TEST BANK
l
,
Maternity lNewborn land lWomen’s lHealth lNursing lA lCase-Based lApproach l1st lEdition
lO’Meara lTest lBank
Chapter l1 lImmediate lPostpartum lHemorrhage
MULTIPLE lCHOICE
1. A lpregnant lwoman lis lbeing ldischarged lfrom lthe lhospital lafter lthe lplacement lof la
lcervical lcerclage lbecause lof la lhistory lof lrecurrent lpregnancy lloss, lsecondary lto lan
lincompetent lcervix. lWhich linformation lregarding lpostprocedural lcare lshould lthe lnurse
lemphasize lin lthe ldischarge lteaching?
a. Anylvaginal ldischarge lshould lbe limmediately lreported lto lher lhealth lcare lprovider.
b. The lpresence lof lany lcontractions, lrupture lof lmembranes l(ROM), lor lsevere lperineal lpressure
lsho
c. The lclient lwill lneed lto lmake larrangements lfor lcare lat lhome, lbecause lher lactivityllevel lwill lbe
lre
d. The lclient lwill lbe lscheduled lfor la lcesarean lbirth.
lANS: lB
Nursing lcare lshould lstress lthe limportance lof lmonitoring lfor lthe lsigns land lsymptoms lof lpreterm
labor. lVaginal lbleeding lneeds lto lbe lreported lto lher lprimary lhealth lcare lprovider. lBed lrest lis
lan lelement lof lcare. lHowever, lthe lwoman lmay lstand lfor lperiods lof lup lto l90 lminutes, lwhich
lallows lher lthe lfreedom lto lsee lher lphysician. lHome luterine lactivity lmonitoring lmay lbe lused
lto llimit lthe lwomans lneed lfor lvisits land lto lmonitor lher lstatus lsafely lat lhome. lThe lcerclage lcan
lbe lremoved lat l37 lweeks lof lgestation l(to lprepare lfor la lvaginal lbirth), lor la lcesarean lbirth lcan
lbe lplanned.
DIF: lCognitive lLevel: lApply lREF: ldm. l675
TOP: lNursing lProcess: lPlanning l| lNursing lProcess: lImplementation
lMSC: lClient lNeeds: lHealth lPromotion land lMaintenance
2. A lperinatal lnurse lis lgiving ldischarge linstructions lto la lwoman, lstatus lpostsuction, land lcurettage
lsecondary lto la lhydatidiform lmole. lThe lwoman lasks lwhy lshe lmust ltake loral lcontraceptives
lfor lthe lnext l12 lmonths. lWhat lis lthe lbestresponse lby lthe lnurse?
If lyou lget lpregnant lwithin l1 lyear, lthe lchance lof la lsuccessful lpregnancy lis lverylsmall. lTherefore,
a. pregnancy, lit lwould lbe lbetter lfor lyou lto luse lthe lmost lreliable lmethod lof lcontraception lavailable.
The lmajor lrisk lto lyou lafter la lmolar lpregnancy lis la ltype lof lcancer lthat lcan lbe ldiagnosed lonly
lby lhormone lthat lyour lbody lproduces lduring lpregnancy. lIf lyou lwere lto lget lpregnant, lthen lit
lwould
b. this lcancer lmore ldifficult.
If lyou lcan lavoid la lpregnancy lfor lthe lnext lyear, lthe lchance lof ldeveloping la lsecond lmolar
lpregna
c. improve lyour lchance lof la lsuccessful lpregnancy, lnot lgetting lpregnant lat lthis ltime lis lbest.
d. Oral lcontraceptives lare lthe lonly lform lof lbirth lcontrol lthat lwill lprevent la lrecurrence lof la lmolar
lp lANS: lB
,Betahuman lchorionic lgonadotropin l(beta-hCG) lhormone llevels lare ldrawn lfor l1 lyear lto lensure
that lthe lmole lis lcompletely lgone. lThe lchance lof ldeveloping lchoriocarcinoma lafter lthe
ldevelopment lof la lhydatidiform lmole lis lincreased. lTherefore, lthe lgoal lis lto lachieve la lzero
lhuman lchorionic lgonadotropin l(hCG) llevel. lIf lthe lwoman lwere lto lbecome lpregnant, lthen lit lmay
lobscure lthe lpresence lof lthe lpotentially lcarcinogenic lcells. lWomen lshould lbe linstructed lto luse
lbirth lcontrol lfor l1 lyear lafter ltreatment lfor la lhydatidiform lmole. lThe lrationale lfor lavoiding
lpregnancy
, for l1 lyear lis lto lensure lthat lcarcinogenic lcells lare lnot lpresent. lAny lcontraceptive lmethod lexcept
lan lintrauterine ldevice l(IUD) lis lacceptable.
DIF: lCognitive lLevel: lApply lREF: ldm. l679
TOP: lNursing lProcess: lPlanning l| lNursing lProcess: lImplementation
lMSC: lClient lNeeds: lPhysiologic lIntegrity
3. The lnurse lis lpreparing lto ladminister lmethotrexate lto lthe lclient. lThis lhazardous ldrug
lis lmost loften lused lfor lwhich lobstetric lcomplication?
a. Complete lhydatidiform lmole
b. Missed labortion
c. Unruptured lectopic lpregnancy
d. Abruptio lplacentae
lANS: lC
Methotrexate lis lan leffective lnonsurgical ltreatment loption lfor la lhemodynamically lstable lwoman
whose lectopic lpregnancy lis lunruptured land lmeasures lless lthan l4 lcm lin ldiameter. lMethotrexate lis
lnot lindicated lor lrecommended las la ltreatment loption lfor la lcomplete lhydatidiform lmole, lfor la
lmissed labortion, lor lfor labruptio lplacentae.
DIF: lCognitive lLevel: lApply lREF: ldm. l677 lTOP: lNursing lProcess: lPlanning
lMSC: lClient lNeeds: lPhysiologic lIntegrity
4. A l26-year-old lpregnant lwoman, lgravida l2, lpara l1-0-0-1, lis l28 lweeks lpregnant lwhen lshe
lexperiences lbright lred, lpainless lvaginal lbleeding. lOn lher larrival lat lthe lhospital, lwhich
ldiagnostic lprocedure lwill lthe lclient lmost llikely lhave lperformed?
a. Amniocentesis lfor lfetal llung lmaturity
b. Transvaginal lultrasound lfor lplacental llocation
c. Contraction lstress ltest l(CST)
d. Internal lfetal lmonitoring
lANS: lB
The lpresence lof lpainless lbleeding lshould lalways lalert lthe lhealth lcare lteam lto lthe lpossibilitylof
placenta lprevia, lwhich lcan lbe lconfirmed lthrough lultrasonography. lAmniocentesis lis lnot
lperformed lon la lwoman lwho lis lexperiencing lbleeding. lIn lthe levent lof lan limminent ldelivery,
lthe lfetus lis lpresumed lto lhave limmature llungs lat lthis lgestational lage, land lthe lmother lis lgiven
lcorticosteroids lto laid lin lfetal llung lmaturity. lA lCST lis lnot lperformed lat la lpreterm lgestational lage.
lFurthermore, lbleeding lis la lcontraindication lto la l CST. lInternal lfetal lmonitoring lis lalso
lcontraindicated lin lthe lpresence lof lbleeding.
DIF: lCognitive lLevel: lApply lREF: ldm. l680
TOP: lNursing lProcess: lAssessment lMSC: lClient lNeeds: lHealth lPromotion land lMaintenance
5. A llaboring lwoman lwith lno lknown lrisk lfactors lsuddenly lexperiences lspontaneous lROM.
lThe lfluid lconsists lof lbright lred lblood. lHer lcontractions lare lconsistent lwith lher lcurrent lstage lof
llabor. lNo lchange lin luterine lresting ltone lhas loccurred. lThe lfetal lheart lrate l(FHR) lbegins lto
ldecline lrapidly lafter lthe lROM. lThe lnurse l should l suspect lthe lpossibility lof lwhat lcondition?
a. Placenta lprevia
b. Vasa lprevia
c. Severe labruptio lplacentae
l
,
Maternity lNewborn land lWomen’s lHealth lNursing lA lCase-Based lApproach l1st lEdition
lO’Meara lTest lBank
Chapter l1 lImmediate lPostpartum lHemorrhage
MULTIPLE lCHOICE
1. A lpregnant lwoman lis lbeing ldischarged lfrom lthe lhospital lafter lthe lplacement lof la
lcervical lcerclage lbecause lof la lhistory lof lrecurrent lpregnancy lloss, lsecondary lto lan
lincompetent lcervix. lWhich linformation lregarding lpostprocedural lcare lshould lthe lnurse
lemphasize lin lthe ldischarge lteaching?
a. Anylvaginal ldischarge lshould lbe limmediately lreported lto lher lhealth lcare lprovider.
b. The lpresence lof lany lcontractions, lrupture lof lmembranes l(ROM), lor lsevere lperineal lpressure
lsho
c. The lclient lwill lneed lto lmake larrangements lfor lcare lat lhome, lbecause lher lactivityllevel lwill lbe
lre
d. The lclient lwill lbe lscheduled lfor la lcesarean lbirth.
lANS: lB
Nursing lcare lshould lstress lthe limportance lof lmonitoring lfor lthe lsigns land lsymptoms lof lpreterm
labor. lVaginal lbleeding lneeds lto lbe lreported lto lher lprimary lhealth lcare lprovider. lBed lrest lis
lan lelement lof lcare. lHowever, lthe lwoman lmay lstand lfor lperiods lof lup lto l90 lminutes, lwhich
lallows lher lthe lfreedom lto lsee lher lphysician. lHome luterine lactivity lmonitoring lmay lbe lused
lto llimit lthe lwomans lneed lfor lvisits land lto lmonitor lher lstatus lsafely lat lhome. lThe lcerclage lcan
lbe lremoved lat l37 lweeks lof lgestation l(to lprepare lfor la lvaginal lbirth), lor la lcesarean lbirth lcan
lbe lplanned.
DIF: lCognitive lLevel: lApply lREF: ldm. l675
TOP: lNursing lProcess: lPlanning l| lNursing lProcess: lImplementation
lMSC: lClient lNeeds: lHealth lPromotion land lMaintenance
2. A lperinatal lnurse lis lgiving ldischarge linstructions lto la lwoman, lstatus lpostsuction, land lcurettage
lsecondary lto la lhydatidiform lmole. lThe lwoman lasks lwhy lshe lmust ltake loral lcontraceptives
lfor lthe lnext l12 lmonths. lWhat lis lthe lbestresponse lby lthe lnurse?
If lyou lget lpregnant lwithin l1 lyear, lthe lchance lof la lsuccessful lpregnancy lis lverylsmall. lTherefore,
a. pregnancy, lit lwould lbe lbetter lfor lyou lto luse lthe lmost lreliable lmethod lof lcontraception lavailable.
The lmajor lrisk lto lyou lafter la lmolar lpregnancy lis la ltype lof lcancer lthat lcan lbe ldiagnosed lonly
lby lhormone lthat lyour lbody lproduces lduring lpregnancy. lIf lyou lwere lto lget lpregnant, lthen lit
lwould
b. this lcancer lmore ldifficult.
If lyou lcan lavoid la lpregnancy lfor lthe lnext lyear, lthe lchance lof ldeveloping la lsecond lmolar
lpregna
c. improve lyour lchance lof la lsuccessful lpregnancy, lnot lgetting lpregnant lat lthis ltime lis lbest.
d. Oral lcontraceptives lare lthe lonly lform lof lbirth lcontrol lthat lwill lprevent la lrecurrence lof la lmolar
lp lANS: lB
,Betahuman lchorionic lgonadotropin l(beta-hCG) lhormone llevels lare ldrawn lfor l1 lyear lto lensure
that lthe lmole lis lcompletely lgone. lThe lchance lof ldeveloping lchoriocarcinoma lafter lthe
ldevelopment lof la lhydatidiform lmole lis lincreased. lTherefore, lthe lgoal lis lto lachieve la lzero
lhuman lchorionic lgonadotropin l(hCG) llevel. lIf lthe lwoman lwere lto lbecome lpregnant, lthen lit lmay
lobscure lthe lpresence lof lthe lpotentially lcarcinogenic lcells. lWomen lshould lbe linstructed lto luse
lbirth lcontrol lfor l1 lyear lafter ltreatment lfor la lhydatidiform lmole. lThe lrationale lfor lavoiding
lpregnancy
, for l1 lyear lis lto lensure lthat lcarcinogenic lcells lare lnot lpresent. lAny lcontraceptive lmethod lexcept
lan lintrauterine ldevice l(IUD) lis lacceptable.
DIF: lCognitive lLevel: lApply lREF: ldm. l679
TOP: lNursing lProcess: lPlanning l| lNursing lProcess: lImplementation
lMSC: lClient lNeeds: lPhysiologic lIntegrity
3. The lnurse lis lpreparing lto ladminister lmethotrexate lto lthe lclient. lThis lhazardous ldrug
lis lmost loften lused lfor lwhich lobstetric lcomplication?
a. Complete lhydatidiform lmole
b. Missed labortion
c. Unruptured lectopic lpregnancy
d. Abruptio lplacentae
lANS: lC
Methotrexate lis lan leffective lnonsurgical ltreatment loption lfor la lhemodynamically lstable lwoman
whose lectopic lpregnancy lis lunruptured land lmeasures lless lthan l4 lcm lin ldiameter. lMethotrexate lis
lnot lindicated lor lrecommended las la ltreatment loption lfor la lcomplete lhydatidiform lmole, lfor la
lmissed labortion, lor lfor labruptio lplacentae.
DIF: lCognitive lLevel: lApply lREF: ldm. l677 lTOP: lNursing lProcess: lPlanning
lMSC: lClient lNeeds: lPhysiologic lIntegrity
4. A l26-year-old lpregnant lwoman, lgravida l2, lpara l1-0-0-1, lis l28 lweeks lpregnant lwhen lshe
lexperiences lbright lred, lpainless lvaginal lbleeding. lOn lher larrival lat lthe lhospital, lwhich
ldiagnostic lprocedure lwill lthe lclient lmost llikely lhave lperformed?
a. Amniocentesis lfor lfetal llung lmaturity
b. Transvaginal lultrasound lfor lplacental llocation
c. Contraction lstress ltest l(CST)
d. Internal lfetal lmonitoring
lANS: lB
The lpresence lof lpainless lbleeding lshould lalways lalert lthe lhealth lcare lteam lto lthe lpossibilitylof
placenta lprevia, lwhich lcan lbe lconfirmed lthrough lultrasonography. lAmniocentesis lis lnot
lperformed lon la lwoman lwho lis lexperiencing lbleeding. lIn lthe levent lof lan limminent ldelivery,
lthe lfetus lis lpresumed lto lhave limmature llungs lat lthis lgestational lage, land lthe lmother lis lgiven
lcorticosteroids lto laid lin lfetal llung lmaturity. lA lCST lis lnot lperformed lat la lpreterm lgestational lage.
lFurthermore, lbleeding lis la lcontraindication lto la l CST. lInternal lfetal lmonitoring lis lalso
lcontraindicated lin lthe lpresence lof lbleeding.
DIF: lCognitive lLevel: lApply lREF: ldm. l680
TOP: lNursing lProcess: lAssessment lMSC: lClient lNeeds: lHealth lPromotion land lMaintenance
5. A llaboring lwoman lwith lno lknown lrisk lfactors lsuddenly lexperiences lspontaneous lROM.
lThe lfluid lconsists lof lbright lred lblood. lHer lcontractions lare lconsistent lwith lher lcurrent lstage lof
llabor. lNo lchange lin luterine lresting ltone lhas loccurred. lThe lfetal lheart lrate l(FHR) lbegins lto
ldecline lrapidly lafter lthe lROM. lThe lnurse l should l suspect lthe lpossibility lof lwhat lcondition?
a. Placenta lprevia
b. Vasa lprevia
c. Severe labruptio lplacentae
