MATERNITY NEWBORN AND WOMEN’S
a a a
a HEALTH NURSING A CASE-BASED APPROACH
a a a a
2ND EDITIONO’MEARA’S TEST BANK
a a a a a
Chapter: a1 aImmediate aPostpartum aHemorrhage
MULTIPLE aCHOICE
,1. An aexpectant awoman ais abeing adischarged afrom athe ahealth acenter aafter athe
aplacementaof aa a cervical acerclage abecause aof aa a history aof arecurrent
agestation/pregnancy aloss, asecondary ato aan aincompetent acervix. aWhich ainformation
aregarding apost aprocedural acare ashould athe anursing aattendantaemphasize ain athe
a discharge a teaching?
a. Any avaginal adischarge ashould abe aimmediately areported ato aher ahealth acare
aprovider. ab. The apresence aof aany acontractions, arupture aof amembranes a(ROM), aor
asevere aperineal apressure a should a be a reported
c. The aclient awill aneed ato amake aarrangements afor acare aat ahome, abecause aher
aactivityalevel awill a be arestricted
d. The aclient awill abe ascheduled afor aa acesarean
abirth.aACCURATE aCHOICE:-B
Reasoning:->>>>Nursing acare ashould astress athe aimportance a of amonitoring afor athe
asigns aand asymptoms a of a preterm alabor. aVaginal ableeding a needs ato abe areported a to aher
aprimary ahealth a care aprovider. aBed arest ais aan a element aof a care. aHowever, athe awoman
amay astand afor aperiods a of aup ato a90 aminutes, awhich aallows aher athe afreedom ato asee
aher aphysician. aHome auterine aactivity amonitoring a may a be a used a to a limit a the
a womans a need a for a visits a and a to a monitor a her a status a safely a at ahome. aThe acerclage a can
a be a removed a at a 37 a weeks a of a gestation a (to a prepare a for a a a vaginal a birth), a or aa acesarean
a birth a can abe a planned.
DIF: aCognitive a Level: a Apply aREF: a dm. a 675
TOPIC a Nursing aProcess: aPlanning a| a Nursing aProcess: a Implementation a MSC: aClient aNeeds:
aHealthPromotion aand aMaintenance
2. A a perinatal a nursing aattendant a is a giving a discharge a instructions a to a a
a woman, a status a postsuction,aand acurettage asecondary ato aa ahydatidiform amole. aThe
awoman aasks awhy ashe amust atake aoral acontraceptives a for a the anext a 12 amonths. aWhat a is
a the abest a response aby a the anursing aattendant?
a. If ayou aget aexpectant awithin a1 ayear, athe achance aof a a a successful
a gestation/pregnancy ais a very asmall. aTherefore, aif agestation/pregnancy, ait awould
abe abetter afor ayou ato ause athe amost areliable amethodaof acontraception a available.
b. The amajor arisk ato ayou aafter aa amolar agestation/pregnancy ais aa atype aof acancer athat
acan abe adiagnosed a only aby ame ahormone athat ayour abody aproduces aduring
agestation/pregnancy. aIf ayou awere ato aget aexpectant, athen aitwould a make a this acancer
a more a difficult.
c. If ayou acan aavoid aa agestation/pregnancy afor athe anext ayear, athe achance aof
adeveloping aa asecond amolar agestation/pregnancy aimprove ayour achance aof aa
asuccessful agestation/pregnancy, anot agetting aexpectant aat athis atimeaisbest.
d. Oral acontraceptives aare athe aonly aform aof abirth acontrol athat awill aprevent aa
arecurrence aof aaamolar a gestation/pregnancy
ACCURATE aCHOICE:-B
Reasoning:->>>>Betahuman a chorionic a gonadotropin a (beta-hCG) a hormone a levels a are
a drawn a fora1 a year a to a ensure athat athe amole ais acompletely agone. aThe achance aof
adeveloping achoriocarcinomaaafter athe a development aof aa ahydatidiform amole ais
aincreased. aTherefore, athe agoal ais ato aachieve aaazero
,human achorionic agonadotropin a(hCG) alevel. aIf a the awoman awere a to abecome aexpectant,
athen a it amay a obscure a the a presence a of a the a potentially a carcinogenic a cells. a Women
a should a be a instructed a to ause abirth acontrol afor a1 ayear aafter atreatment afor aa
ahydatidiform amole. aThe arationale afor aavoiding agestation/pregnancy a for a 1 a year a is a to
a ensure a that a carcinogenic a cells a are a not a present. a Any a contraceptive amethod a except a an
a intrauterine a device a(IUD) a is a acceptable.
DIF: aCognitive a Level: aApply a REF: adm. a 679
TOPIC a Nursing aProcess: aPlanning a| aNursing aProcess: a Implementation a MSC: aClient
a Needs:aPhysiologic aIntegrity
3. The a nursing aattendant a is a preparing a to a administer a methotrexate a to a the a client.
a This a hazardousadrug a is amost a often a used a for a which a obstetric a complication?
a. Complete ahydatidiform amole
b. Missed a abortion
c. Unruptured aectopic agestation/pregnancy
d. Abruptio
aplacentaeaACCURATE
aCHOICE:-C
Reasoning:->>>>Methotrexate ais aan aeffective anonsurgical atreatment aoption afor aa
ahemodynamically a stable a woman a whose a ectopic a gestation/pregnancy a is a unruptured
a and a measures a less a than a4 acm ain adiameter. aMethotrexate ais anot aindicated aor
arecommended aas aa atreatment aoption afor aa acomplete ahydatidiform amole, afor aamissed
a abortion, a or afor aabruptio a placentae.
DIF: aCognitive aLevel: aApply aREF: adm. a677 a TOPIC aNursing aProcess: aPlanning aMSC:
aClient aNeeds: aPhysiologic a Integrity
4. A a 26-year-old a expectant a woman, agravida a 2, a para a 1-0-0-1, a is a 28 a weeks
a expectant a whenashe aexperiences abright ared, apainless avaginal ableeding. aOn aher
aarrival aat athe ahealth acenter, awhich adiagnostic a procedure a will a the a client a most
alikely a have a performed?
a. Amniocentesis a for a fetal a lung a maturity
b. Transvaginal a ultrasound a for a placental a location
c. Contraction a stress a test a (CST)
d. Internal afetal
amonitoringaACCURATE
aCHOICE:-B
Reasoning:->>>>The apresence aof apainless ableeding ashould aalways aalert athe ahealth
acare ateamato athe apossibility aofplacenta aprevia, awhich acan abe aconfirmed athrough
a ultrasonography.
Amniocentesis ais anot aperformed aon aa awoman awho ais aexperiencing ableeding. aIn athe
aevent aof aanaimminent adelivery, athe afetus ais apresumed ato ahave aimmature alungs aat athis
agestational aage, aandathe amother ais agiven acorticosteroids ato aaid ain afetal alung amaturity.
aA aCST ais anot aperformed aat aa apreterm agestational aage. aFurthermore, ableeding ais aa
acontraindication ato aa aCST. aInternal afetal amonitoring ais aalso a contraindicated a in a the
a presence aof a bleeding.
DIF: aCognitive a Level: a Apply aREF: a dm. a 680
TOPIC aNursing aProcess: aAssessment aMSC: aClient aNeeds: aHealth aPromotion aand aMaintenance
5. A alaboring awoman awith ano aknown arisk afactors asuddenly aexperiences
aspontaneous aROM. aThe afluid aconsists aof abright ared ablood. a Her acontractions aare
, aconsistent awith aher acurrent astage aofalabor. aNo achange ain auterine aresting atone ahas
aoccurred. a The afetal aheart arate a(FHR) a begins ato adecline arapidly aafter athe aROM. aThe
anursing aattendant ashould asuspect athe apossibility aof awhat acondition?
a. Placenta a previa
a a a
a HEALTH NURSING A CASE-BASED APPROACH
a a a a
2ND EDITIONO’MEARA’S TEST BANK
a a a a a
Chapter: a1 aImmediate aPostpartum aHemorrhage
MULTIPLE aCHOICE
,1. An aexpectant awoman ais abeing adischarged afrom athe ahealth acenter aafter athe
aplacementaof aa a cervical acerclage abecause aof aa a history aof arecurrent
agestation/pregnancy aloss, asecondary ato aan aincompetent acervix. aWhich ainformation
aregarding apost aprocedural acare ashould athe anursing aattendantaemphasize ain athe
a discharge a teaching?
a. Any avaginal adischarge ashould abe aimmediately areported ato aher ahealth acare
aprovider. ab. The apresence aof aany acontractions, arupture aof amembranes a(ROM), aor
asevere aperineal apressure a should a be a reported
c. The aclient awill aneed ato amake aarrangements afor acare aat ahome, abecause aher
aactivityalevel awill a be arestricted
d. The aclient awill abe ascheduled afor aa acesarean
abirth.aACCURATE aCHOICE:-B
Reasoning:->>>>Nursing acare ashould astress athe aimportance a of amonitoring afor athe
asigns aand asymptoms a of a preterm alabor. aVaginal ableeding a needs ato abe areported a to aher
aprimary ahealth a care aprovider. aBed arest ais aan a element aof a care. aHowever, athe awoman
amay astand afor aperiods a of aup ato a90 aminutes, awhich aallows aher athe afreedom ato asee
aher aphysician. aHome auterine aactivity amonitoring a may a be a used a to a limit a the
a womans a need a for a visits a and a to a monitor a her a status a safely a at ahome. aThe acerclage a can
a be a removed a at a 37 a weeks a of a gestation a (to a prepare a for a a a vaginal a birth), a or aa acesarean
a birth a can abe a planned.
DIF: aCognitive a Level: a Apply aREF: a dm. a 675
TOPIC a Nursing aProcess: aPlanning a| a Nursing aProcess: a Implementation a MSC: aClient aNeeds:
aHealthPromotion aand aMaintenance
2. A a perinatal a nursing aattendant a is a giving a discharge a instructions a to a a
a woman, a status a postsuction,aand acurettage asecondary ato aa ahydatidiform amole. aThe
awoman aasks awhy ashe amust atake aoral acontraceptives a for a the anext a 12 amonths. aWhat a is
a the abest a response aby a the anursing aattendant?
a. If ayou aget aexpectant awithin a1 ayear, athe achance aof a a a successful
a gestation/pregnancy ais a very asmall. aTherefore, aif agestation/pregnancy, ait awould
abe abetter afor ayou ato ause athe amost areliable amethodaof acontraception a available.
b. The amajor arisk ato ayou aafter aa amolar agestation/pregnancy ais aa atype aof acancer athat
acan abe adiagnosed a only aby ame ahormone athat ayour abody aproduces aduring
agestation/pregnancy. aIf ayou awere ato aget aexpectant, athen aitwould a make a this acancer
a more a difficult.
c. If ayou acan aavoid aa agestation/pregnancy afor athe anext ayear, athe achance aof
adeveloping aa asecond amolar agestation/pregnancy aimprove ayour achance aof aa
asuccessful agestation/pregnancy, anot agetting aexpectant aat athis atimeaisbest.
d. Oral acontraceptives aare athe aonly aform aof abirth acontrol athat awill aprevent aa
arecurrence aof aaamolar a gestation/pregnancy
ACCURATE aCHOICE:-B
Reasoning:->>>>Betahuman a chorionic a gonadotropin a (beta-hCG) a hormone a levels a are
a drawn a fora1 a year a to a ensure athat athe amole ais acompletely agone. aThe achance aof
adeveloping achoriocarcinomaaafter athe a development aof aa ahydatidiform amole ais
aincreased. aTherefore, athe agoal ais ato aachieve aaazero
,human achorionic agonadotropin a(hCG) alevel. aIf a the awoman awere a to abecome aexpectant,
athen a it amay a obscure a the a presence a of a the a potentially a carcinogenic a cells. a Women
a should a be a instructed a to ause abirth acontrol afor a1 ayear aafter atreatment afor aa
ahydatidiform amole. aThe arationale afor aavoiding agestation/pregnancy a for a 1 a year a is a to
a ensure a that a carcinogenic a cells a are a not a present. a Any a contraceptive amethod a except a an
a intrauterine a device a(IUD) a is a acceptable.
DIF: aCognitive a Level: aApply a REF: adm. a 679
TOPIC a Nursing aProcess: aPlanning a| aNursing aProcess: a Implementation a MSC: aClient
a Needs:aPhysiologic aIntegrity
3. The a nursing aattendant a is a preparing a to a administer a methotrexate a to a the a client.
a This a hazardousadrug a is amost a often a used a for a which a obstetric a complication?
a. Complete ahydatidiform amole
b. Missed a abortion
c. Unruptured aectopic agestation/pregnancy
d. Abruptio
aplacentaeaACCURATE
aCHOICE:-C
Reasoning:->>>>Methotrexate ais aan aeffective anonsurgical atreatment aoption afor aa
ahemodynamically a stable a woman a whose a ectopic a gestation/pregnancy a is a unruptured
a and a measures a less a than a4 acm ain adiameter. aMethotrexate ais anot aindicated aor
arecommended aas aa atreatment aoption afor aa acomplete ahydatidiform amole, afor aamissed
a abortion, a or afor aabruptio a placentae.
DIF: aCognitive aLevel: aApply aREF: adm. a677 a TOPIC aNursing aProcess: aPlanning aMSC:
aClient aNeeds: aPhysiologic a Integrity
4. A a 26-year-old a expectant a woman, agravida a 2, a para a 1-0-0-1, a is a 28 a weeks
a expectant a whenashe aexperiences abright ared, apainless avaginal ableeding. aOn aher
aarrival aat athe ahealth acenter, awhich adiagnostic a procedure a will a the a client a most
alikely a have a performed?
a. Amniocentesis a for a fetal a lung a maturity
b. Transvaginal a ultrasound a for a placental a location
c. Contraction a stress a test a (CST)
d. Internal afetal
amonitoringaACCURATE
aCHOICE:-B
Reasoning:->>>>The apresence aof apainless ableeding ashould aalways aalert athe ahealth
acare ateamato athe apossibility aofplacenta aprevia, awhich acan abe aconfirmed athrough
a ultrasonography.
Amniocentesis ais anot aperformed aon aa awoman awho ais aexperiencing ableeding. aIn athe
aevent aof aanaimminent adelivery, athe afetus ais apresumed ato ahave aimmature alungs aat athis
agestational aage, aandathe amother ais agiven acorticosteroids ato aaid ain afetal alung amaturity.
aA aCST ais anot aperformed aat aa apreterm agestational aage. aFurthermore, ableeding ais aa
acontraindication ato aa aCST. aInternal afetal amonitoring ais aalso a contraindicated a in a the
a presence aof a bleeding.
DIF: aCognitive a Level: a Apply aREF: a dm. a 680
TOPIC aNursing aProcess: aAssessment aMSC: aClient aNeeds: aHealth aPromotion aand aMaintenance
5. A alaboring awoman awith ano aknown arisk afactors asuddenly aexperiences
aspontaneous aROM. aThe afluid aconsists aof abright ared ablood. a Her acontractions aare
, aconsistent awith aher acurrent astage aofalabor. aNo achange ain auterine aresting atone ahas
aoccurred. a The afetal aheart arate a(FHR) a begins ato adecline arapidly aafter athe aROM. aThe
anursing aattendant ashould asuspect athe apossibility aof awhat acondition?
a. Placenta a previa
