Test Bank For
Maternity Newborn And Women’s Health Nursing A
Case-Based Approach
By Amy Mandeville O’Meara
2nd EDITION
,Chapter 1 Immediate Postpartum Hemorrhage
MULTIPLE CHOICE
1. A Pregnant Woman Is Being Discharged From The Hospital After The Placement Of A
Cervical Cerclage Because Of A History Of Recurrent Pregnancy Loss, Secondary To An
Incompetent Cervix. Which Information Regarding Post Procedural Care Should The Nurse
Emphasize In The Discharge Teaching?
A. Any Vaginal Discharge Should Be Immediately Reported To Her Health Care Provider.
B. The Presence Of Any Contractions, Rupture Of Membranes (ROM), Or Severe Perineal
Pressure Should
C. The Client Will Need To Make Arrangements For Care At Home, Because Her Activity
Level Will Be Restri
D. The Client Will Be Scheduled For A Cesarean Birth.
ANSWER: B
Nursing Care Should Stress The Importance Of Monitoring For The Signs And Symptoms Of
Preterm
Labor. Vaginal Bleeding Needs To Be Reported To Her Primary Health Care Provider. Bed Rest
Is An Element Of Care. However, The Woman May Stand For Periods Of Up To 90 Minutes,
Which Allows Her The Freedom To See Her Physician. Home Uterine Activity Monitoring May
Be Used To Limit The Womans Need For Visits And To Monitor Her Status Safely At Home.
The Cerclage Can Be Removed At 37 Weeks Of Gestation (To Prepare For A Vaginal Birth), Or
A Cesarean Birth Can Be Planned.
DIF: Cognitive Level: Apply REF: Dm. 675
TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs: Health
Promotion And Maintenance
2. A Perinatal Nurse Is Giving Discharge Instructions To A Woman, Status Post suction,
And Curettage Secondary To A Hydatidiform Mole. The Woman Asks Why She Must Take Oral
Contraceptives For The Next 12 Months. What Is The Best response By The Nurse?
If You Get Pregnant Within 1 Year, The Chance Of A Successful Pregnancy Is Very Small.
Therefore, If
A. Pregnancy, It Would Be Better For You To Use The Most Reliable Method Of
Contraception Available.
The Major Risk To You After A Molar Pregnancy Is A Type Of Cancer That Can Be Diagnosed
Only By Me
Hormone That Your Body Produces During Pregnancy. If You Were To Get Pregnant, Then It
Would Mak
B. This Cancer More Difficult.
If You Can Avoid A Pregnancy For The Next Year, The Chance Of Developing A Second Molar
Pregnancy
,C. Improve Your Chance Of A Successful Pregnancy, Not Getting Pregnant At This Time Is
Best.
D. Oral Contraceptives Are The Only Form Of Birth Control That Will Prevent A
Recurrence Of A Molar Preg
ANSWER: B
Betahuman Chorionic Gonadotropin (Beta-Hcg) Hormone Levels Are Drawn For 1 Year To
Ensure
That The Mole Is Completely Gone. The Chance Of Developing Choriocarcinoma After The
Development Of A Hydatidiform Mole Is Increased. Therefore, The Goal Is To Achieve A Zero
Human Chorionic Gonadotropin (Hcg) Level. If The Woman Were To Become Pregnant, Then
It May Obscure The Presence Of The Potentially Carcinogenic Cells. Women Should Be
Instructed To Use Birth Control For 1 Year After Treatment For A Hydatidiform Mole. The
Rationale For Avoiding Pregnancy
For 1 Year Is To Ensure That Carcinogenic Cells Are Not Present. Any Contraceptive Method
Except An Intrauterine Device (IUD) Is Acceptable.
DIF: Cognitive Level: Apply REF: Dm. 679
TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs:
Physiologic Integrity
3. The Nurse Is Preparing To Administer Methotrexate To The Client. This Hazardous Drug
Is Most Often Used For Which Obstetric Complication?
A. Complete Hydatidiform Mole
B. Missed Abortion
C. Unruptured Ectopic Pregnancy
D. Abruptio Placentae
ANSWER: C
Methotrexate Is An Effective Nonsurgical Treatment Option For A Hemodynamically Stable
Woman
Whose Ectopic Pregnancy Is Unruptured And Measures Less Than 4 Cm In Diameter.
Methotrexate Is Not Indicated Or Recommended As A Treatment Option For A Complete
Hydatidiform Mole, For A Missed Abortion, Or For Abruptio Placentae.
DIF: Cognitive Level: Apply REF: Dm. 677 TOP: Nursing Process: Planning MSC: Client
Needs: Physiologic Integrity
4. A 26-Year-Old Pregnant Woman, Gravida 2, Para 1-0-0-1, Is 28 Weeks Pregnant When
She Experiences Bright Red, Painless Vaginal Bleeding. On Her Arrival At The Hospital, Which
Diagnostic Procedure Will The Client Most Likely Have Performed?
A. Amniocentesis For Fetal Lung Maturity
B. Transvaginal Ultrasound For Placental Location
C. Contraction Stress Test (CST)
D. Internal Fetal Monitoring
ANSWER: B
, The Presence Of Painless Bleeding Should Always Alert The Health Care Team To The
Possibility Of
Placenta Previa, Which Can Be Confirmed Through Ultrasonography. Amniocentesis Is Not
Performed On A Woman Who Is Experiencing Bleeding. In The Event Of An Imminent
Delivery, The Fetus Is Presumed To Have Immature Lungs At This Gestational Age, And The
Mother Is Given Corticosteroids To Aid In Fetal Lung Maturity. A CST Is Not Performed At A
Preterm Gestational Age. Furthermore, Bleeding Is A Contraindication To A CST. Internal Fetal
Monitoring Is Also Contraindicated In The Presence Of Bleeding.
DIF: Cognitive Level: Apply REF: Dm. 680
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion And Maintenance
5. A Laboring Woman With No Known Risk Factors Suddenly Experiences Spontaneous
ROM. The Fluid Consists Of Bright Red Blood. Her Contractions Are Consistent With Her
Current Stage Of Labor. No Change In Uterine Resting Tone Has Occurred. The Fetal Heart
Rate (FHR) Begins To Decline Rapidly After The ROM. The Nurse Should Suspect The
Possibility Of What Condition?
A. Placenta Previa
B. Vasa Previa
C. Severe Abruptio Placentae
D. Disseminated Intravascular Coagulation (DIC)
ANSWER: B
Vasa Previa Is The Result Of A Velamentous Insertion Of The Umbilical Cord. The Umbilical
Vessels
Are Not Surrounded By Wharton Jelly And Have No Supportive Tissue. The Umbilical Blood
Vessels Thus Are At Risk For Laceration At Any Time, But Laceration Occurs Most Frequently
During ROM. The Sudden Appearance Of Bright Red Blood At The Time Of ROM And A
Sudden Change In The FHR Without Other Known Risk Factors Should Immediately Alert The
Nurse To The Possibility Of Vasa Previa. The Presence Of Placenta Previa Most Likely Would
Be Ascertained Before Labor And Is Considered A Risk Factor For This Pregnancy. In Addition,
If The Woman Had A Placenta Previa, It Is Unlikely That She Would Be Allowed To Pursue
Labor And A Vaginal Birth. With The Presence Of Severe Abruptio Placentae, The Uterine
Tonicity Typically Is Tetanus (I.E., A Boardlike Uterus). DIC Is A Pathologic Form Of Diffuse
Clotting That Consumes Large Amounts Of Clotting Factors, Causing Widespread External
Bleeding, Internal Bleeding, Or Both. DIC Is Always A Secondary Diagnosis, Often Associated
With Obstetric Risk Factors Such As The Hemolysis, Elevated Liver Enzyme Levels, And Low
Platelet Levels (HELLP) Syndrome. This Woman Did Not Have Any Prior Risk Factors.
DIF: Cognitive Level: Analyze REF: Dm. 684 TOP: Nursing Process: Diagnosis MSC: Client
Needs: Physiologic Integrity
6. A Woman Arrives For Evaluation Of Signs And Symptoms That Include A Missed
Period, Adnexal Fullness, Tenderness, And Dark Red Vaginal Bleeding. On Examination, The
Nurse Notices An Ecchymotic Blueness Around The Womans Umbilicus. What Does This
Finding Indicate?
A. Normal Integumentary Changes Associated With Pregnancy
Maternity Newborn And Women’s Health Nursing A
Case-Based Approach
By Amy Mandeville O’Meara
2nd EDITION
,Chapter 1 Immediate Postpartum Hemorrhage
MULTIPLE CHOICE
1. A Pregnant Woman Is Being Discharged From The Hospital After The Placement Of A
Cervical Cerclage Because Of A History Of Recurrent Pregnancy Loss, Secondary To An
Incompetent Cervix. Which Information Regarding Post Procedural Care Should The Nurse
Emphasize In The Discharge Teaching?
A. Any Vaginal Discharge Should Be Immediately Reported To Her Health Care Provider.
B. The Presence Of Any Contractions, Rupture Of Membranes (ROM), Or Severe Perineal
Pressure Should
C. The Client Will Need To Make Arrangements For Care At Home, Because Her Activity
Level Will Be Restri
D. The Client Will Be Scheduled For A Cesarean Birth.
ANSWER: B
Nursing Care Should Stress The Importance Of Monitoring For The Signs And Symptoms Of
Preterm
Labor. Vaginal Bleeding Needs To Be Reported To Her Primary Health Care Provider. Bed Rest
Is An Element Of Care. However, The Woman May Stand For Periods Of Up To 90 Minutes,
Which Allows Her The Freedom To See Her Physician. Home Uterine Activity Monitoring May
Be Used To Limit The Womans Need For Visits And To Monitor Her Status Safely At Home.
The Cerclage Can Be Removed At 37 Weeks Of Gestation (To Prepare For A Vaginal Birth), Or
A Cesarean Birth Can Be Planned.
DIF: Cognitive Level: Apply REF: Dm. 675
TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs: Health
Promotion And Maintenance
2. A Perinatal Nurse Is Giving Discharge Instructions To A Woman, Status Post suction,
And Curettage Secondary To A Hydatidiform Mole. The Woman Asks Why She Must Take Oral
Contraceptives For The Next 12 Months. What Is The Best response By The Nurse?
If You Get Pregnant Within 1 Year, The Chance Of A Successful Pregnancy Is Very Small.
Therefore, If
A. Pregnancy, It Would Be Better For You To Use The Most Reliable Method Of
Contraception Available.
The Major Risk To You After A Molar Pregnancy Is A Type Of Cancer That Can Be Diagnosed
Only By Me
Hormone That Your Body Produces During Pregnancy. If You Were To Get Pregnant, Then It
Would Mak
B. This Cancer More Difficult.
If You Can Avoid A Pregnancy For The Next Year, The Chance Of Developing A Second Molar
Pregnancy
,C. Improve Your Chance Of A Successful Pregnancy, Not Getting Pregnant At This Time Is
Best.
D. Oral Contraceptives Are The Only Form Of Birth Control That Will Prevent A
Recurrence Of A Molar Preg
ANSWER: B
Betahuman Chorionic Gonadotropin (Beta-Hcg) Hormone Levels Are Drawn For 1 Year To
Ensure
That The Mole Is Completely Gone. The Chance Of Developing Choriocarcinoma After The
Development Of A Hydatidiform Mole Is Increased. Therefore, The Goal Is To Achieve A Zero
Human Chorionic Gonadotropin (Hcg) Level. If The Woman Were To Become Pregnant, Then
It May Obscure The Presence Of The Potentially Carcinogenic Cells. Women Should Be
Instructed To Use Birth Control For 1 Year After Treatment For A Hydatidiform Mole. The
Rationale For Avoiding Pregnancy
For 1 Year Is To Ensure That Carcinogenic Cells Are Not Present. Any Contraceptive Method
Except An Intrauterine Device (IUD) Is Acceptable.
DIF: Cognitive Level: Apply REF: Dm. 679
TOP: Nursing Process: Planning | Nursing Process: Implementation MSC: Client Needs:
Physiologic Integrity
3. The Nurse Is Preparing To Administer Methotrexate To The Client. This Hazardous Drug
Is Most Often Used For Which Obstetric Complication?
A. Complete Hydatidiform Mole
B. Missed Abortion
C. Unruptured Ectopic Pregnancy
D. Abruptio Placentae
ANSWER: C
Methotrexate Is An Effective Nonsurgical Treatment Option For A Hemodynamically Stable
Woman
Whose Ectopic Pregnancy Is Unruptured And Measures Less Than 4 Cm In Diameter.
Methotrexate Is Not Indicated Or Recommended As A Treatment Option For A Complete
Hydatidiform Mole, For A Missed Abortion, Or For Abruptio Placentae.
DIF: Cognitive Level: Apply REF: Dm. 677 TOP: Nursing Process: Planning MSC: Client
Needs: Physiologic Integrity
4. A 26-Year-Old Pregnant Woman, Gravida 2, Para 1-0-0-1, Is 28 Weeks Pregnant When
She Experiences Bright Red, Painless Vaginal Bleeding. On Her Arrival At The Hospital, Which
Diagnostic Procedure Will The Client Most Likely Have Performed?
A. Amniocentesis For Fetal Lung Maturity
B. Transvaginal Ultrasound For Placental Location
C. Contraction Stress Test (CST)
D. Internal Fetal Monitoring
ANSWER: B
, The Presence Of Painless Bleeding Should Always Alert The Health Care Team To The
Possibility Of
Placenta Previa, Which Can Be Confirmed Through Ultrasonography. Amniocentesis Is Not
Performed On A Woman Who Is Experiencing Bleeding. In The Event Of An Imminent
Delivery, The Fetus Is Presumed To Have Immature Lungs At This Gestational Age, And The
Mother Is Given Corticosteroids To Aid In Fetal Lung Maturity. A CST Is Not Performed At A
Preterm Gestational Age. Furthermore, Bleeding Is A Contraindication To A CST. Internal Fetal
Monitoring Is Also Contraindicated In The Presence Of Bleeding.
DIF: Cognitive Level: Apply REF: Dm. 680
TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion And Maintenance
5. A Laboring Woman With No Known Risk Factors Suddenly Experiences Spontaneous
ROM. The Fluid Consists Of Bright Red Blood. Her Contractions Are Consistent With Her
Current Stage Of Labor. No Change In Uterine Resting Tone Has Occurred. The Fetal Heart
Rate (FHR) Begins To Decline Rapidly After The ROM. The Nurse Should Suspect The
Possibility Of What Condition?
A. Placenta Previa
B. Vasa Previa
C. Severe Abruptio Placentae
D. Disseminated Intravascular Coagulation (DIC)
ANSWER: B
Vasa Previa Is The Result Of A Velamentous Insertion Of The Umbilical Cord. The Umbilical
Vessels
Are Not Surrounded By Wharton Jelly And Have No Supportive Tissue. The Umbilical Blood
Vessels Thus Are At Risk For Laceration At Any Time, But Laceration Occurs Most Frequently
During ROM. The Sudden Appearance Of Bright Red Blood At The Time Of ROM And A
Sudden Change In The FHR Without Other Known Risk Factors Should Immediately Alert The
Nurse To The Possibility Of Vasa Previa. The Presence Of Placenta Previa Most Likely Would
Be Ascertained Before Labor And Is Considered A Risk Factor For This Pregnancy. In Addition,
If The Woman Had A Placenta Previa, It Is Unlikely That She Would Be Allowed To Pursue
Labor And A Vaginal Birth. With The Presence Of Severe Abruptio Placentae, The Uterine
Tonicity Typically Is Tetanus (I.E., A Boardlike Uterus). DIC Is A Pathologic Form Of Diffuse
Clotting That Consumes Large Amounts Of Clotting Factors, Causing Widespread External
Bleeding, Internal Bleeding, Or Both. DIC Is Always A Secondary Diagnosis, Often Associated
With Obstetric Risk Factors Such As The Hemolysis, Elevated Liver Enzyme Levels, And Low
Platelet Levels (HELLP) Syndrome. This Woman Did Not Have Any Prior Risk Factors.
DIF: Cognitive Level: Analyze REF: Dm. 684 TOP: Nursing Process: Diagnosis MSC: Client
Needs: Physiologic Integrity
6. A Woman Arrives For Evaluation Of Signs And Symptoms That Include A Missed
Period, Adnexal Fullness, Tenderness, And Dark Red Vaginal Bleeding. On Examination, The
Nurse Notices An Ecchymotic Blueness Around The Womans Umbilicus. What Does This
Finding Indicate?
A. Normal Integumentary Changes Associated With Pregnancy
