test bank for maternity newborn and women s health nursinga case based approach 1st edition o meara

, Maternity Newborn and Women’s Health Nursing A Case-Based Approach t t t t t t t t t




1st Edition O’Meara Test Bank t




Chapter 1 t t Immediate Postpartum Hemorrhage t t




MULTIPLE CHOICE
1. A pregnant woman is being discharged from the hospital after the
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placement of a cervical
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pregnancy loss, secondary to an incompetent cervix.Which information
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regarding postprocedural care should the nurse emphasize in the
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dischargeteaching?
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a. Anyvaginal discharge should be immediately reported to her health care provider. t t t t t t t NHNH t t




b. The presence of any contractions, rupture of membranes (ROM), orsevere perineal
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pressure should
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c. The client will need to make arrangements for care at home, becauseher activity
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level will be restri
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d. The client will be scheduled for t t t t t t




a cesarean birth.ANS: B
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Nursing care should stress the importance of monitoring for the signs and symptoms of
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preterm
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labor. Vaginal bleeding needs to be reported to her primary healthcare provider.
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Bed rest is an element of care. However, the woman may stand for periods
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of up to 90 minutes, which allows her the freedom to see her physician. Home
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uterine activitymonitoring may be used to limit the womans need for visits and
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to monitor her status safelyathome. The cerclage can be removed at 3 7
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gestation (to prepare for a vaginal birth), or acesarean birthcan be
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DIF: Cognitive Level: Apply REF: dm. 675
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TOP: Nursing Process: Planning | Nursing Process:
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ImplementationMSC: Client Needs: Health Promotion and t NHNH t t t




Maintenance
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2.A perinatal nurse is giving discharge instructions to a woman, status
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postsuction, and curettagesecondary to a hydatidiformmole. The
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woman asks why she must take oral contraceptives for the next NHNH


12 months. What is the bestresponse bythe nurse?
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If you get pregnantwithin 1 year, the chance of a successful pregnancy is very sma
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Therefore, if t




a. pregnancy,itwould be better for you to use the most reliable method of t t t t t t t t t t t t t




contraception available. t t




Themajor risk to you after a molar pregnancy is a type of cancer that can be
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diagnosed only by me hormonethat your bodyproduces during pregnancy. If you
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were to get pregnant, then it would mak
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b. this cancer more difficult. t t t




Ifyou can avoid a pregnancy for the next year, the chance of developing a
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second molar pregnancy
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c. improve your chance of a successful pregnancy, not getting pregnant at this time
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is best. t t




d. Oral contraceptives are the only form of birth control that will prevent a
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, recurrence of a molar pregA NS: B t t t t t q, t




Betahuman chorionic gonadotropin (beta-hCG) hormone levels are drawn for 1 year to
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tensure that the mole is completely gone. The chance of developing choriocarcinoma after
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the development of a hydatidiform mole is increased. Therefore, the goal is
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to achieve a zero human chorionic gonadotropin (hCG) level. If the woman
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were to become pregnant, then it may obscurethe presence of the potentially
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carcinogenic cells. Women should be instructed to use birth control for 1
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year after treatment for a hydatidiform mole. The rationale for avoiding
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pregnancy
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, for 1 year is to ensure that carcinogenic cells are not present. Any
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contraceptive method exceptan intrauterine
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acceptable.
DIF: Cognitive Level: Apply REF: dm. 679 t t t




TOP: Nursing Process: Planning | Nursing
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tProcess:
ImplementationMSC: Client Needs: Physiologic Integrity
3. The nurse is preparing to administer methotrexate to the client. This hazardous drugis
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most often used for which obstetric complication?
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a. Complete hydatidiform mole t




b. Missed abortion t




c. Unruptured ectopic t t pregnancy
d. Abruptio
placentaeANS: C t q, t




Methotrexate is an effective nonsurgical treatment option for a hemodynamicallystable woman t t t t t t t t t t t




whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter.
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Methotrexate isn ot indicated or recommended as a treatment option for a
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complete hydatidiform mole, for a missed abortion, or for abruptio placentae.
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DIF: Cognitive Level: Apply REF: dm. 677 TOP: Nursing
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Process: PlanningMSC: Client Needs: Physiologic
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4.A 26-year-old pregnant woman, gravida 2, para 1-0-0-1,is28 weeks
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pregnant when she
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vaginal bleeding. Onher arrival at the hospital, t t t




which diagnosticprocedure will the clientmost likely have ,q t t




performed?
a. Amniocentesis for fetal lung maturity t t NHNH



b. Transvaginal ultrasound NH t for placental location t NH



c. Contraction stress test (CST) t NHNH



d. Internal
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monitoringANS: B
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The presence of painless bleedingshould always alert the health care team to the possibility of
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placenta previa, which canbe confirmed through ultrasonography. Amniocentesis is not
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performed on a woman who is experiencing bleeding. In the event of an
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imminent delivery, the fetus is presumed to haveimmature lungs at this
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gestational age, and the mother is given corticosteroids to
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lung maturity. A CST is not performed at a preterm gestational
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age.Furthermore, bleeding is acontraindication to a CST. Internal
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monitoring is also contraindicated in the presence ofbleeding.
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DIF: Cognitive Level: Apply REF: dm. 680
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TOP: 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
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spontaneous ROM. The fluid consists of bright red blood. Her contractions
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are consistent
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tone has occurred. The fetal heart rate (FHR) begins to decline rapidly
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after the
t ROM. The nurse should suspect the possibility of what
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condition?