TEST BANK
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, Maternity Newborn and Women’s Health Nursing A Case-Based Approach 1st Edition
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O’Meara Test Bank df df df
Chapter 1 Immediate Postpartum Hemorrhage df df df df
MULTIPLE CHOICE df
1. A pregnant woman is being discharged from the hospital after the placement of a
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cervical cerclage because of a history of recurrent pregnancy loss, secondary to an
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incompetent cervix. Which information regarding postprocedural care should the nurse
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emphasize in the discharge teaching?
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a. Any vaginal discharge should be immediately reported to her health care provider. df df df df df df df df df df df
b. The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure
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sho
df
c. The client will need to make arrangements for care at home, because her activity level will be
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re
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d. The client will be scheduled for a cesarean birth. df df df df df df df df
ANS: B
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Nursing care should stress the importance of monitoring for the signs and symptoms of preterm
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labor. Vaginal bleeding needs to be reported to her primary health care provider. Bed rest is
df df df df df df df df df df df df df df df
an element of care. However, the woman may stand for periods of up to 90 minutes, which
df df df df df df df df df df df df df df df df df
allows her the freedom to see her physician. Home uterine activity monitoring may be used
df df df df df df df df df df df df df df df
to limit the womans need for visits and to monitor her status safely at home. The cerclage
df df df df df df df df df df df df df df df df df
can be removed at 37 weeks of gestation (to prepare for a vaginal birth), or a cesarean birth
df df df df df df df df df df df df df df df df df df
can be planned.
df df df
DIF: Cognitive Level: Apply REF: dm. 675
df df df df df df
TOP: Nursing Process: Planning | Nursing Process: Implementation
df df df df df df df
MSC: Client Needs: Health Promotion and Maintenance
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2. A perinatal nurse is giving discharge instructions to a woman, status postsuction, and
df df df df df df df df df df df df
curettage secondary to a hydatidiform mole. The woman asks why she must take oral
df df df df df df df df df df df df df df
contraceptives for the next 12 months. What is the bestresponse by the nurse?
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If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore,
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a. pregnancy, it would be better for you to use the most reliable method of contraception available. df df df df df df df df df df df df df df df
The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only
df df df df df df df df df df df df df df df df df df
by hormone that your body produces during pregnancy. If you were to get pregnant, then it
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would
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b. this cancer more difficult.
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If you can avoid a pregnancy for the next year, the chance of developing a second molar
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pregna
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c. improve your chance of a successful pregnancy, not getting pregnant at this time is best.
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d. Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar df df df df df df df df df df df df df df df df
p ANS: B
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Betahuman chorionic gonadotropin (beta-hCG) hormone levels are drawn for 1 year to ensure
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that the mole is completely gone. The chance of developing choriocarcinoma after the
df df df df df df df df df df df df
development of a hydatidiform mole is increased. Therefore, the goal is to achieve a zero
df df df df df df df df df df df df df df df
human chorionic gonadotropin (hCG) level. If the woman were to become pregnant, then it
df df df df df df df df df df df df df df
may obscure the presence of the potentially carcinogenic cells. Women should be instructed
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Med C df
,df to use birth control for 1 year after treatment for a hydatidiform mole. The rationale for
df df df df df df df df df df df df df df df
df avoiding pregnancy
df
Med C df
, for 1 year is to ensure that carcinogenic cells are not present. Any contraceptive method
df df df df df df df df df df df df df df
except an intrauterine device (IUD) is acceptable.
df df df df df df df
DIF: Cognitive Level: Apply REF: dm. 679
df df df df df df
TOP: Nursing Process: Planning | Nursing Process: Implementation
df df df df df df df
MSC: Client Needs: Physiologic Integrity
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3. The nurse is preparing to administer methotrexate to the client. This hazardous
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drug is most often used for which obstetric complication?
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a. Complete hydatidiform mole df df
b. Missed abortion df
c. Unruptured ectopic pregnancy df df
d. Abruptio placentae df
ANS: C
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Methotrexate is an effective nonsurgical treatment option for a hemodynamically stable woman
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whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter. Methotrexate
df df df df df df df df df df df df df
is not indicated or recommended as a treatment option for a complete hydatidiform mole,
df df df df df df df df df df df df df df
for a missed abortion, or for abruptio placentae.
df df df df df df df df
DIF: Cognitive Level: Apply REF: dm. 677 TOP: Nursing Process: Planning
df df df df df df df df df df
MSC: Client Needs: Physiologic Integrity
df df df df df
4. A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she
df df df df df df df df df df df df df
experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which
df df df df df df df df df df df df df
diagnostic procedure will the client most likely have performed?
df df df df df df df df df
a. Amniocentesis for fetal lung maturity df df df df
b. Transvaginal ultrasound for placental location df df df df
c. Contraction stress test (CST) df df df
d. Internal fetal monitoring df df
ANS: B
df df
The presence of painless bleeding should always alert the health care team to the possibility of
df df df df df df df df df df df df df df df
placenta previa, which can be confirmed through ultrasonography. Amniocentesis is not
df df df df df df df df df df
performed on a woman who is experiencing bleeding. In the event of an imminent delivery,
df df df df df df df df df df df df df df df
the fetus is presumed to have immature lungs at this gestational age, and the mother is
df df df df df df df df df df df df df df df df
given corticosteroids to aid in fetal lung maturity. A CST is not performed at a preterm
df df df df df df df df df df df df df df df df
gestational age. Furthermore, bleeding is a contraindication to a CST. Internal fetal
df df df df df df df df df df df df
monitoring is also contraindicated in the presence of bleeding.
df df df df df df df df df
DIF: Cognitive Level: Apply REF: dm. 680
df df df df df df
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
df df df df df df df df df df
5. A laboring woman with no known risk factors suddenly experiences spontaneous ROM.
df df df df df df df df df df df
The fluid consists of bright red blood. Her contractions are consistent with her current stage
df df df df df df df df df df df df df df df
of labor. No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins
df df df df df df df df df df df df df df df df
to decline rapidly after the ROM. The nurse should suspect the possibility of what
df df df df df df df df df df df df df df
condition?
df
a. Placenta previa df
b. Vasa previa df
c. Severe abruptio placentae df df
Med C df
df
, Maternity Newborn and Women’s Health Nursing A Case-Based Approach 1st Edition
df df df df df df df df df df
O’Meara Test Bank df df df
Chapter 1 Immediate Postpartum Hemorrhage df df df df
MULTIPLE CHOICE df
1. A pregnant woman is being discharged from the hospital after the placement of a
df df df df df df df df df df df df df
cervical cerclage because of a history of recurrent pregnancy loss, secondary to an
df df df df df df df df df df df df df
incompetent cervix. Which information regarding postprocedural care should the nurse
df df df df df df df df df df
emphasize in the discharge teaching?
df df df df df
a. Any vaginal discharge should be immediately reported to her health care provider. df df df df df df df df df df df
b. The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure
df df df df df df df df df df df df
sho
df
c. The client will need to make arrangements for care at home, because her activity level will be
df df df df df df df df df df df df df df df df
re
df
d. The client will be scheduled for a cesarean birth. df df df df df df df df
ANS: B
df df
Nursing care should stress the importance of monitoring for the signs and symptoms of preterm
df df df df df df df df df df df df df df
labor. Vaginal bleeding needs to be reported to her primary health care provider. Bed rest is
df df df df df df df df df df df df df df df
an element of care. However, the woman may stand for periods of up to 90 minutes, which
df df df df df df df df df df df df df df df df df
allows her the freedom to see her physician. Home uterine activity monitoring may be used
df df df df df df df df df df df df df df df
to limit the womans need for visits and to monitor her status safely at home. The cerclage
df df df df df df df df df df df df df df df df df
can be removed at 37 weeks of gestation (to prepare for a vaginal birth), or a cesarean birth
df df df df df df df df df df df df df df df df df df
can be planned.
df df df
DIF: Cognitive Level: Apply REF: dm. 675
df df df df df df
TOP: Nursing Process: Planning | Nursing Process: Implementation
df df df df df df df
MSC: Client Needs: Health Promotion and Maintenance
df df df df df df df
2. A perinatal nurse is giving discharge instructions to a woman, status postsuction, and
df df df df df df df df df df df df
curettage secondary to a hydatidiform mole. The woman asks why she must take oral
df df df df df df df df df df df df df df
contraceptives for the next 12 months. What is the bestresponse by the nurse?
df df df df df df df df df df df df df
If you get pregnant within 1 year, the chance of a successful pregnancy is very small. Therefore,
df df df df df df df df df df df df df df df df
a. pregnancy, it would be better for you to use the most reliable method of contraception available. df df df df df df df df df df df df df df df
The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only
df df df df df df df df df df df df df df df df df df
by hormone that your body produces during pregnancy. If you were to get pregnant, then it
df df df df df df df df df df df df df df df df
would
df
b. this cancer more difficult.
df df df
If you can avoid a pregnancy for the next year, the chance of developing a second molar
df df df df df df df df df df df df df df df df
pregna
df
c. improve your chance of a successful pregnancy, not getting pregnant at this time is best.
df df df df df df df df df df df df df df
d. Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar df df df df df df df df df df df df df df df df
p ANS: B
df df df
Betahuman chorionic gonadotropin (beta-hCG) hormone levels are drawn for 1 year to ensure
df df df df df df df df df df df df
that the mole is completely gone. The chance of developing choriocarcinoma after the
df df df df df df df df df df df df
development of a hydatidiform mole is increased. Therefore, the goal is to achieve a zero
df df df df df df df df df df df df df df df
human chorionic gonadotropin (hCG) level. If the woman were to become pregnant, then it
df df df df df df df df df df df df df df
may obscure the presence of the potentially carcinogenic cells. Women should be instructed
df df df df df df df df df df df df df
Med C df
,df to use birth control for 1 year after treatment for a hydatidiform mole. The rationale for
df df df df df df df df df df df df df df df
df avoiding pregnancy
df
Med C df
, for 1 year is to ensure that carcinogenic cells are not present. Any contraceptive method
df df df df df df df df df df df df df df
except an intrauterine device (IUD) is acceptable.
df df df df df df df
DIF: Cognitive Level: Apply REF: dm. 679
df df df df df df
TOP: Nursing Process: Planning | Nursing Process: Implementation
df df df df df df df
MSC: Client Needs: Physiologic Integrity
df df df df df
3. The nurse is preparing to administer methotrexate to the client. This hazardous
df df df df df df df df df df df
drug is most often used for which obstetric complication?
df df df df df df df df df
a. Complete hydatidiform mole df df
b. Missed abortion df
c. Unruptured ectopic pregnancy df df
d. Abruptio placentae df
ANS: C
df df
Methotrexate is an effective nonsurgical treatment option for a hemodynamically stable woman
df df df df df df df df df df df
whose ectopic pregnancy is unruptured and measures less than 4 cm in diameter. Methotrexate
df df df df df df df df df df df df df
is not indicated or recommended as a treatment option for a complete hydatidiform mole,
df df df df df df df df df df df df df df
for a missed abortion, or for abruptio placentae.
df df df df df df df df
DIF: Cognitive Level: Apply REF: dm. 677 TOP: Nursing Process: Planning
df df df df df df df df df df
MSC: Client Needs: Physiologic Integrity
df df df df df
4. A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she
df df df df df df df df df df df df df
experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which
df df df df df df df df df df df df df
diagnostic procedure will the client most likely have performed?
df df df df df df df df df
a. Amniocentesis for fetal lung maturity df df df df
b. Transvaginal ultrasound for placental location df df df df
c. Contraction stress test (CST) df df df
d. Internal fetal monitoring df df
ANS: B
df df
The presence of painless bleeding should always alert the health care team to the possibility of
df df df df df df df df df df df df df df df
placenta previa, which can be confirmed through ultrasonography. Amniocentesis is not
df df df df df df df df df df
performed on a woman who is experiencing bleeding. In the event of an imminent delivery,
df df df df df df df df df df df df df df df
the fetus is presumed to have immature lungs at this gestational age, and the mother is
df df df df df df df df df df df df df df df df
given corticosteroids to aid in fetal lung maturity. A CST is not performed at a preterm
df df df df df df df df df df df df df df df df
gestational age. Furthermore, bleeding is a contraindication to a CST. Internal fetal
df df df df df df df df df df df df
monitoring is also contraindicated in the presence of bleeding.
df df df df df df df df df
DIF: Cognitive Level: Apply REF: dm. 680
df df df df df df
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
df df df df df df df df df df
5. A laboring woman with no known risk factors suddenly experiences spontaneous ROM.
df df df df df df df df df df df
The fluid consists of bright red blood. Her contractions are consistent with her current stage
df df df df df df df df df df df df df df df
of labor. No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins
df df df df df df df df df df df df df df df df
to decline rapidly after the ROM. The nurse should suspect the possibility of what
df df df df df df df df df df df df df df
condition?
df
a. Placenta previa df
b. Vasa previa df
c. Severe abruptio placentae df df
Med C df
