Case-Based Approach 2nd Edition
O’Meara Test Bank
, Maternity Newborn and Women’s Health Nursing A Case-Based Approach 2nd Edition
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O’Meara Test Bank kr kr
Chapter 1 Immediate Postpartum Hemorrhage
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MULTIPLE CHOICE kr
1. A pregnant woman is being discharged from the hospital after the placement of a cervical
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cerclage because of a history of recurrent pregnancy loss, secondary to an incompetent
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cervix.Which information regarding postprocedural care should the nurse emphasize in the
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dischargeteaching?
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a. Any vaginal discharge should be immediately reported to her health care provider. kr kr kr kr kr kr kr kr kr kr kr
b. The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure
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should
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c. The client will need to make arrangements for care at home, because her activity level will be
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restri
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d. The client will be scheduled for a cesarean kr kr kr kr kr kr kr
birth.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 an
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element of care. However, the woman may stand for periods of up to 90 minutes, which allows
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her the freedom to see her physician. Home uterine activity monitoring may be used to limit
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the womans need for visits and to monitor her status safely at home. The cerclage can be
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removed at37 weeks of gestation (to prepare for a vaginal birth), or a cesarean birth can be
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planned.
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DIF: Cognitive Level: Apply REF: dm. 675
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TOP: Nursing Process: Planning | Nursing Process:
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ImplementationMSC: Client Needs: Health Promotion and
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Maintenance
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2. A perinatal nurse is giving discharge instructions to a woman, status postsuction, and
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curettagesecondary to a hydatidiform mole. The woman asks why she must take oral
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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. kr kr kr kr kr kr kr kr kr kr kr kr kr kr kr
The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by
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me
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hormone that your body produces during pregnancy. If you were to get pregnant, then it would
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mak
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b. this cancer more difficult. kr kr kr
If you can avoid a pregnancy for the next year, the chance of developing a second molar
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pregnancy
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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
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pregANS: 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
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development of a hydatidiform mole is increased. Therefore, the goal is to achieve a zero
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human chorionic gonadotropin (hCG) level. If the woman were to become pregnant, then it may
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, obscurethe presence of the potentially carcinogenic cells. Women should be instructed to use
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birth control for 1 year after treatment for a hydatidiform mole. The rationale for avoiding
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pregnancy
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, for 1 year is to ensure that carcinogenic cells are not present. Any contraceptive method
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exceptan intrauterine device (IUD) is acceptable.
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DIF: Cognitive Level: Apply REF: dm. 679
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TOP: Nursing Process: Planning | Nursing Process:
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ImplementationMSC: 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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drugis most often used for which obstetric complication?
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a. Complete hydatidiform mole kr kr
b. Missed abortion kr
c. Unruptured ectopic pregnancy kr kr
d. Abruptio
placentaeANS: 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
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isnot indicated or recommended as a treatment option for a complete hydatidiform mole, for a
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missed abortion, or for abruptio placentae.
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DIF: Cognitive Level: Apply REF: dm. 677 TOP: Nursing Process:
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PlanningMSC: Client Needs: Physiologic Integrity
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4. A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she
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experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which
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diagnosticprocedure will the client most likely have performed?
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a. Amniocentesis for fetal lung maturity kr kr kr kr
b. Transvaginal ultrasound for placental location kr kr kr kr
c. Contraction stress test (CST) kr kr kr
d. Internal fetal kr
monitoringANS: B
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The presence of painless bleeding should always alert the health care team to the possibility of
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placenta previa, which can be confirmed through ultrasonography. Amniocentesis is not
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performed on a woman who is experiencing bleeding. In the event of an imminent delivery, the
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fetus is presumed to have immature lungs at this gestational age, and the mother is given
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corticosteroids to aid in fetal lung maturity. A CST is not performed at a preterm gestational
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age.Furthermore, bleeding is a contraindication to a CST. Internal fetal monitoring is also
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contraindicated in the presence of bleeding.
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DIF: Cognitive Level: Apply REF: dm. 680
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TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
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5. A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The
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fluid consists of bright red blood. Her contractions are consistent with her current stage of
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labor.No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins to
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decline rapidly after the ROM. The nurse should suspect the possibility of what condition?
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a. Placenta previa kr
b. Vasa previa kr
c. Severe abruptio placentae kr kr