Test Bank for Maternity, Newborn, and Women’s Health Nursing: A Case-Based Approach, 2nd Edition | Amy O’Meara | Complete Questions & Correct Answers

MATERNITY NEWBORN AND WOMEN’S HEALTH
NURSING A CASE-BASED APPROACH 2ND EDITION
O’MEARA’S TEST BANK




Chapter: 1 Immediate Postpartum Hemorrhage

MULTIPLE CHOICE

,1. An expectant woman is being discharged from the health center after the
D D D D D D D D D D D


Dplacement of a cervical cerclage because of a history of recurrent gestation/pregnancy
D D D D D D D D D D D


Dloss, secondary to an incompetent cervix. Which information regarding post procedural
D D D D D D D D D D


Dcare should the nursing attendant emphasize in the discharge teaching?
D D D D D D D D D


a. Any vaginal discharge should be immediately reported to her health care
D D D D D D D D D D


Dprovider. b. The presence of any contractions, rupture of membranes (ROM), or severe
D D D D D D D D D D D


Dperineal pressure should be reported
D D D D


c. The client will need to make arrangements for care at home, because her activity
D D D D D D D D D D D D D


level will be restricted
D D D D


d. The client will be scheduled for a cesareanD D D D D D D


Dbirth.ACCURATE CHOICE:-B
D D


Reasoning:->>>>Nursing care should stress the importance of monitoring for the signs D D D D D D D D D D


Dand symptoms of preterm labor. Vaginal bleeding needs to be reported to her primary health
D D D D D D D D D D D D D D


Dcare provider. Bed rest is an element of care. However, the woman may stand for periods
D D D D D D D D D D D D D D D


Dof up to 90 minutes, which allows her the freedom to see her physician. Home uterine
D D D D D D D D D D D D D D D


Dactivity monitoring may be used to limit the womans need for visits and to monitor her
D D D D D D D D D D D D D D D


Dstatus safely at home. The cerclage can be removed at 37 weeks of gestation (to prepare
D D D D D D D D D D D D D D D


Dfor a vaginal birth), or a cesarean birth can be planned.
D D D D D D D D D D


DIF: Cognitive Level: Apply REF: dm. 675
D D D D D D


TOPIC Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs:
D D D D D D D D D D


HealthPromotion and Maintenance
D D D




2. A perinatal nursing attendant is giving discharge instructions to a woman, status
D D D D D D D D D D D


Dpostsuction,and curettage secondary to a hydatidiform mole. The woman asks why she
D D D D D D D D D D D D


Dmust take oral contraceptives for the next 12 months. What is the best response by the
D D D D D D D D D D D D D D D


Dnursing attendant? D


a. If you get expectant within 1 year, the chance of a successful
D D D D D D D D D D D


D gestation/pregnancy is very small. Therefore, if gestation/pregnancy, it would be D D D D D D D D D


better for you to use the most reliable methodof contraception available.
D D D D D D D D D D D D


b. The major risk to you after a molar gestation/pregnancy is a type of cancer that can be
D D D D D D D D D D D D D D D D


Ddiagnosed only by me hormone that your body produces during gestation/pregnancy. If
D D D D D D D D D D D


Dyou were to get expectant, then itwould make this cancer more difficult.
D D D D D D D D D D D


c. If you can avoid a gestation/pregnancy for the next year, the chance of developing a
D D D D D D D D D D D D D D


Dsecond molar gestation/pregnancy improve your chance of a successful
D D D D D D D D


Dgestation/pregnancy, not getting expectant at this timeisbest. D D D D D D D


d. Oral contraceptives are the only form of birth control that will prevent a recurrence of
D D D D D D D D D D D D D D


Da molar gestation/pregnancy
D D


ACCURATE CHOICE:-B D


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


Dfor 1 year to ensure that the mole is completely gone. The chance of developing
D D D D D D D D D D D D D D


choriocarcinoma after the development of a hydatidiform mole is increased. Therefore,
D D D D D D D D D D D


Dthe goal is to achieve a zero
D D D D D D

,human chorionic gonadotropin (hCG) level. If the woman were to become expectant, then
D D D D D D D D D D D D


D it may obscure the presence of the potentially carcinogenic cells. Women should be
D D D D D D D D D D D D


Dinstructed to use birth control for 1 year after treatment for a hydatidiform mole. The
D D D D D D D D D D D D D D


rationale for avoiding gestation/pregnancy for 1 year is to ensure that carcinogenic cells
D D D D D D D D D D D D D


Dare not present. Any contraceptive method except an intrauterine device (IUD) is
D D D D D D D D D D D


acceptable.
D


DIF: Cognitive Level: Apply REF: dm. 679
D D D D D D


TOPIC Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs:
D D D D D D D D D D


Physiologic Integrity
D D




3. The nursing attendant is preparing to administer methotrexate to the client. This
D D D D D D D D D D D


Dhazardousdrug is most often used for which obstetric complication?
D D D D D D D D D


a. Complete hydatidiform mole D D


b. Missed abortion D


c. Unruptured ectopic gestation/pregnancy D D


d. Abruptio
DplacentaeACCURATE D


DCHOICE:-C
Reasoning:->>>>Methotrexate is an effective nonsurgical treatment option for a D D D D D D D D


Dhemodynamically stable woman whose ectopic gestation/pregnancy is unruptured and D D D D D D D D


Dmeasures less than 4 cm in diameter. Methotrexate is not indicated or recommended as a
D D D D D D D D D D D D D D


Dtreatment option for a complete hydatidiform mole, for amissed abortion, or for abruptio
D D D D D D D D D D D D


Dplacentae.
DIF: Cognitive Level: Apply REF: dm. 677 TOPIC Nursing Process: Planning MSC: Client
D D D D D D D D D D D D


DNeeds: Physiologic Integrity
D D




4. A 26-year-old expectant woman, gravida 2, para 1-0-0-1, is 28 weeks expectant
D D D D D D D D D D D


Dwhenshe experiences bright red, painless vaginal bleeding. On her arrival at the health
D D D D D D D D D D D D D


Dcenter, which diagnostic procedure will the client most likely have performed?
D D D D D D D D D D


a. Amniocentesis for fetal lung maturity D D D D


b. Transvaginal ultrasound for placental location D D D D


c. Contraction stress test (CST) D D D


d. Internal fetal D


DmonitoringACCURATE D


DCHOICE:-B
Reasoning:->>>>The presence of painless bleeding should always alert the health care D D D D D D D D D D


Dteam to the possibility ofplacenta previa, which can be confirmed through
D D D D D D D D D D


Dultrasonography.
Amniocentesis is not performed on a woman who is experiencing bleeding. In the event of
D D D D D D D D D D D D D D


an imminent delivery, the fetus is presumed to have immature lungs at this gestational age,
D D D D D D D D D D D D D D D


Dand the mother is given corticosteroids to aid in fetal lung maturity. A CST is not
D D D D D D D D D D D D D D D


Dperformed at a preterm gestational age. Furthermore, bleeding is a contraindication to a
D D D D D D D D D D D D


DCST. Internal fetal monitoring is also contraindicated in the presence of bleeding.
D D D D D D D D D D D


DIF: Cognitive Level: Apply REF: dm. 680
D D D D D D


TOPIC Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
D D D D D D D D D D




5. A laboring woman with no known risk factors suddenly experiences spontaneous
D D D D D D D D D D


DROM. The fluid consists of bright red blood. Her contractions are consistent with her
D D D D D D D D D D D D D


current stage of labor. No change in uterine resting tone has occurred. The fetal heart rate
D D D D D D D D D D D D D D D D


D(FHR) begins to decline rapidly after the ROM. The nursing attendant should suspect the
D D D D D D D D D D D D D


Dpossibility of what condition? D D D


a. Placenta previa D

, b. Vasa previa D


c. Severe abruptio placentae D D


d. Disseminated intravascular coagulation D D


D(DIC)ACCURATE CHOICE:-B
D D


Reasoning:->>>>Vasa previa is the result of a velamentous insertion of the umbilical cord. D D D D D D D D D D D D


DThe umbilical vessels are not surrounded by Wharton jelly and have no supportive tissue.
D D D D D D D D D D D D D


DThe umbilical blood vessels thus are at risk for laceration at any time, but laceration
D D D D D D D D D D D D D D


Doccurs most frequently during ROM. The sudden appearance of bright red blood at the
D D D D D D D D D D D D D


Dtime of ROM and a sudden change in the FHR without other known risk factors should
D D D D D D D D D D D D D D D


Dimmediately alert the nursing attendant to the possibility of vasa previa. The presence of
D D D D D D D D D D D D D


Dplacenta previa most likely would be ascertained before labor andis considered a risk
D D D D D D D D D D D D


Dfactor for this gestation/pregnancy. In addition, if the woman had a placenta previa, itis
D D D D D D D D D D D D D


Dunlikely that she would be allowed to pursue labor and a vaginal birth. With the presence
D D D D D D D D D D D D D D D


Dof severe abruptio placentae, the uterine tonicity typically is tetanus (i.e., a boardlike
D D D D D D D D D D D D


Duterus). DIC is a pathologic form of diffuse clotting that consumes large amounts of
D D D D D D D D D D D D D


Dclotting factors, causing widespread external bleeding, internal bleeding, or both. DIC is
D D D D D D D D D D D


Dalways a secondary diagnosis, often associated with obstetric risk factors such as the
D D D D D D D D D D D D


Dhemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome. This
D D D D D D D D D D D


Dwoman did not have any prior risk factors.
D D D D D D D


DIF: Cognitive Level: Analyze REF: dm. 684 TOPIC Nursing Process: Diagnosis MSC:
D D D D D D D D D D D


DClient Needs: Physiologic Integrity
D D D




6. A woman arrives for evaluation of signs and symptoms that include a missed
D D D D D D D D D D D D


Dperiod, adnexal fullness, tenderness, and dark red vaginal bleeding. On examination, the
D D D D D D D D D D D


Dnursing attendant noticesan ecchymotic blueness around the womans umbilicus. What
D D D D D D D D D


Ddoes this finding indicate?
D D D


a. Normal integumentary changes associated with gestation/pregnancy
D D D D D


b. Turner sign associated with appendicitis D D D D


c. Cullen sign associated with a ruptured ectopic gestation/pregnancy
D D D D D D D


d. Chadwick sign associated with early D D D D


Dgestation/pregnancy ACCURATE CHOICE:-C D D


Cullen sign, the blue ecchymosis observed in the umbilical area, indicates
D D D D D D D D D D


Dhematoperitoneum Reasoning:->>>>associated with an undiagnosed ruptured D D D D D


Dintraabdominal ectopic gestation/pregnancy.Linea nigra on theabdomen is the normal
D D D D D D D D D


D integumentary change associated with gestation/pregnancy and exhibits a brown
D D D D D D D D


Dpigmented, vertical line on the lower abdomen. Turner sign is ecchymosis in the flank
D D D D D D D D D D D D D


Darea, often associated with pancreatitis. A Chadwick sign is a blue- purple cervix that may
D D D D D D D D D D D D D D


Dbe seen during or around the eighth week of gestation/pregnancy.
D D D D D D D D D


DIF: Cognitive Level: Analyze REF: dm. 676
D D D D D D


TOPIC Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
D D D D D D D D




7. The nursing attendant who elects to practice in the area of womens health must
D D D D D D D D D D D D D


Dhave a thorough understanding of miscarriage. Which statement regarding this
D D D D D D D D D


Dcondition is mostaccurate? D D D


a. A miscarriage is a natural gestation/pregnancy loss before labor begins.
D D D D D D D D D


b. It occurs in fewer than 5% of all clinically recognized pregnancies.
D D D D D D D D D D


c. Careless maternal behavior, such as poor nutrition or excessive exercise, can be a
D D D D D D D D D D D D


Dfactorin causing miscarriage
D D D


d. If a miscarriage occurs before the 12th week of gestation/pregnancy, then it may be
D D D D D D D D D D D D D


Dobserved only asmoderate blood lossD D D D D


ACCURATE CHOICE:-D D