, MaternityNewbornandWomen’sHealth NursingACase-BasedApproach 1stEdition 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
O’Meara Test Bank 2q 2q
Chapter1 ImmediatePostpartumHemorrhage 2q 2 q 2q 2q
MULTIPLECHOICE 2q
1. Apregnant woman isbeingdischarged from the hospital aftertheplacement ofa cervical
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
cerclage because of a historyof recurrent pregnancy loss, secondaryto an incompetent
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
cervix.Whichinformationregardingpostproceduralcareshouldthenurseemphasizeinthe
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
dischargeteaching?
2q
a. Anyvaginaldischargeshould beimmediately reportedto herhealthcareprovider. 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
b. The presence of anycontractions, rupture of membranes (ROM), or severeperineal pressure
2q 2q 2q 2q 2q 2q 2q 2q til til 2q 2q
should 2q
c. Theclientwillneedtomakearrangementsforcareathome,becauseheractivitylevelwillbe restri
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
d. Theclientwillbescheduledforacesarean 2q 2q 2q 2q 2q 2q 2q
birth.ANS: B
2q 2q
Nursingcareshould stressthe importance ofmonitoring forthe signs andsymptoms ofpreterm
2q 2q 2q 2q 2q 2q 2q t 2 q 2q til 2 q 2q 2q 2q
labor.Vaginalbleedingneedstobereportedtoherprimary healthcareprovider.Bedrestisan element
2q 2q 2q 2q 2q 2q 2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q
ofcare. However,thewomanmaystandfor periodsofupto90minutes,whichallows her thefreedom
2q 2q 2q 2q 2q 2q 2q 2q il
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
toseeher physician. Homeuterine activitymonitoringmaybe usedtolimit thewomans needfor
2q 2q 2q 2q 2 q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
visits andto monitorher statussafelyat home. Thecerclage can be removedat37 weeksof gestation
2q 2q 2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
(toprepare for avaginal birth),or acesarean birth canbe planned.
2q 2q t 2 q til 2q 2q 2q 2q 2q 2q 2q 2q 2q
DIF:Cognitive Level: ApplyREF: dm. 675
2q 2q 2q 2q 2q t 2 q y 2q
TOP: Nursing Process: Planning |Nursing Process:
2q 2q 2q 2q 2q 2q
ImplementationMSC:Client Needs: Health Promotion and Maintenance 2q 2q til 2q 2q 2q
2. Aperinatal nurse is givingdischarge instructions to a woman, status postsuction, and
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
curettagesecondary to a hydatidiform mole. The woman asks why she must take oral
2q 2q til til 2q 2q 2q 2q 2q 2q 2q 2q 2q
contraceptives for the next 12 months. What is the bestresponse bythe nurse?
2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q
Ifyou get pregnant within1 year,thechance ofasuccessfulpregnancyisverysmall. Therefore, if 2q ti 2q y 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
a. pregnancy,it wouldbebetterfor youto usethemostreliablemethodofcontraceptionavailable. 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
Themajorrisktoyouafteramolarpregnancyisatypeofcancerthatcanbediagnosedonlybyme hormonethat
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
yourbodyproducesduringpregnancy.Ifyouweretogetpregnant,thenitwouldmak
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
b. thiscancermoredifficult. 2q 2q 2q
Ifyoucanavoidapregnancyforthenext year,thechanceofdevelopinga secondmolarpregnancy
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
c. improveyourchance ofasuccessfulpregnancy, notgettingpregnantatthistimeisbest. 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
d. Oralcontraceptivesaretheonlyformofbirthcontrolthatwillpreventarecurrenceofamolar 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
pregANS: B
2q 2q
Betahumanchorionicgonadotropin(beta-hCG)hormonelevels aredrawnfor1 yeartoensure 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
that the mole is completely gone. The chance of developing choriocarcinoma after the developmentof
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
ahydatidiformmoleisincreased.Therefore,thegoalistoachieveazero human chorionic
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2 q 2q
gonadotropin(hCG)level.Ifthe womanweretobecome pregnant, thenitmay
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
,obscurethepresenceofthepotentiallycarcinogeniccells.Womenshouldbeinstructedtouse birth
ilt 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
controlfor 1 year aftertreatment for ahydatidiform mole.The rationale for avoiding pregnancy
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
, for1 yearistoensurethat carcinogenic cellsare not present. Anycontraceptivemethodexcept an
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q ilt
2qintrauterine device (IUD) is acceptable. 2q 2q 2q 2q
DIF:CognitiveLevel:ApplyREF: dm.679
2q 2q 2q 2q 2q 2q
TOP:NursingProcess: Planning |Nursing Process:
2q 2q 2q 2q 2q 2q
ImplementationMSC:ClientNeeds:PhysiologicIntegrity 2q 2q 2q 2q
3. The nurse is preparingto administer methotrexate to the client. Thishazardous
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
2qdrugis most often used for which obstetric complication?
i 2q 2q 2q 2q 2q 2q 2q
a. Completehydatidiform mole 2q 2 q
b. Missedabortion 2q
c. Unrupturedectopic pregnancy 2q 2q
d. Abruptio
placentaeANS: C
2q 2q
Methotrexateisaneffectivenonsurgicaltreatmentoptionforahemodynamicallystable woman 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter. Methotrexate isnot
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
indicated or recommended as a treatment option for a complete hydatidiform mole, for a missed
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
abortion, or for abruptio placentae.
2q 2q 2q 2q 2q
DIF: Cognitive Level: ApplyREF: dm.677 TOP: NursingProcess:
2q 2q 2q 2q 2q 2q 2q 2q 2q
PlanningMSC: Client Needs: Physiologic Integrity 2q 2q 2q 2q
4. A26-year-old pregnant woman,gravida2, para 1-0-0-1, is 28 weeks pregnant when she
2q 2q 2q 2q 2q 2q 2q til til 2q 2q 2q 2q
experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which
2q 2q 2q 2q 2q 2q 2q til y 2q 2q 2q 2q
diagnosticprocedure will the client most likely have performed?
2q 2q 2q 2q 2q 2q 2q til
a. Amniocentesis forfetallungmaturity 2q 2q 2q 2q
b. Transvaginalultrasoundfor placentallocation 2q 2q til 2q
c. Contractionstress test (CST) 2q 2q
d. Internalfetal
monitoringANS: B
2q ilt 2q
Thepresenceofpainlessbleeding shouldalwaysalertthe healthcareteamtothepossibilityof
2q 2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
placenta previa, which can be confirmed through ultrasonography. Amniocentesis is not
2q 2q 2q y 2q 2q 2q 2q 2q 2q
performedonawoman whoisexperiencingbleeding. Intheeventofanimminent delivery, the fetus is
2q 2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
presumed to have immature lungs at this gestational age, and the mother is given corticosteroids to
2q 2q til y 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q til
aid in fetallungmaturity. A CSTis not performedat apreterm gestational age.Furthermore,
il
2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
bleeding is a contraindication to a CST. Internal fetal monitoring is also contraindicated in the
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q til 2q
presence of bleeding.
2q 2q 2q
DIF:CognitiveLevel:ApplyREF: dm.680
2q 2q 2q 2q 2q 2q
TOP:NursingProcess:AssessmentMSC:ClientNeeds:HealthPromotionandMaintenance
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
5. Alaboring woman with no known risk factors suddenly experiences spontaneous ROM. The fluid
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
consists ofbright red blood. Hercontractions areconsistent with hercurrent stageof labor.Nochange
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
inuterinerestingtonehasoccurred.Thefetalheart rate(FHR)beginstodecline rapidly after the ROM.
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
The nurse should suspect the possibilityof what condition?
2q 2q 2q 2q 2q 2q 2q 2q 2q
a. Placentaprevia 2q
b. Vasaprevia 2q
c. Severeabruptio placentae 2q 2q
O’Meara Test Bank 2q 2q
Chapter1 ImmediatePostpartumHemorrhage 2q 2 q 2q 2q
MULTIPLECHOICE 2q
1. Apregnant woman isbeingdischarged from the hospital aftertheplacement ofa cervical
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
cerclage because of a historyof recurrent pregnancy loss, secondaryto an incompetent
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
cervix.Whichinformationregardingpostproceduralcareshouldthenurseemphasizeinthe
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
dischargeteaching?
2q
a. Anyvaginaldischargeshould beimmediately reportedto herhealthcareprovider. 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
b. The presence of anycontractions, rupture of membranes (ROM), or severeperineal pressure
2q 2q 2q 2q 2q 2q 2q 2q til til 2q 2q
should 2q
c. Theclientwillneedtomakearrangementsforcareathome,becauseheractivitylevelwillbe restri
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
d. Theclientwillbescheduledforacesarean 2q 2q 2q 2q 2q 2q 2q
birth.ANS: B
2q 2q
Nursingcareshould stressthe importance ofmonitoring forthe signs andsymptoms ofpreterm
2q 2q 2q 2q 2q 2q 2q t 2 q 2q til 2 q 2q 2q 2q
labor.Vaginalbleedingneedstobereportedtoherprimary healthcareprovider.Bedrestisan element
2q 2q 2q 2q 2q 2q 2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q
ofcare. However,thewomanmaystandfor periodsofupto90minutes,whichallows her thefreedom
2q 2q 2q 2q 2q 2q 2q 2q il
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
toseeher physician. Homeuterine activitymonitoringmaybe usedtolimit thewomans needfor
2q 2q 2q 2q 2 q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
visits andto monitorher statussafelyat home. Thecerclage can be removedat37 weeksof gestation
2q 2q 2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
(toprepare for avaginal birth),or acesarean birth canbe planned.
2q 2q t 2 q til 2q 2q 2q 2q 2q 2q 2q 2q 2q
DIF:Cognitive Level: ApplyREF: dm. 675
2q 2q 2q 2q 2q t 2 q y 2q
TOP: Nursing Process: Planning |Nursing Process:
2q 2q 2q 2q 2q 2q
ImplementationMSC:Client Needs: Health Promotion and Maintenance 2q 2q til 2q 2q 2q
2. Aperinatal nurse is givingdischarge instructions to a woman, status postsuction, and
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
curettagesecondary to a hydatidiform mole. The woman asks why she must take oral
2q 2q til til 2q 2q 2q 2q 2q 2q 2q 2q 2q
contraceptives for the next 12 months. What is the bestresponse bythe nurse?
2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q
Ifyou get pregnant within1 year,thechance ofasuccessfulpregnancyisverysmall. Therefore, if 2q ti 2q y 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
a. pregnancy,it wouldbebetterfor youto usethemostreliablemethodofcontraceptionavailable. 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
Themajorrisktoyouafteramolarpregnancyisatypeofcancerthatcanbediagnosedonlybyme hormonethat
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
yourbodyproducesduringpregnancy.Ifyouweretogetpregnant,thenitwouldmak
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
b. thiscancermoredifficult. 2q 2q 2q
Ifyoucanavoidapregnancyforthenext year,thechanceofdevelopinga secondmolarpregnancy
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
c. improveyourchance ofasuccessfulpregnancy, notgettingpregnantatthistimeisbest. 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
d. Oralcontraceptivesaretheonlyformofbirthcontrolthatwillpreventarecurrenceofamolar 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
pregANS: B
2q 2q
Betahumanchorionicgonadotropin(beta-hCG)hormonelevels aredrawnfor1 yeartoensure 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
that the mole is completely gone. The chance of developing choriocarcinoma after the developmentof
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
ahydatidiformmoleisincreased.Therefore,thegoalistoachieveazero human chorionic
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2 q 2q
gonadotropin(hCG)level.Ifthe womanweretobecome pregnant, thenitmay
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
,obscurethepresenceofthepotentiallycarcinogeniccells.Womenshouldbeinstructedtouse birth
ilt 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
controlfor 1 year aftertreatment for ahydatidiform mole.The rationale for avoiding pregnancy
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
, for1 yearistoensurethat carcinogenic cellsare not present. Anycontraceptivemethodexcept an
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q ilt
2qintrauterine device (IUD) is acceptable. 2q 2q 2q 2q
DIF:CognitiveLevel:ApplyREF: dm.679
2q 2q 2q 2q 2q 2q
TOP:NursingProcess: Planning |Nursing Process:
2q 2q 2q 2q 2q 2q
ImplementationMSC:ClientNeeds:PhysiologicIntegrity 2q 2q 2q 2q
3. The nurse is preparingto administer methotrexate to the client. Thishazardous
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
2qdrugis most often used for which obstetric complication?
i 2q 2q 2q 2q 2q 2q 2q
a. Completehydatidiform mole 2q 2 q
b. Missedabortion 2q
c. Unrupturedectopic pregnancy 2q 2q
d. Abruptio
placentaeANS: C
2q 2q
Methotrexateisaneffectivenonsurgicaltreatmentoptionforahemodynamicallystable woman 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter. Methotrexate isnot
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
indicated or recommended as a treatment option for a complete hydatidiform mole, for a missed
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
abortion, or for abruptio placentae.
2q 2q 2q 2q 2q
DIF: Cognitive Level: ApplyREF: dm.677 TOP: NursingProcess:
2q 2q 2q 2q 2q 2q 2q 2q 2q
PlanningMSC: Client Needs: Physiologic Integrity 2q 2q 2q 2q
4. A26-year-old pregnant woman,gravida2, para 1-0-0-1, is 28 weeks pregnant when she
2q 2q 2q 2q 2q 2q 2q til til 2q 2q 2q 2q
experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which
2q 2q 2q 2q 2q 2q 2q til y 2q 2q 2q 2q
diagnosticprocedure will the client most likely have performed?
2q 2q 2q 2q 2q 2q 2q til
a. Amniocentesis forfetallungmaturity 2q 2q 2q 2q
b. Transvaginalultrasoundfor placentallocation 2q 2q til 2q
c. Contractionstress test (CST) 2q 2q
d. Internalfetal
monitoringANS: B
2q ilt 2q
Thepresenceofpainlessbleeding shouldalwaysalertthe healthcareteamtothepossibilityof
2q 2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
placenta previa, which can be confirmed through ultrasonography. Amniocentesis is not
2q 2q 2q y 2q 2q 2q 2q 2q 2q
performedonawoman whoisexperiencingbleeding. Intheeventofanimminent delivery, the fetus is
2q 2q 2q 2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
presumed to have immature lungs at this gestational age, and the mother is given corticosteroids to
2q 2q til y 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q til
aid in fetallungmaturity. A CSTis not performedat apreterm gestational age.Furthermore,
il
2q til 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
bleeding is a contraindication to a CST. Internal fetal monitoring is also contraindicated in the
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q til 2q
presence of bleeding.
2q 2q 2q
DIF:CognitiveLevel:ApplyREF: dm.680
2q 2q 2q 2q 2q 2q
TOP:NursingProcess:AssessmentMSC:ClientNeeds:HealthPromotionandMaintenance
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
5. Alaboring woman with no known risk factors suddenly experiences spontaneous ROM. The fluid
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
consists ofbright red blood. Hercontractions areconsistent with hercurrent stageof labor.Nochange
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
inuterinerestingtonehasoccurred.Thefetalheart rate(FHR)beginstodecline rapidly after the ROM.
2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q 2q
The nurse should suspect the possibilityof what condition?
2q 2q 2q 2q 2q 2q 2q 2q 2q
a. Placentaprevia 2q
b. Vasaprevia 2q
c. Severeabruptio placentae 2q 2q
