bbNursing bbProcess: bbImplementation b b MSC: bbClient bbNeeds:
bHealthPromotion bband bbMaintenance
2. A b b perinatal b b nursing bbattendant b b is b b giving b b discharge b b instructions b b to b b a
b b woman, b b status b b postsuction,band bbcurettage bbsecondary bbto bba bbhydatidiform bbmole. bbThe
bbwoman bbasks bbwhy bbshe bbmust bbtake bboral bbcontraceptives bb for bbthe bbnext bb 12 bbmonths. bbWhat
bb is bb the bbbest bb response bbby bb the bbnursing bbattendant?
a. If bbyou bbget bbexpectant bbwithin bb1 bbyear, bbthe bbchance bbof b b a b b successful
b b gestation/pregnancy bbis b b very bbsmall. bbTherefore, bbif bbgestation/pregnancy, bbit
bbwould bbbe bbbetter bbfor bbyou bbto bbuse bbthe bbmost bbreliable bbmethodbof bbcontraception
bb available.
b. The bbmajor bbrisk bbto bbyou bbafter bba bbmolar bbgestation/pregnancy bbis bba bbtype bbof bbcancer bbthat
bbcan bbbe bbdiagnosed bbonly bbby bbme bbhormone bbthat bbyour bbbody bbproduces bbduring
bbgestation/pregnancy. bbIf bbyou bbwere bbto bbget bbexpectant, bbthen bbitwould bb make bb this bbcancer
bb more bb difficult.
c. If bbyou bbcan bbavoid bba bbgestation/pregnancy bbfor bbthe bbnext bbyear, bbthe bbchance bbof
bbdeveloping bba bbsecond bbmolar bbgestation/pregnancy bbimprove bbyour bbchance bbof bba
bbsuccessful bbgestation/pregnancy, bbnot bbgetting bbexpectant bbat bbthis bbtimebisbest.
d. Oral bbcontraceptives bbare bbthe bbonly bbform bbof bbbirth bbcontrol bbthat bbwill bbprevent bba
bbrecurrence bbof bbabmolar bb gestation/pregnancy
ACCURATE bbCHOICE:-B
Reasoning:->>>>Betahuman b b chorionic b b gonadotropin b b (beta-hCG) b b hormone b b levels b b are
b b drawn b b forb1 bb year bb to bb ensure bbthat bbthe bbmole bbis bbcompletely bbgone. bbThe bbchance bbof
bbdeveloping bbchoriocarcinoma bafter bbthe bbdevelopment bbof bba bbhydatidiform bbmole bbis
bbincreased. bbTherefore, bbthe bbgoal bbis bbto bbachieve bbabzero
,human bbchorionic bbgonadotropin bb(hCG) bblevel. bbIf b b the bbwoman bbwere b b to bbbecome
bbexpectant, bbthen b b it bbmay b b obscure b b the b b presence b b of b b the b b potentially b b carcinogenic b b cells.
b b Women b b should b b be b b instructed b b to bbuse bbbirth bbcontrol bbfor bb1 bbyear bbafter bbtreatment bbfor bba
bbhydatidiform bbmole. bbThe bbrationale bbfor bbavoiding bbgestation/pregnancy bb for bb 1 b b year bb is b b to
bb ensure bb that bb carcinogenic b b cells b b are bb not bb present. bb Any bb contraceptive bbmethod bb except
bb an bb intrauterine bb device bb(IUD) b b is bbacceptable.
DIF: bbCognitive bb Level: bbApply bb REF: bbdm. bb 679
TOPIC bb Nursing bbProcess: bbPlanning bb| bbNursing bbProcess: bbImplementation b b MSC: bbClient
bb Needs:bPhysiologic bbIntegrity
3. The bb nursing bbattendant b b is b b preparing b b to b b administer bb methotrexate b b to bb the
b b client. b b This bb hazardousbdrug b b is bbmost bb often bb used bb for bb which bb obstetric bb complication?
a. Complete bbhydatidiform bbmole
b. Missed b b abortion
c. Unruptured bbectopic bbgestation/pregnancy
d. Abruptio
bbplacentaebACCURATE
bbCHOICE:-C
Reasoning:->>>>Methotrexate bbis bban bbeffective bbnonsurgical bbtreatment bboption bbfor bba
bbhemodynamically b b stable b b woman b b whose b b ectopic b b gestation/pregnancy b b is b b unruptured
b b and b b measures b b less b b than bb4 bbcm bbin bbdiameter. bbMethotrexate bbis bbnot bbindicated bbor
bbrecommended bbas bba bbtreatment bboption bbfor bba bbcomplete bbhydatidiform bbmole, bbfor bbamissed
bbabortion, bbor bbfor bbabruptio bb placentae.
DIF: bbCognitive bbLevel: bbApply bbREF: bbdm. bb677 bbTOPIC bbNursing bbProcess: bbPlanning bbMSC:
bbClient bbNeeds: bbPhysiologic bb Integrity
4. A b b 26-year-old b b expectant bb woman, bbgravida b b 2, bb para bb 1-0-0-1, bbis bb 28 bb weeks
b b expectant bb whenbshe bbexperiences bbbright bbred, bbpainless bbvaginal bbbleeding. bbOn bbher
bbarrival bbat bbthe bbhealth bbcenter, bbwhich bbdiagnostic bb procedure bb will bb the bb client bb most
bblikely bb have bb performed?
a. Amniocentesis b b for b b fetal b b lung b b maturity
b. Transvaginal b b ultrasound b b for b b placental b b location
c. Contraction bb stress bb test bb (CST)
d. Internal bbfetal
bbmonitoringbACCURATE
bbCHOICE:-B
Reasoning:->>>>The bbpresence bbof bbpainless bbbleeding bbshould bbalways bbalert bbthe bbhealth
bbcare bbteambto bbthe bbpossibility bbofplacenta bbprevia, bbwhich bbcan bbbe bbconfirmed bbthrough
bb ultrasonography.
Amniocentesis bbis bbnot bbperformed bbon bba bbwoman bbwho bbis bbexperiencing bbbleeding. bbIn bbthe
bbevent bbof bbanbimminent bbdelivery, bbthe bbfetus bbis bbpresumed bbto bbhave bbimmature bblungs bbat
bbthis bbgestational bbage, bbandbthe bbmother bbis bbgiven bbcorticosteroids bbto bbaid bbin bbfetal bblung
bbmaturity. bbA bbCST bbis bbnot bbperformed bbat bba bbpreterm bbgestational bbage. bbFurthermore,
bbbleeding bbis bba bbcontraindication bbto bba bbCST. bbInternal bbfetal bbmonitoring bbis bbalso
bb contraindicated bb in bbthe bb presence bbof bb bleeding.
DIF: bbCognitive bb Level: bb Apply bbREF: bbdm. bb680
TOPIC bbNursing bbProcess: bbAssessment bbMSC: bbClient bbNeeds: bbHealth bbPromotion bband bbMaintenance
5. A bblaboring bbwoman bbwith bbno bbknown bbrisk bbfactors bbsuddenly bbexperiences
bbspontaneous bbROM. bbThe bbfluid bbconsists bbof bbbright bbred bbblood. bbHer bbcontractions bbare
bbconsistent bbwith bbher bbcurrent bbstage bbofblabor. bbNo bbchange bbin bbuterine bbresting bbtone bbhas
bboccurred. bbThe bbfetal bbheart bbrate bb(FHR) bbbegins bbto bb decline bbrapidly bbafter bbthe bbROM. bbThe
bbnursing bbattendant bbshould bbsuspect bbthe bbpossibility bbof bbwhat bbcondition?
, a. Placenta b b previa
