MATERNITY NEWBORN AND WOMEN’S
xx xx xx
HEALTH NURSING A CASE-BASED APPROACH
xx xx xx xx xx
2ND EDITIONO’MEARA’S TEST BANK
xx xx x x x xx
Chapter: xx1 xxImmediate xxPostpartum xxHemorrhage
MULTIPLE xxCHOICE
,1. An xxexpectant xxwoman xxis xxbeing xxdischarged xxfrom xxthe xxhealth xxcenter xxafter
xxthe xxplacementxof xxa xxcervical xx cerclage xx because xxof xxa xxhistory xxof xxrecurrent
xxgestation/pregnancy xxloss, xxsecondary xxto xxan xxincompetent xxcervix. xxWhich
xxinformation xxregarding xxpost xxprocedural xxcare xxshould xxthe xxnursing xxattendant
xemphasize xxin xxthe x x discharge x x teaching?
a. Any xxvaginal xxdischarge xxshould xxbe xximmediately xxreported xxto xxher xxhealth
xxcare xxprovider. xb. The xxpresence xxof xxany xxcontractions, xxrupture xxof xxmembranes
xx(ROM), xxor xxsevere xxperineal xxpressure xx should xx be xx reported
c. The xxclient xxwill xxneed xxto xxmake xxarrangements xxfor xxcare xxat xxhome, xxbecause
xxher xxactivityxlevel xxwill x x be xx restricted
d. The xxclient xxwill xxbe xxscheduled xxfor xxa
xxcesarean xxbirth.xACCURATE xxCHOICE:-B
Reasoning:->>>>Nursing xxcare xxshould xxstress xxthe xximportance xxof xxmonitoring xxfor
xxthe xxsigns xxand xxsymptoms xx of xx preterm xxlabor. xxVaginal xxbleeding xxneeds xxto xxbe
xxreported xx to xxher xxprimary xxhealth xx care xxprovider. xxBed xxrest xxis xxan xxelement xxof xxcare.
xxHowever, xxthe xxwoman xxmay xxstand xxfor xxperiods xx of xxup xxto xx90 xxminutes, xxwhich
xxallows xxher xxthe xx freedom xxto xxsee xxher xxphysician. xxHome xxuterine xxactivity
xxmonitoring x x may x x be x x used x x to x x limit x x the x x womans x x need x x for xx visits x x and x x to
x x monitor xx her x x status x x safely x x at xxhome. xxThe xxcerclage xx can x x be x x removed xx at x x 37 x x weeks
x x of x x gestation x x (to x x prepare xx for x x a x x vaginal x x birth), x x or xxa xxcesarean x x birth x x can xxbe
xx planned.
DIF: xxCognitive x xLevel: xxApply xxREF: xxdm. xx675
TOPIC x xNursing xxProcess: xxPlanning xx| xxNursing xxProcess: xxImplementation x x MSC: xxClient
xxNeeds: xHealthPromotion xxand xxMaintenance
2. A x x perinatal x x nursing xxattendant x x is x x giving x x discharge x x instructions x x to x x a
x x woman, x x status x x postsuction,xand xxcurettage xxsecondary xxto xxa xxhydatidiform xxmole.
xxThe xxwoman xxasks xxwhy xxshe xxmust xxtake xxoral xxcontraceptives xx for xx the xxnext x x 12
xxmonths. xxWhat xx is xx the xxbest x x response xxby xx the xxnursing xxattendant?
a. If xxyou xxget xxexpectant xxwithin xx1 xxyear, xxthe xxchance xxof x x a x x successful
x x gestation/pregnancy xxis x x very xxsmall. xxTherefore, xxif xxgestation/pregnancy, xxit
xxwould xxbe xxbetter xxfor xxyou xxto xxuse xxthe xxmost xxreliable xxmethodxof xxcontraception
xx available.
b. The xxmajor xxrisk xxto xxyou xxafter xxa xxmolar xxgestation/pregnancy xxis xxa xxtype xxof xxcancer
xxthat xxcan xx be xxdiagnosed xxonly xx by xxme xxhormone xxthat xxyour xx body xxproduces xx during
xxgestation/pregnancy. xxIf xxyou xxwere xxto xxget xxexpectant, xxthen xxitwould x x make x x this
xxcancer xx more xx difficult.
c. If xxyou xxcan xxavoid xxa xxgestation/pregnancy xxfor xxthe xxnext xxyear, xxthe xxchance xxof
xxdeveloping xx a xxsecond xxmolar xxgestation/pregnancy xximprove xxyour xxchance xxof xxa
xxsuccessful xxgestation/pregnancy, xxnot xxgetting xxexpectant xxat xxthis xxtimexisbest.
d. Oral xxcontraceptives xxare xxthe xxonly xxform xxof xxbirth xxcontrol xxthat xxwill xxprevent xxa
xxrecurrence xxof xxaxmolar xx gestation/pregnancy
ACCURATE xxCHOICE:-B
Reasoning:->>>>Betahuman x x chorionic x x gonadotropin x x (beta-hCG) x x hormone x x levels
x x are x x drawn x x forx1 xx year x x to xx ensure xxthat xxthe xxmole xxis xxcompletely xxgone. xxThe xxchance
xxof xxdeveloping xxchoriocarcinomaxafter xxthe xx development xxof xxa xxhydatidiform xxmole xxis
xxincreased. xx Therefore, xxthe xxgoal xxis xxto xxachieve xxaxzero
,human xxchorionic xxgonadotropin xx(hCG) xxlevel. xxIf x x the xxwoman xxwere x x to xxbecome
xxexpectant, xxthen x x it xxmay x x obscure x x the x x presence x x of x x the x x potentially x x carcinogenic
x x cells. x x Women x x should x x be x x instructed x x to xxuse xxbirth xxcontrol xxfor xx1 xxyear xxafter
xxtreatment xxfor xxa xxhydatidiform xxmole. xxThe xxrationale xxfor xxavoiding xxgestation/pregnancy
xx for x x 1 x x year xx is x x to x x ensure x x that x x carcinogenic x x cells x x are x x not x x present. xx Any
xx contraceptive xxmethod xx except xx an xx intrauterine xx device xx(IUD) x x is xx acceptable.
DIF: xxCognitive x xLevel: xxApply x x REF: xxdm. x x679
TOPIC xxNursing xxProcess: xxPlanning xx| xxNursing xxProcess: xxImplementation x x MSC:
xx Client xx Needs: xPhysiologic xxIntegrity
3. The xx nursing xxattendant x x is x x preparing x x to x x administer x x methotrexate x x to xx the
x x client. x x This x x hazardousxdrug x x is xxmost xx often x x used x x for xx which x x obstetric
x x complication?
a. Complete xxhydatidiform xxmole
b. Missed x x abortion
c. Unruptured xxectopic xxgestation/pregnancy
d. Abruptio
xxplacentaexACCURATE
xxCHOICE:-C
Reasoning:->>>>Methotrexate xxis xxan xxeffective xxnonsurgical xxtreatment xxoption xxfor xxa
xxhemodynamically x x stable x x woman x x whose x x ectopic x x gestation/pregnancy x x is
x x unruptured x x and x x measures x x less x x than xx4 xxcm xxin xxdiameter. xxMethotrexate xxis xxnot
xxindicated xxor xxrecommended xxas xxa xxtreatment xxoption xxfor xxa xx complete xxhydatidiform
xxmole, xxfor xxamissed xx abortion, xx or xxfor xxabruptio x x placentae.
DIF: xxCognitive xxLevel: xxApply xxREF: xxdm. xx677 xxTOPIC xxNursing xxProcess: xxPlanning
xxMSC: xxClient xxNeeds: xxPhysiologic xx Integrity
4. A x x 26-year-old x x expectant x x woman, xxgravida x x 2, x xpara xx 1-0-0-1, xxis x x 28 x x weeks
x x expectant x x whenxshe xxexperiences xx bright xxred, xxpainless xxvaginal xxbleeding. xxOn xxher
xxarrival xxat xxthe xxhealth xxcenter, xxwhich xx diagnostic xx procedure x x will x x the xx client
xx most xxlikely x x have xx performed?
a. Amniocentesis x x for x x fetal x x lung x x maturity
b. Transvaginal x x ultrasound x x for x x placental x x location
c. Contraction x xstress x xtest xx(CST)
d. Internal xxfetal
xxmonitoringxACCURATE
xxCHOICE:-B
Reasoning:->>>>The xxpresence xxof xxpainless xxbleeding xxshould xxalways xxalert xxthe
xxhealth xxcare xxteamxto xxthe xxpossibility xxofplacenta xxprevia, xxwhich xxcan xxbe xxconfirmed
xxthrough x x ultrasonography.
Amniocentesis xxis xxnot xxperformed xxon xxa xxwoman xxwho xxis xxexperiencing xxbleeding. xxIn
xxthe xxevent xxof xxanximminent xxdelivery, xxthe xxfetus xxis xxpresumed xxto xxhave xximmature
xxlungs xxat xxthis xxgestational xxage, xxandxthe xxmother xxis xxgiven xxcorticosteroids xxto xxaid xxin
xxfetal xxlung xxmaturity. xxA xxCST xxis xxnot xxperformed xxat xxa xxpreterm xxgestational xxage.
xxFurthermore, xxbleeding xxis xxa xxcontraindication xxto xxa xxCST. xxInternal xxfetal xxmonitoring
xxis xxalso x x contraindicated xx in xx the x x presence xxof xx bleeding.
DIF: xxCognitive x xLevel: xxApply xxREF: xxdm. xx680
TOPIC xxNursing xxProcess: xxAssessment xxMSC: xxClient xxNeeds: xxHealth xxPromotion xxand
xxMaintenance
, 5. A xxlaboring xxwoman xxwith xxno xxknown xxrisk xxfactors xxsuddenly xxexperiences
xxspontaneous xxROM. xx The xxfluid xxconsists xxof xxbright xxred xxblood. xx Her xxcontractions xxare
xxconsistent xxwith xxher xxcurrent xxstage xxofxlabor. xxNo xxchange xxin xxuterine xxresting xxtone
xxhas xx occurred. xx The xxfetal xxheart xxrate xx(FHR) xxbegins xxto xxdecline xxrapidly xxafter xxthe
xxROM. xxThe xxnursing xxattendant xxshould xxsuspect xxthe xxpossibility xxof xxwhat xxcondition?
a. Placenta x x previa
xx xx xx
HEALTH NURSING A CASE-BASED APPROACH
xx xx xx xx xx
2ND EDITIONO’MEARA’S TEST BANK
xx xx x x x xx
Chapter: xx1 xxImmediate xxPostpartum xxHemorrhage
MULTIPLE xxCHOICE
,1. An xxexpectant xxwoman xxis xxbeing xxdischarged xxfrom xxthe xxhealth xxcenter xxafter
xxthe xxplacementxof xxa xxcervical xx cerclage xx because xxof xxa xxhistory xxof xxrecurrent
xxgestation/pregnancy xxloss, xxsecondary xxto xxan xxincompetent xxcervix. xxWhich
xxinformation xxregarding xxpost xxprocedural xxcare xxshould xxthe xxnursing xxattendant
xemphasize xxin xxthe x x discharge x x teaching?
a. Any xxvaginal xxdischarge xxshould xxbe xximmediately xxreported xxto xxher xxhealth
xxcare xxprovider. xb. The xxpresence xxof xxany xxcontractions, xxrupture xxof xxmembranes
xx(ROM), xxor xxsevere xxperineal xxpressure xx should xx be xx reported
c. The xxclient xxwill xxneed xxto xxmake xxarrangements xxfor xxcare xxat xxhome, xxbecause
xxher xxactivityxlevel xxwill x x be xx restricted
d. The xxclient xxwill xxbe xxscheduled xxfor xxa
xxcesarean xxbirth.xACCURATE xxCHOICE:-B
Reasoning:->>>>Nursing xxcare xxshould xxstress xxthe xximportance xxof xxmonitoring xxfor
xxthe xxsigns xxand xxsymptoms xx of xx preterm xxlabor. xxVaginal xxbleeding xxneeds xxto xxbe
xxreported xx to xxher xxprimary xxhealth xx care xxprovider. xxBed xxrest xxis xxan xxelement xxof xxcare.
xxHowever, xxthe xxwoman xxmay xxstand xxfor xxperiods xx of xxup xxto xx90 xxminutes, xxwhich
xxallows xxher xxthe xx freedom xxto xxsee xxher xxphysician. xxHome xxuterine xxactivity
xxmonitoring x x may x x be x x used x x to x x limit x x the x x womans x x need x x for xx visits x x and x x to
x x monitor xx her x x status x x safely x x at xxhome. xxThe xxcerclage xx can x x be x x removed xx at x x 37 x x weeks
x x of x x gestation x x (to x x prepare xx for x x a x x vaginal x x birth), x x or xxa xxcesarean x x birth x x can xxbe
xx planned.
DIF: xxCognitive x xLevel: xxApply xxREF: xxdm. xx675
TOPIC x xNursing xxProcess: xxPlanning xx| xxNursing xxProcess: xxImplementation x x MSC: xxClient
xxNeeds: xHealthPromotion xxand xxMaintenance
2. A x x perinatal x x nursing xxattendant x x is x x giving x x discharge x x instructions x x to x x a
x x woman, x x status x x postsuction,xand xxcurettage xxsecondary xxto xxa xxhydatidiform xxmole.
xxThe xxwoman xxasks xxwhy xxshe xxmust xxtake xxoral xxcontraceptives xx for xx the xxnext x x 12
xxmonths. xxWhat xx is xx the xxbest x x response xxby xx the xxnursing xxattendant?
a. If xxyou xxget xxexpectant xxwithin xx1 xxyear, xxthe xxchance xxof x x a x x successful
x x gestation/pregnancy xxis x x very xxsmall. xxTherefore, xxif xxgestation/pregnancy, xxit
xxwould xxbe xxbetter xxfor xxyou xxto xxuse xxthe xxmost xxreliable xxmethodxof xxcontraception
xx available.
b. The xxmajor xxrisk xxto xxyou xxafter xxa xxmolar xxgestation/pregnancy xxis xxa xxtype xxof xxcancer
xxthat xxcan xx be xxdiagnosed xxonly xx by xxme xxhormone xxthat xxyour xx body xxproduces xx during
xxgestation/pregnancy. xxIf xxyou xxwere xxto xxget xxexpectant, xxthen xxitwould x x make x x this
xxcancer xx more xx difficult.
c. If xxyou xxcan xxavoid xxa xxgestation/pregnancy xxfor xxthe xxnext xxyear, xxthe xxchance xxof
xxdeveloping xx a xxsecond xxmolar xxgestation/pregnancy xximprove xxyour xxchance xxof xxa
xxsuccessful xxgestation/pregnancy, xxnot xxgetting xxexpectant xxat xxthis xxtimexisbest.
d. Oral xxcontraceptives xxare xxthe xxonly xxform xxof xxbirth xxcontrol xxthat xxwill xxprevent xxa
xxrecurrence xxof xxaxmolar xx gestation/pregnancy
ACCURATE xxCHOICE:-B
Reasoning:->>>>Betahuman x x chorionic x x gonadotropin x x (beta-hCG) x x hormone x x levels
x x are x x drawn x x forx1 xx year x x to xx ensure xxthat xxthe xxmole xxis xxcompletely xxgone. xxThe xxchance
xxof xxdeveloping xxchoriocarcinomaxafter xxthe xx development xxof xxa xxhydatidiform xxmole xxis
xxincreased. xx Therefore, xxthe xxgoal xxis xxto xxachieve xxaxzero
,human xxchorionic xxgonadotropin xx(hCG) xxlevel. xxIf x x the xxwoman xxwere x x to xxbecome
xxexpectant, xxthen x x it xxmay x x obscure x x the x x presence x x of x x the x x potentially x x carcinogenic
x x cells. x x Women x x should x x be x x instructed x x to xxuse xxbirth xxcontrol xxfor xx1 xxyear xxafter
xxtreatment xxfor xxa xxhydatidiform xxmole. xxThe xxrationale xxfor xxavoiding xxgestation/pregnancy
xx for x x 1 x x year xx is x x to x x ensure x x that x x carcinogenic x x cells x x are x x not x x present. xx Any
xx contraceptive xxmethod xx except xx an xx intrauterine xx device xx(IUD) x x is xx acceptable.
DIF: xxCognitive x xLevel: xxApply x x REF: xxdm. x x679
TOPIC xxNursing xxProcess: xxPlanning xx| xxNursing xxProcess: xxImplementation x x MSC:
xx Client xx Needs: xPhysiologic xxIntegrity
3. The xx nursing xxattendant x x is x x preparing x x to x x administer x x methotrexate x x to xx the
x x client. x x This x x hazardousxdrug x x is xxmost xx often x x used x x for xx which x x obstetric
x x complication?
a. Complete xxhydatidiform xxmole
b. Missed x x abortion
c. Unruptured xxectopic xxgestation/pregnancy
d. Abruptio
xxplacentaexACCURATE
xxCHOICE:-C
Reasoning:->>>>Methotrexate xxis xxan xxeffective xxnonsurgical xxtreatment xxoption xxfor xxa
xxhemodynamically x x stable x x woman x x whose x x ectopic x x gestation/pregnancy x x is
x x unruptured x x and x x measures x x less x x than xx4 xxcm xxin xxdiameter. xxMethotrexate xxis xxnot
xxindicated xxor xxrecommended xxas xxa xxtreatment xxoption xxfor xxa xx complete xxhydatidiform
xxmole, xxfor xxamissed xx abortion, xx or xxfor xxabruptio x x placentae.
DIF: xxCognitive xxLevel: xxApply xxREF: xxdm. xx677 xxTOPIC xxNursing xxProcess: xxPlanning
xxMSC: xxClient xxNeeds: xxPhysiologic xx Integrity
4. A x x 26-year-old x x expectant x x woman, xxgravida x x 2, x xpara xx 1-0-0-1, xxis x x 28 x x weeks
x x expectant x x whenxshe xxexperiences xx bright xxred, xxpainless xxvaginal xxbleeding. xxOn xxher
xxarrival xxat xxthe xxhealth xxcenter, xxwhich xx diagnostic xx procedure x x will x x the xx client
xx most xxlikely x x have xx performed?
a. Amniocentesis x x for x x fetal x x lung x x maturity
b. Transvaginal x x ultrasound x x for x x placental x x location
c. Contraction x xstress x xtest xx(CST)
d. Internal xxfetal
xxmonitoringxACCURATE
xxCHOICE:-B
Reasoning:->>>>The xxpresence xxof xxpainless xxbleeding xxshould xxalways xxalert xxthe
xxhealth xxcare xxteamxto xxthe xxpossibility xxofplacenta xxprevia, xxwhich xxcan xxbe xxconfirmed
xxthrough x x ultrasonography.
Amniocentesis xxis xxnot xxperformed xxon xxa xxwoman xxwho xxis xxexperiencing xxbleeding. xxIn
xxthe xxevent xxof xxanximminent xxdelivery, xxthe xxfetus xxis xxpresumed xxto xxhave xximmature
xxlungs xxat xxthis xxgestational xxage, xxandxthe xxmother xxis xxgiven xxcorticosteroids xxto xxaid xxin
xxfetal xxlung xxmaturity. xxA xxCST xxis xxnot xxperformed xxat xxa xxpreterm xxgestational xxage.
xxFurthermore, xxbleeding xxis xxa xxcontraindication xxto xxa xxCST. xxInternal xxfetal xxmonitoring
xxis xxalso x x contraindicated xx in xx the x x presence xxof xx bleeding.
DIF: xxCognitive x xLevel: xxApply xxREF: xxdm. xx680
TOPIC xxNursing xxProcess: xxAssessment xxMSC: xxClient xxNeeds: xxHealth xxPromotion xxand
xxMaintenance
, 5. A xxlaboring xxwoman xxwith xxno xxknown xxrisk xxfactors xxsuddenly xxexperiences
xxspontaneous xxROM. xx The xxfluid xxconsists xxof xxbright xxred xxblood. xx Her xxcontractions xxare
xxconsistent xxwith xxher xxcurrent xxstage xxofxlabor. xxNo xxchange xxin xxuterine xxresting xxtone
xxhas xx occurred. xx The xxfetal xxheart xxrate xx(FHR) xxbegins xxto xxdecline xxrapidly xxafter xxthe
xxROM. xxThe xxnursing xxattendant xxshould xxsuspect xxthe xxpossibility xxof xxwhat xxcondition?
a. Placenta x x previa
