NUR 335 EXAM 2 QUESTIONS AND
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT RATED A+
||UPDATED 2026
What is the pathophysiological definition of placenta previa, and how does its
anatomical placement differ from a normal pregnancy?
✔✔ Placenta previa is an obstetrical complication where the placenta
implants abnormally in the lower uterine segment, completely or partially
covering the internal cervical os (the opening of the cervix).
Question 2
When performing a clinical assessment on a patient in her second or third
trimester, which classic presentation and objective findings would strongly support
a diagnosis of placenta previa?
✔✔ Expected assessment findings include:
Bleeding: Sudden onset of painless, bright red vaginal bleeding during the
second or third trimester.
Uterine Tone: A characteristically soft, relaxed, and non-tender uterus
upon palpation (unlike the rigid, painful abdomen seen in placental
abruption).
Anatomy: An increased or higher-than-expected fundal height, as the low-
lying placenta can prevent the fetal presenting part from deeply engaging in
the pelvis.
Diagnostics: Early or incidental identification via a routine screening
ultrasound.
Perfusion Status: A potential decrease in maternal urine output, signaling
early systemic hypovolemia if significant, hidden, or visible bleeding occurs.
Question 3
,From a patient-safety standpoint, what is the single most critical and life-
threatening maternal-fetal risk associated with placenta previa that the healthcare
team must prevent?
✔✔ Severe, catastrophic maternal hemorrhaging.
Critical Clinical Rule: Because the lower uterine segment stretches and thins as
labor approaches or begins, the placental vessels overlying the cervix can tear
easily. To prevent fatal hemorrhage, digital vaginal examinations are strictly
contraindicated for any patient presenting with third-trimester vaginal bleeding
until placenta previa has been definitively ruled out by ultrasound.
Question 4
When developing a nursing care plan for a hospitalized prenatal patient diagnosed
with stable placenta previa, what are the three priority clinical parameters the nurse
must continuously assess and document?
✔✔ The nurse must closely monitor:
1. Uterine Activity: Assessing for the onset of any uterine contractions, which
can cause cervical effacement, dilation, and subsequent bleeding.
2. Vaginal Bleeding: Quantifying the amount, color, and frequency of blood
loss (e.g., checking and weighing perineal pads).
3. Fundal Height: Measuring and tracking fundal height to detect an occult
(hidden) intrauterine accumulation of blood.
Question 5
During an intake assessment, the nurse reviews the patient's obstetrical
background. Which maternal demographic characteristics, medical histories, and
lifestyle choices are recognized as independent risk factors for the development of
placenta previa?
✔✔ Key risk factors include:
Surgical History: A history of a prior Cesarean delivery, uterine curettage,
or any past surgical procedures that left endometrial scarring.
Substance Use: Maternal tobacco smoking or cocaine use during
pregnancy, which alters placental perfusion and architecture.
, Gestational Variables: Multiple gestation pregnancies (carrying twins,
triplets, etc.) or a history of high multiparity (giving birth multiple times).
Reproductive History: Conception achieved through advanced infertility
treatments (such as IVF).
Maternal Age: Advanced maternal age (typically classified as patients older
than 35 years).
Placenta previa treatments? -ANSWER......-bed rest
-nothing in vagina
-Leopold maneuver
-Have O2 ready
-C-section for severe bleeds
-Delivery between 36 & 37 weeks
-Blood products and IV fluids
-NO massaging or activity
What are reasons for a C-section? -ANSWER......-platepoid pelvis
-too many contractions
-herpes
-chorioamnitis
-fetus isn't perfusing well.
What is an ectopic pregnancy? -ANSWER......When an egg implants outside the
uterus.
What are the risks of an ectopic pregnancy? -ANSWER......Rupture, can lead to
hypovolemic shock.
ANSWERS WITH COMPLETE
SOLUTIONS 100% CORRECT RATED A+
||UPDATED 2026
What is the pathophysiological definition of placenta previa, and how does its
anatomical placement differ from a normal pregnancy?
✔✔ Placenta previa is an obstetrical complication where the placenta
implants abnormally in the lower uterine segment, completely or partially
covering the internal cervical os (the opening of the cervix).
Question 2
When performing a clinical assessment on a patient in her second or third
trimester, which classic presentation and objective findings would strongly support
a diagnosis of placenta previa?
✔✔ Expected assessment findings include:
Bleeding: Sudden onset of painless, bright red vaginal bleeding during the
second or third trimester.
Uterine Tone: A characteristically soft, relaxed, and non-tender uterus
upon palpation (unlike the rigid, painful abdomen seen in placental
abruption).
Anatomy: An increased or higher-than-expected fundal height, as the low-
lying placenta can prevent the fetal presenting part from deeply engaging in
the pelvis.
Diagnostics: Early or incidental identification via a routine screening
ultrasound.
Perfusion Status: A potential decrease in maternal urine output, signaling
early systemic hypovolemia if significant, hidden, or visible bleeding occurs.
Question 3
,From a patient-safety standpoint, what is the single most critical and life-
threatening maternal-fetal risk associated with placenta previa that the healthcare
team must prevent?
✔✔ Severe, catastrophic maternal hemorrhaging.
Critical Clinical Rule: Because the lower uterine segment stretches and thins as
labor approaches or begins, the placental vessels overlying the cervix can tear
easily. To prevent fatal hemorrhage, digital vaginal examinations are strictly
contraindicated for any patient presenting with third-trimester vaginal bleeding
until placenta previa has been definitively ruled out by ultrasound.
Question 4
When developing a nursing care plan for a hospitalized prenatal patient diagnosed
with stable placenta previa, what are the three priority clinical parameters the nurse
must continuously assess and document?
✔✔ The nurse must closely monitor:
1. Uterine Activity: Assessing for the onset of any uterine contractions, which
can cause cervical effacement, dilation, and subsequent bleeding.
2. Vaginal Bleeding: Quantifying the amount, color, and frequency of blood
loss (e.g., checking and weighing perineal pads).
3. Fundal Height: Measuring and tracking fundal height to detect an occult
(hidden) intrauterine accumulation of blood.
Question 5
During an intake assessment, the nurse reviews the patient's obstetrical
background. Which maternal demographic characteristics, medical histories, and
lifestyle choices are recognized as independent risk factors for the development of
placenta previa?
✔✔ Key risk factors include:
Surgical History: A history of a prior Cesarean delivery, uterine curettage,
or any past surgical procedures that left endometrial scarring.
Substance Use: Maternal tobacco smoking or cocaine use during
pregnancy, which alters placental perfusion and architecture.
, Gestational Variables: Multiple gestation pregnancies (carrying twins,
triplets, etc.) or a history of high multiparity (giving birth multiple times).
Reproductive History: Conception achieved through advanced infertility
treatments (such as IVF).
Maternal Age: Advanced maternal age (typically classified as patients older
than 35 years).
Placenta previa treatments? -ANSWER......-bed rest
-nothing in vagina
-Leopold maneuver
-Have O2 ready
-C-section for severe bleeds
-Delivery between 36 & 37 weeks
-Blood products and IV fluids
-NO massaging or activity
What are reasons for a C-section? -ANSWER......-platepoid pelvis
-too many contractions
-herpes
-chorioamnitis
-fetus isn't perfusing well.
What is an ectopic pregnancy? -ANSWER......When an egg implants outside the
uterus.
What are the risks of an ectopic pregnancy? -ANSWER......Rupture, can lead to
hypovolemic shock.
