MATERNITY NEWBORN AND WOMEN’S
ll ll ll
ll HEALTH NURSING A CASE-BASED APPROACH
ll ll ll ll
2ND EDITIONO’MEARA’S TEST BANK
ll ll l ll ll
Chapter: ll1 llImmediate llPostpartum llHemorrhage
MULTIPLE llCHOICE
, 1. An llexpectant llwoman llis llbeing lldischarged llfrom llthe llhealth llcenter llafter llthe
llplacementlof lla llcervical ll cerclage ll because llof ll a llhistory ll of llrecurrent
llgestation/pregnancy llloss, llsecondary llto llan llincompetent llcervix. llWhich llinformation
llregarding llpost llprocedural llcare llshould llthe llnursing llattendantlemphasize llin llthe
ll discharge ll teaching?
a. Any llvaginal lldischarge llshould llbe llimmediately llreported llto llher llhealth llcare
llprovider. lb. The llpresence llof llany llcontractions, llrupture llof llmembranes ll(ROM), llor
llsevere llperineal llpressure ll should ll be ll reported
c. The llclient llwill llneed llto llmake llarrangements llfor llcare llat llhome, llbecause llher
llactivityllevel llwill ll be llrestricted
d. The llclient llwill llbe llscheduled llfor lla llcesarean
llbirth. lACCURATE llCHOICE:-B
Reasoning:->>>>Nursing llcare llshould llstress llthe llimportance llof llmonitoring llfor llthe
llsigns lland llsymptoms ll of llpreterm lllabor. llVaginal llbleeding ll needs llto llbe llreported ll to llher
llprimary llhealth ll care llprovider. ll Bed llrest llis llan llelement llof llcare. llHowever, llthe llwoman
llmay llstand llfor llperiods llof llup llto ll90 llminutes, llwhich llallows llher llthe llfreedom llto llsee
llher llphysician. llHome lluterine llactivity llmonitoring l l may l l be l l used ll to ll limit l l the
l l womans ll need ll for ll visits ll and l l to l l monitor ll her ll status ll safely l l at llhome. llThe llcerclage
ll can l l be ll removed ll at l l 37 ll weeks l l of l l gestation l l (to ll prepare ll for l l a ll vaginal ll birth), l l or lla
llcesarean l l birth l l can llbe ll planned.
DIF: llCognitive ll Level: llApply llREF: lldm. ll675
TOPIC llNursing llProcess: llPlanning ll| llNursing llProcess: llImplementation l l MSC: llClient llNeeds:
lHealthPromotion lland llMaintenance
2. A l l perinatal l l nursing llattendant l l is l l giving l l discharge l l instructions l l to l l a
l l woman, l l status l l postsuction,land llcurettage llsecondary llto lla llhydatidiform llmole. llThe
llwoman llasks llwhy llshe llmust lltake lloral llcontraceptives ll for ll the llnext ll 12 llmonths. llWhat
ll is ll the llbest ll response ll by ll the llnursing llattendant?
a. If llyou llget llexpectant llwithin ll1 llyear, llthe llchance llof l l a l l successful
l l gestation/pregnancy llis l l very llsmall. llTherefore, llif llgestation/pregnancy, llit
llwould ll be llbetter llfor llyou llto lluse llthe llmost llreliable llmethodlof llcontraception
ll available.
b. The llmajor llrisk llto llyou llafter lla llmolar llgestation/pregnancy llis lla lltype llof llcancer llthat
llcan ll be ll diagnosed ll only ll by llme llhormone llthat llyour ll body llproduces llduring
llgestation/pregnancy. llIf llyou llwere llto llget llexpectant, llthen llitwould l l make ll this llcancer
ll more ll difficult.
c. If llyou llcan llavoid lla llgestation/pregnancy llfor llthe llnext llyear, llthe llchance llof
lldeveloping lla llsecond llmolar llgestation/pregnancy llimprove llyour llchance llof lla
llsuccessful llgestation/pregnancy, llnot llgetting llexpectant llat llthis lltimelisbest.
d. Oral llcontraceptives llare llthe llonly llform llof llbirth llcontrol llthat llwill llprevent lla
llrecurrence llof llalmolar ll gestation/pregnancy
ACCURATE llCHOICE:-B
Reasoning:->>>>Betahuman l l chorionic l l gonadotropin l l (beta-hCG) l l hormone l l levels l l are
l l drawn l l forl1 ll year ll to ll ensure llthat llthe llmole llis llcompletely llgone. llThe llchance llof
lldeveloping llchoriocarcinomalafter llthe lldevelopment llof lla llhydatidiform llmole llis
llincreased. llTherefore, llthe llgoal llis llto llachieve ll alzero
,human llchorionic llgonadotropin ll(hCG) lllevel. llIf l l the llwoman llwere l l to llbecome
llexpectant, llthen l l it llmay ll obscure l l the l l presence l l of l l the l l potentially l l carcinogenic
l l cells. ll Women l l should l l be l l instructed l l to lluse ll birth llcontrol llfor ll1 llyear llafter lltreatment
llfor lla llhydatidiform llmole. llThe llrationale ll for llavoiding llgestation/pregnancy ll for ll 1 ll year
ll is l l to ll ensure ll that ll carcinogenic ll cells l l are ll not ll present. ll Any ll contraceptive llmethod
ll except ll an ll intrauterine ll device ll (IUD) l l is llacceptable.
DIF: llCognitive ll Level: llApply ll REF: lldm. ll679
TOPIC llNursing llProcess: llPlanning ll| llNursing llProcess: llImplementation l l MSC: llClient
ll Needs:lPhysiologic llIntegrity
3. The ll nursing llattendant l l is l l preparing l l to l l administer l l methotrexate ll to ll the
l l client. l l This l l hazardousldrug l l is llmost ll often ll used ll for ll which l l obstetric ll complication?
a. Complete llhydatidiform llmole
b. Missed l l abortion
c. Unruptured llectopic llgestation/pregnancy
d. Abruptio
llplacentaelACCURATE
llCHOICE:-C
Reasoning:->>>>Methotrexate llis llan lleffective llnonsurgical lltreatment lloption llfor lla
llhemodynamically l l stable l l woman l l whose l l ectopic l l gestation/pregnancy l l is l l unruptured
l l and l l measures l l less l l than ll4 llcm llin lldiameter. llMethotrexate llis llnot llindicated llor
llrecommended llas lla lltreatment lloption llfor lla llcomplete llhydatidiform llmole, llfor llamissed
ll abortion, ll or llfor llabruptio ll placentae.
DIF: llCognitive llLevel: llApply llREF: lldm. ll677 llTOPIC llNursing llProcess: llPlanning llMSC:
llClient llNeeds: llPhysiologic ll Integrity
4. A ll 26-year-old l l expectant ll woman, llgravida l l 2, llpara ll 1-0-0-1, llis ll 28 ll weeks
l l expectant ll whenlshe llexperiences ll bright llred, llpainless llvaginal ll bleeding. llOn llher
llarrival llat llthe llhealth llcenter, llwhich ll diagnostic ll procedure ll will ll the ll client ll most
lllikely ll have ll performed?
a. Amniocentesis l l for l l fetal l l lung l l maturity
b. Transvaginal l l ultrasound l l for l l placental l l location
c. Contraction ll stress ll test ll(CST)
d. Internal llfetal
llmonitoringlACCURATE
llCHOICE:-B
Reasoning:->>>>The llpresence llof llpainless llbleeding llshould llalways llalert llthe llhealth
llcare llteamlto llthe llpossibility llofplacenta llprevia, llwhich llcan llbe llconfirmed llthrough
ll ultrasonography.
Amniocentesis llis llnot llperformed llon lla llwoman llwho llis llexperiencing llbleeding. llIn llthe
llevent llof llanlimminent lldelivery, llthe llfetus llis llpresumed llto llhave llimmature lllungs llat llthis
llgestational llage, llandlthe llmother llis llgiven llcorticosteroids llto llaid llin llfetal lllung
llmaturity. llA llCST llis llnot llperformed llat lla llpreterm llgestational llage. llFurthermore,
llbleeding llis lla llcontraindication llto lla llCST. llInternal llfetal llmonitoring llis llalso
ll contraindicated ll in ll the ll presence llof ll bleeding.
DIF: llCognitive ll Level: llApply llREF: lldm. ll680
TOPIC llNursing llProcess: llAssessment llMSC: llClient llNeeds: llHealth llPromotion lland
llMaintenance
5. A lllaboring llwoman llwith llno llknown llrisk llfactors llsuddenly llexperiences
, llspontaneous llROM. llThe llfluid llconsists llof llbright llred llblood. llHer llcontractions llare
llconsistent llwith llher llcurrent llstage llofllabor. llNo llchange llin lluterine llresting lltone llhas
lloccurred. llThe llfetal llheart llrate ll(FHR) llbegins ll to ll decline llrapidly llafter llthe llROM. llThe
llnursing llattendant llshould llsuspect llthe llpossibility llof llwhat llcondition?
a. Placenta l l previa
ll ll ll
ll HEALTH NURSING A CASE-BASED APPROACH
ll ll ll ll
2ND EDITIONO’MEARA’S TEST BANK
ll ll l ll ll
Chapter: ll1 llImmediate llPostpartum llHemorrhage
MULTIPLE llCHOICE
, 1. An llexpectant llwoman llis llbeing lldischarged llfrom llthe llhealth llcenter llafter llthe
llplacementlof lla llcervical ll cerclage ll because llof ll a llhistory ll of llrecurrent
llgestation/pregnancy llloss, llsecondary llto llan llincompetent llcervix. llWhich llinformation
llregarding llpost llprocedural llcare llshould llthe llnursing llattendantlemphasize llin llthe
ll discharge ll teaching?
a. Any llvaginal lldischarge llshould llbe llimmediately llreported llto llher llhealth llcare
llprovider. lb. The llpresence llof llany llcontractions, llrupture llof llmembranes ll(ROM), llor
llsevere llperineal llpressure ll should ll be ll reported
c. The llclient llwill llneed llto llmake llarrangements llfor llcare llat llhome, llbecause llher
llactivityllevel llwill ll be llrestricted
d. The llclient llwill llbe llscheduled llfor lla llcesarean
llbirth. lACCURATE llCHOICE:-B
Reasoning:->>>>Nursing llcare llshould llstress llthe llimportance llof llmonitoring llfor llthe
llsigns lland llsymptoms ll of llpreterm lllabor. llVaginal llbleeding ll needs llto llbe llreported ll to llher
llprimary llhealth ll care llprovider. ll Bed llrest llis llan llelement llof llcare. llHowever, llthe llwoman
llmay llstand llfor llperiods llof llup llto ll90 llminutes, llwhich llallows llher llthe llfreedom llto llsee
llher llphysician. llHome lluterine llactivity llmonitoring l l may l l be l l used ll to ll limit l l the
l l womans ll need ll for ll visits ll and l l to l l monitor ll her ll status ll safely l l at llhome. llThe llcerclage
ll can l l be ll removed ll at l l 37 ll weeks l l of l l gestation l l (to ll prepare ll for l l a ll vaginal ll birth), l l or lla
llcesarean l l birth l l can llbe ll planned.
DIF: llCognitive ll Level: llApply llREF: lldm. ll675
TOPIC llNursing llProcess: llPlanning ll| llNursing llProcess: llImplementation l l MSC: llClient llNeeds:
lHealthPromotion lland llMaintenance
2. A l l perinatal l l nursing llattendant l l is l l giving l l discharge l l instructions l l to l l a
l l woman, l l status l l postsuction,land llcurettage llsecondary llto lla llhydatidiform llmole. llThe
llwoman llasks llwhy llshe llmust lltake lloral llcontraceptives ll for ll the llnext ll 12 llmonths. llWhat
ll is ll the llbest ll response ll by ll the llnursing llattendant?
a. If llyou llget llexpectant llwithin ll1 llyear, llthe llchance llof l l a l l successful
l l gestation/pregnancy llis l l very llsmall. llTherefore, llif llgestation/pregnancy, llit
llwould ll be llbetter llfor llyou llto lluse llthe llmost llreliable llmethodlof llcontraception
ll available.
b. The llmajor llrisk llto llyou llafter lla llmolar llgestation/pregnancy llis lla lltype llof llcancer llthat
llcan ll be ll diagnosed ll only ll by llme llhormone llthat llyour ll body llproduces llduring
llgestation/pregnancy. llIf llyou llwere llto llget llexpectant, llthen llitwould l l make ll this llcancer
ll more ll difficult.
c. If llyou llcan llavoid lla llgestation/pregnancy llfor llthe llnext llyear, llthe llchance llof
lldeveloping lla llsecond llmolar llgestation/pregnancy llimprove llyour llchance llof lla
llsuccessful llgestation/pregnancy, llnot llgetting llexpectant llat llthis lltimelisbest.
d. Oral llcontraceptives llare llthe llonly llform llof llbirth llcontrol llthat llwill llprevent lla
llrecurrence llof llalmolar ll gestation/pregnancy
ACCURATE llCHOICE:-B
Reasoning:->>>>Betahuman l l chorionic l l gonadotropin l l (beta-hCG) l l hormone l l levels l l are
l l drawn l l forl1 ll year ll to ll ensure llthat llthe llmole llis llcompletely llgone. llThe llchance llof
lldeveloping llchoriocarcinomalafter llthe lldevelopment llof lla llhydatidiform llmole llis
llincreased. llTherefore, llthe llgoal llis llto llachieve ll alzero
,human llchorionic llgonadotropin ll(hCG) lllevel. llIf l l the llwoman llwere l l to llbecome
llexpectant, llthen l l it llmay ll obscure l l the l l presence l l of l l the l l potentially l l carcinogenic
l l cells. ll Women l l should l l be l l instructed l l to lluse ll birth llcontrol llfor ll1 llyear llafter lltreatment
llfor lla llhydatidiform llmole. llThe llrationale ll for llavoiding llgestation/pregnancy ll for ll 1 ll year
ll is l l to ll ensure ll that ll carcinogenic ll cells l l are ll not ll present. ll Any ll contraceptive llmethod
ll except ll an ll intrauterine ll device ll (IUD) l l is llacceptable.
DIF: llCognitive ll Level: llApply ll REF: lldm. ll679
TOPIC llNursing llProcess: llPlanning ll| llNursing llProcess: llImplementation l l MSC: llClient
ll Needs:lPhysiologic llIntegrity
3. The ll nursing llattendant l l is l l preparing l l to l l administer l l methotrexate ll to ll the
l l client. l l This l l hazardousldrug l l is llmost ll often ll used ll for ll which l l obstetric ll complication?
a. Complete llhydatidiform llmole
b. Missed l l abortion
c. Unruptured llectopic llgestation/pregnancy
d. Abruptio
llplacentaelACCURATE
llCHOICE:-C
Reasoning:->>>>Methotrexate llis llan lleffective llnonsurgical lltreatment lloption llfor lla
llhemodynamically l l stable l l woman l l whose l l ectopic l l gestation/pregnancy l l is l l unruptured
l l and l l measures l l less l l than ll4 llcm llin lldiameter. llMethotrexate llis llnot llindicated llor
llrecommended llas lla lltreatment lloption llfor lla llcomplete llhydatidiform llmole, llfor llamissed
ll abortion, ll or llfor llabruptio ll placentae.
DIF: llCognitive llLevel: llApply llREF: lldm. ll677 llTOPIC llNursing llProcess: llPlanning llMSC:
llClient llNeeds: llPhysiologic ll Integrity
4. A ll 26-year-old l l expectant ll woman, llgravida l l 2, llpara ll 1-0-0-1, llis ll 28 ll weeks
l l expectant ll whenlshe llexperiences ll bright llred, llpainless llvaginal ll bleeding. llOn llher
llarrival llat llthe llhealth llcenter, llwhich ll diagnostic ll procedure ll will ll the ll client ll most
lllikely ll have ll performed?
a. Amniocentesis l l for l l fetal l l lung l l maturity
b. Transvaginal l l ultrasound l l for l l placental l l location
c. Contraction ll stress ll test ll(CST)
d. Internal llfetal
llmonitoringlACCURATE
llCHOICE:-B
Reasoning:->>>>The llpresence llof llpainless llbleeding llshould llalways llalert llthe llhealth
llcare llteamlto llthe llpossibility llofplacenta llprevia, llwhich llcan llbe llconfirmed llthrough
ll ultrasonography.
Amniocentesis llis llnot llperformed llon lla llwoman llwho llis llexperiencing llbleeding. llIn llthe
llevent llof llanlimminent lldelivery, llthe llfetus llis llpresumed llto llhave llimmature lllungs llat llthis
llgestational llage, llandlthe llmother llis llgiven llcorticosteroids llto llaid llin llfetal lllung
llmaturity. llA llCST llis llnot llperformed llat lla llpreterm llgestational llage. llFurthermore,
llbleeding llis lla llcontraindication llto lla llCST. llInternal llfetal llmonitoring llis llalso
ll contraindicated ll in ll the ll presence llof ll bleeding.
DIF: llCognitive ll Level: llApply llREF: lldm. ll680
TOPIC llNursing llProcess: llAssessment llMSC: llClient llNeeds: llHealth llPromotion lland
llMaintenance
5. A lllaboring llwoman llwith llno llknown llrisk llfactors llsuddenly llexperiences
, llspontaneous llROM. llThe llfluid llconsists llof llbright llred llblood. llHer llcontractions llare
llconsistent llwith llher llcurrent llstage llofllabor. llNo llchange llin lluterine llresting lltone llhas
lloccurred. llThe llfetal llheart llrate ll(FHR) llbegins ll to ll decline llrapidly llafter llthe llROM. llThe
llnursing llattendant llshould llsuspect llthe llpossibility llof llwhat llcondition?
a. Placenta l l previa
