TEST BANK
k
, MaternitykNewbornkandkWomen’skHealthkNursingkAkCase-
BasedkApproachk1stkEditionkO’MearakTestkBank
Chapterk1kImmediatekPostpartumkHemorrhage
MULTIPLEkCHOICE
1. Akpregnantkwomankiskbeingkdischargedkfromkthekhospitalkafterkthekplacementkofkakcervic
alkcerclagekbecausekofkakhistorykofkrecurrentkpregnancykloss,ksecondaryktokankincompetentkc
ervix.kWhichkinformationkregardingkpostproceduralkcarekshouldktheknursekemphasizekinkthek
dischargekteaching?
a. Anykvaginalkdischargekshouldkbekimmediatelykreportedktokherkhealthkcarekprovider.
b. Thekpresencekofkanykcontractions,krupturekofkmembranesk(ROM),korkseverekperinealkpressureks
ho
c. Thekclientkwillkneedktokmakekarrangementskforkcarekatkhome,kbecausekherkactivityklevelkwillkb
ekre
d. Thekclientkwillkbekscheduledkforkakcesareankbirt
h.kANS:kB
Nursingkcarekshouldkstresskthekimportancekofkmonitoringkforktheksignskandksymptomskofkpreterm
labor.kVaginalkbleedingkneedsktokbekreportedktokherkprimarykhealthkcarekprovider.kBedkrestkisk
ankelementkofkcare.kHowever,kthekwomankmaykstandkforkperiodskofkupktok90kminutes,kwhichka
llowskherkthekfreedomktokseekherkphysician.kHomekuterinekactivitykmonitoringkmaykbekusedkto
klimitkthekwomanskneedkforkvisitskandktokmonitorkherkstatusksafelykatkhome.kThekcerclagekcank
bekremovedkatk37kweekskofkgestationk(tokpreparekforkakvaginalkbirth),korkakcesareankbirthkcank
bekplanned.
DIF:kCognitivekLevel:kApplykREF:kdm.k675
TOP:kNursingkProcess:kPlanningk|kNursingkProcess:kImplementatio
nkMSC:kClientkNeeds:kHealthkPromotionkandkMaintenance
2. Akperinatalknursekiskgivingkdischargekinstructionsktokakwoman,kstatuskpostsuction,kandkcuretta
geksecondaryktokakhydatidiformkmole.kThekwomankaskskwhykshekmustktakekoralkcontraceptives
kforktheknextk12kmonths.kWhatkiskthekbestresponsekbyktheknurse?
Ifkyoukgetkpregnantkwithink1kyear,kthekchancekofkaksuccessfulkpregnancykiskveryksmall.kTherefore,
a. pregnancy,kitkwouldkbekbetterkforkyouktokusekthekmostkreliablekmethodkofkcontraceptionkavailable.
Thekmajorkriskktokyoukafterkakmolarkpregnancykiskaktypekofkcancerkthatkcankbekdiagnosedkonlyk
bykhormonekthatkyourkbodykproduceskduringkpregnancy.kIfkyoukwerektokgetkpregnant,kthenkitk
would
b. thiskcancerkmorekdifficult.
Ifkyoukcankavoidkakpregnancykforktheknextk year,kthekchancekofkdevelopingkaksecondkmolarkpreg
na
c. improvekyourkchancekofkaksuccessfulkpregnancy,knotkgettingkpregnantkatkthisktimekiskbest.
d. Oralkcontraceptiveskarekthekonlykformkofkbirthkcontrolkthatkwillkpreventkakrecurrencekofkakmol
arkpkANS:kB
Betahumankchorionickgonadotropink(beta-hCG)khormoneklevelskarekdrawnkfork1kyearktokensure
thatkthekmolekiskcompletelykgone.kThekchancekofkdevelopingkchoriocarcinomakafterkthekdevelo
pmentkofkakhydatidiformkmolekiskincreased.kTherefore,kthekgoalkisktokachievekakzerokhumankcho
rionickgonadotropink(hCG)klevel.kIfkthekwomankwerektokbecomekpregnant,kthenkitkmaykobscurekt
hekpresencekofkthekpotentiallykcarcinogenickcells.kWomenkshouldkbekinstructedktokusekbirthkco
,ntrolkfork1kyearkafterktreatmentkforkakhydatidiformkmole.kThekrationalekforkavoidingkpregnancy
, fork1kyearkisktokensurekthatkcarcinogenickcellskareknotkpresent.kAnykcontraceptivekmethodkexce
ptkankintrauterinekdevicek(IUD)kiskacceptable.
DIF:kCognitivekLevel:kApplykREF:kdm.k679
TOP:kNursingkProcess:kPlanningk|kNursingkProcess:kImplementatio
nkMSC:kClientkNeeds:kPhysiologickIntegrity
3. Theknursekiskpreparingktokadministerkmethotrexatektokthekclient.kThiskhazardouskdr
ugkiskmostkoftenkusedkforkwhichkobstetrickcomplication?
a. Completekhydatidiformkmole
b. Missedkabortion
c. Unrupturedkectopickpregnancy
d. Abruptiokplacenta
ekANS:kC
Methotrexatekiskankeffectiveknonsurgicalktreatmentkoptionkforkakhemodynamicallykstablekwoman
whosekectopickpregnancykiskunrupturedkandkmeasuresklesskthank4kcmkinkdiameter.kMethotrexate
kisknotkindicatedkorkrecommendedkaskaktreatmentkoptionkforkakcompletekhydatidiformkmole,kfor
kakmissedkabortion,korkforkabruptiokplacentae.
DIF:kCognitivekLevel:kApplykREF:kdm.k677kTOP:kNursingkProcess:kPlanningkM
SC:kClientkNeeds:kPhysiologickIntegrity
4. Ak26-year-oldkpregnantkwoman,kgravidak2,kparak1-0-0-
1,kisk28kweekskpregnantkwhenkshekexperienceskbrightkred,kpainlesskvaginalkbleeding.kOnkherkar
rivalkatkthekhospital,kwhichkdiagnostickprocedurekwillkthekclientkmostklikelykhavekperformed?
a. Amniocentesiskforkfetalklungkmaturity
b. Transvaginalkultrasoundkforkplacentalklocation
c. Contractionkstressktestk(CST)
d. Internalkfetalkmonitorin
gkANS:kB
Thekpresencekofkpainlessk bleedingkshouldkalwayskalertkthekhealthkcarekteamktokthekpossibilitykof
placentakprevia,kwhichkcankbekconfirmedkthroughkultrasonography.kAmniocentesiskisknotkperfo
rmedkonkakwomankwhokiskexperiencingkbleeding.kInkthekeventkofkankimminentkdelivery,kthekfet
uskiskpresumedktokhavekimmatureklungskatkthiskgestationalkage,kandkthekmotherkiskgivenkcortico
steroidsktokaidkinkfetalklungkmaturity.kAkCSTkisknotkperformedkatkakpretermkgestationalkage.kFur
thermore,kbleedingkiskakcontraindicationktokakCST.kInternalkfetalkmonitoringkiskalsokcontraindic
atedkinkthekpresencekofkbleeding.
DIF:kCognitivekLevel:kApplykREF:kdm.k680
TOP:kNursingkProcess:kAssessmentkMSC:kClientkNeeds:kHealthkPromotionkandkMaintenance
5. AklaboringkwomankwithknokknownkriskkfactorsksuddenlykexperienceskspontaneouskROM.kT
hekfluidkconsistskofkbrightkredkblood.kHerkcontractionskarekconsistentkwithkherkcurrentkstagekof
klabor.kNokchangekinkuterinekrestingktonekhaskoccurred.kThekfetalkheartkratek(FHR)kbeginsktok
declinekrapidlykafterkthekROM.kTheknursekshouldksuspectkthekpossibilitykofkwhatkcondition?
a. Placentakprevia
b. Vasakprevia
c. Severekabruptiokplacentae
k
, MaternitykNewbornkandkWomen’skHealthkNursingkAkCase-
BasedkApproachk1stkEditionkO’MearakTestkBank
Chapterk1kImmediatekPostpartumkHemorrhage
MULTIPLEkCHOICE
1. Akpregnantkwomankiskbeingkdischargedkfromkthekhospitalkafterkthekplacementkofkakcervic
alkcerclagekbecausekofkakhistorykofkrecurrentkpregnancykloss,ksecondaryktokankincompetentkc
ervix.kWhichkinformationkregardingkpostproceduralkcarekshouldktheknursekemphasizekinkthek
dischargekteaching?
a. Anykvaginalkdischargekshouldkbekimmediatelykreportedktokherkhealthkcarekprovider.
b. Thekpresencekofkanykcontractions,krupturekofkmembranesk(ROM),korkseverekperinealkpressureks
ho
c. Thekclientkwillkneedktokmakekarrangementskforkcarekatkhome,kbecausekherkactivityklevelkwillkb
ekre
d. Thekclientkwillkbekscheduledkforkakcesareankbirt
h.kANS:kB
Nursingkcarekshouldkstresskthekimportancekofkmonitoringkforktheksignskandksymptomskofkpreterm
labor.kVaginalkbleedingkneedsktokbekreportedktokherkprimarykhealthkcarekprovider.kBedkrestkisk
ankelementkofkcare.kHowever,kthekwomankmaykstandkforkperiodskofkupktok90kminutes,kwhichka
llowskherkthekfreedomktokseekherkphysician.kHomekuterinekactivitykmonitoringkmaykbekusedkto
klimitkthekwomanskneedkforkvisitskandktokmonitorkherkstatusksafelykatkhome.kThekcerclagekcank
bekremovedkatk37kweekskofkgestationk(tokpreparekforkakvaginalkbirth),korkakcesareankbirthkcank
bekplanned.
DIF:kCognitivekLevel:kApplykREF:kdm.k675
TOP:kNursingkProcess:kPlanningk|kNursingkProcess:kImplementatio
nkMSC:kClientkNeeds:kHealthkPromotionkandkMaintenance
2. Akperinatalknursekiskgivingkdischargekinstructionsktokakwoman,kstatuskpostsuction,kandkcuretta
geksecondaryktokakhydatidiformkmole.kThekwomankaskskwhykshekmustktakekoralkcontraceptives
kforktheknextk12kmonths.kWhatkiskthekbestresponsekbyktheknurse?
Ifkyoukgetkpregnantkwithink1kyear,kthekchancekofkaksuccessfulkpregnancykiskveryksmall.kTherefore,
a. pregnancy,kitkwouldkbekbetterkforkyouktokusekthekmostkreliablekmethodkofkcontraceptionkavailable.
Thekmajorkriskktokyoukafterkakmolarkpregnancykiskaktypekofkcancerkthatkcankbekdiagnosedkonlyk
bykhormonekthatkyourkbodykproduceskduringkpregnancy.kIfkyoukwerektokgetkpregnant,kthenkitk
would
b. thiskcancerkmorekdifficult.
Ifkyoukcankavoidkakpregnancykforktheknextk year,kthekchancekofkdevelopingkaksecondkmolarkpreg
na
c. improvekyourkchancekofkaksuccessfulkpregnancy,knotkgettingkpregnantkatkthisktimekiskbest.
d. Oralkcontraceptiveskarekthekonlykformkofkbirthkcontrolkthatkwillkpreventkakrecurrencekofkakmol
arkpkANS:kB
Betahumankchorionickgonadotropink(beta-hCG)khormoneklevelskarekdrawnkfork1kyearktokensure
thatkthekmolekiskcompletelykgone.kThekchancekofkdevelopingkchoriocarcinomakafterkthekdevelo
pmentkofkakhydatidiformkmolekiskincreased.kTherefore,kthekgoalkisktokachievekakzerokhumankcho
rionickgonadotropink(hCG)klevel.kIfkthekwomankwerektokbecomekpregnant,kthenkitkmaykobscurekt
hekpresencekofkthekpotentiallykcarcinogenickcells.kWomenkshouldkbekinstructedktokusekbirthkco
,ntrolkfork1kyearkafterktreatmentkforkakhydatidiformkmole.kThekrationalekforkavoidingkpregnancy
, fork1kyearkisktokensurekthatkcarcinogenickcellskareknotkpresent.kAnykcontraceptivekmethodkexce
ptkankintrauterinekdevicek(IUD)kiskacceptable.
DIF:kCognitivekLevel:kApplykREF:kdm.k679
TOP:kNursingkProcess:kPlanningk|kNursingkProcess:kImplementatio
nkMSC:kClientkNeeds:kPhysiologickIntegrity
3. Theknursekiskpreparingktokadministerkmethotrexatektokthekclient.kThiskhazardouskdr
ugkiskmostkoftenkusedkforkwhichkobstetrickcomplication?
a. Completekhydatidiformkmole
b. Missedkabortion
c. Unrupturedkectopickpregnancy
d. Abruptiokplacenta
ekANS:kC
Methotrexatekiskankeffectiveknonsurgicalktreatmentkoptionkforkakhemodynamicallykstablekwoman
whosekectopickpregnancykiskunrupturedkandkmeasuresklesskthank4kcmkinkdiameter.kMethotrexate
kisknotkindicatedkorkrecommendedkaskaktreatmentkoptionkforkakcompletekhydatidiformkmole,kfor
kakmissedkabortion,korkforkabruptiokplacentae.
DIF:kCognitivekLevel:kApplykREF:kdm.k677kTOP:kNursingkProcess:kPlanningkM
SC:kClientkNeeds:kPhysiologickIntegrity
4. Ak26-year-oldkpregnantkwoman,kgravidak2,kparak1-0-0-
1,kisk28kweekskpregnantkwhenkshekexperienceskbrightkred,kpainlesskvaginalkbleeding.kOnkherkar
rivalkatkthekhospital,kwhichkdiagnostickprocedurekwillkthekclientkmostklikelykhavekperformed?
a. Amniocentesiskforkfetalklungkmaturity
b. Transvaginalkultrasoundkforkplacentalklocation
c. Contractionkstressktestk(CST)
d. Internalkfetalkmonitorin
gkANS:kB
Thekpresencekofkpainlessk bleedingkshouldkalwayskalertkthekhealthkcarekteamktokthekpossibilitykof
placentakprevia,kwhichkcankbekconfirmedkthroughkultrasonography.kAmniocentesiskisknotkperfo
rmedkonkakwomankwhokiskexperiencingkbleeding.kInkthekeventkofkankimminentkdelivery,kthekfet
uskiskpresumedktokhavekimmatureklungskatkthiskgestationalkage,kandkthekmotherkiskgivenkcortico
steroidsktokaidkinkfetalklungkmaturity.kAkCSTkisknotkperformedkatkakpretermkgestationalkage.kFur
thermore,kbleedingkiskakcontraindicationktokakCST.kInternalkfetalkmonitoringkiskalsokcontraindic
atedkinkthekpresencekofkbleeding.
DIF:kCognitivekLevel:kApplykREF:kdm.k680
TOP:kNursingkProcess:kAssessmentkMSC:kClientkNeeds:kHealthkPromotionkandkMaintenance
5. AklaboringkwomankwithknokknownkriskkfactorsksuddenlykexperienceskspontaneouskROM.kT
hekfluidkconsistskofkbrightkredkblood.kHerkcontractionskarekconsistentkwithkherkcurrentkstagekof
klabor.kNokchangekinkuterinekrestingktonekhaskoccurred.kThekfetalkheartkratek(FHR)kbeginsktok
declinekrapidlykafterkthekROM.kTheknursekshouldksuspectkthekpossibilitykofkwhatkcondition?
a. Placentakprevia
b. Vasakprevia
c. Severekabruptiokplacentae
