TestBanksAdept
, Maternity $jpNewborn $jpand $jpWomen’s $jpHealth $jpNursing $jpA $jpCase-Based $jpApproach $jp1st
$jpEdition $jpO’Meara $jpTest $jpBank
Chapter $jp1 $jpImmediate $jpPostpartum
$jpHemorrhage $jpMULTIPLE $jpCHOICE
1. A $jppregnant $jpwoman $jpis $jpbeing $jpdischarged $jpfrom $jpthe $jphospital $jpafter $jpthe $jpplacement $jpof $jpa $jpcervical
cerclage $jpbecause $jpof $jpa $jphistory $jpof $jprecurrent $jppregnancy $jploss, $jpsecondary $jpto $jpan
$jpincompetent $jpcervix. $jpWhich $jpinformation $jpregarding $jppostprocedural $jpcare $jpshould $jpthe
$jpnurse $jpemphasize $jpin $jpthe $jpdischarge $jpteaching?
a. Any $jpvaginal $jpdischarge $jpshould $jpbe $jpimmediately $jpreported $jpto $jpher $jphealth $jpcare $jpprovider.
b. The $jppresence $jpof $jpany $jpcontractions, $jprupture $jpof $jpmembranes $jp(ROM), $jpor $jpsevere $jpperineal
$jppressure $jpshould
c. The $jpclient $jpwill $jpneed $jpto $jpmake $jparrangements $jpfor $jpcare $jpat $jphome, $jpbecause $jpher $jpactivity $jplev
$jpwill $jpbe $jprestri
d. The $jpclient $jpwill $jpbe $jpscheduled $jpfor $jpa $jpcesarean
$jpbirth. $jpANS: $jpB
Nursing $jpcare $jpshould $jpstress $jpthe $jpimportance $jpof $jpmonitoring $jpfor $jpthe $jpsigns $jpand $jpsymptoms $jpof $jppreterm
labor. $jpVaginal $jpbleeding $jpneeds $jpto $jpbe $jpreported $jpto $jpher $jpprimary $jphealth $jpcare $jpprovider.
$jpBed $jprest $jpis $jpan $jpelement $jpof $jpcare. $jpHowever, $jpthe $jpwoman $jpmay $jpstand $jpfor $jpperiods $jpof $jpup
$jpto $jp90 $jpminutes, $jpwhich $jpallows $jpher $jpthe $jpfreedom $jpto $jpsee $jpher $jpphysician. $jpHome $jputerine
$jpactivity $jpmonitoring $jpmay $jpbe $jpused $jpto $jplimit $jpthe $jpwomans $jpneed $jpfor $jpvisits $jpand $jpto $jpmonitor
$jpher $jpstatus $jpsafely $jpat $jphome. $jpThe $jpcerclage $jpcan $jpbe $jpremoved $jpat $jp37 $jpweeks $jpof $jpgestation $jp(to
$jpprepare $jpfor $jpa $jpvaginal $jpbirth), $jpor $jpa $jpcesarean $jpbirth $jpcan $jpbe $jpplanned.
DIF: $jpCognitive $jpLevel: $jpApply $jpREF: $jpdm. $jp675
TOP: $jpNursing $jpProcess: $jpPlanning $jp| $jpNursing $jpProcess:
$jpImplementation $jpMSC: $jpClient $jpNeeds: $jpHealth $jpPromotion $jpand
$jpMaintenance
2. A $jpperinatal $jpnurse $jpis $jpgiving $jpdischarge $jpinstructions $jpto $jpa $jpwoman, $jpstatus $jppostsuction, $jpand
$jpcurettage $jpsecondary $jpto $jpa $jphydatidiform $jpmole. $jpThe $jpwoman $jpasks $jpwhy $jpshe $jpmust $jptake
$jporal $jpcontraceptives $jpfor $jpthe $jpnext $jp12 $jpmonths. $jpWhat $jpis $jpthe $jpbestresponse $jpby $jpthe $jpnurse?
If $jpyou $jpget $jppregnant $jpwithin $jp1 $jpyear, $jpthe $jpchance $jpof $jpa $jpsuccessful $jppregnancy $jpis $jpvery $jpsma
$jpTherefore, $jpif
a. pregnancy, $jpit $jpwould $jpbe $jpbetter $jpfor $jpyou $jpto $jpuse $jpthe $jpmost $jpreliable $jpmethod $jpof $jpcontraceptio
$jpavailable.
The $jpmajor $jprisk $jpto $jpyou $jpafter $jpa $jpmolar $jppregnancy $jpis $jpa $jptype $jpof $jpcancer $jpthat $jpcan $jpbe
$jpdiagnosed $jponly $jpby $jpme $jphormone $jpthat $jpyour $jpbody $jpproduces $jpduring $jppregnancy. $jpIf $jpyou
$jpwere $jpto $jpget $jppregnant, $jpthen $jpit $jpwould $jpmak
b. this $jpcancer $jpmore $jpdifficult.
If $jpyou $jpcan $jpavoid $jpa $jppregnancy $jpfor $jpthe $jpnext $jpyear, $jpthe $jpchance $jpof $jpdeveloping $jpa $jpsecond
$jpmolar $jppregnancy
c. improve $jpyour $jpchance $jpof $jpa $jpsuccessful $jppregnancy, $jpnot $jpgetting $jppregnant $jpat $jpthis $jptime $jpis
$jpbest.
d. Oral $jpcontraceptives $jpare $jpthe $jponly $jpform $jpof $jpbirth $jpcontrol $jpthat $jpwill $jpprevent $jpa $jprecurrence $jpo
$jpa $jpmolar $jppreg $jpANS: $jpB
TestBanksAdept
,Betahuman $jpchorionic $jpgonadotropin $jp(beta-hCG) $jphormone $jplevels $jpare $jpdrawn $jpfor $jp1 $jpyear $jpto $jpensure
that $jpthe $jpmole $jpis $jpcompletely $jpgone. $jpThe $jpchance $jpof $jpdeveloping $jpchoriocarcinoma $jpafter
$jpthe $jpdevelopment $jpof $jpa $jphydatidiform $jpmole $jpis $jpincreased. $jpTherefore, $jpthe $jpgoal $jpis $jpto
$jpachieve $jpa $jpzero $jphuman $jpchorionic $jpgonadotropin $jp(hCG) $jplevel. $jpIf $jpthe $jpwoman $jpwere $jpto
$jpbecome $jppregnant, $jpthen $jpit $jpmay $jpobscure $jpthe $jppresence $jpof $jpthe $jppotentially $jpcarcinogenic
$jpcells. $jpWomen $jpshould $jpbe $jpinstructed $jpto $jpuse $jpbirth $jpcontrol $jpfor $jp1 $jpyear $jpafter $jptreatment
$jpfor $jpa $jphydatidiform $jpmole. $jpThe $jprationale $jpfor $jpavoiding $jppregnancy
TestBanksAdept
, 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
ANS: 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
ANS: 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
TestBanksAdept
, Maternity $jpNewborn $jpand $jpWomen’s $jpHealth $jpNursing $jpA $jpCase-Based $jpApproach $jp1st
$jpEdition $jpO’Meara $jpTest $jpBank
Chapter $jp1 $jpImmediate $jpPostpartum
$jpHemorrhage $jpMULTIPLE $jpCHOICE
1. A $jppregnant $jpwoman $jpis $jpbeing $jpdischarged $jpfrom $jpthe $jphospital $jpafter $jpthe $jpplacement $jpof $jpa $jpcervical
cerclage $jpbecause $jpof $jpa $jphistory $jpof $jprecurrent $jppregnancy $jploss, $jpsecondary $jpto $jpan
$jpincompetent $jpcervix. $jpWhich $jpinformation $jpregarding $jppostprocedural $jpcare $jpshould $jpthe
$jpnurse $jpemphasize $jpin $jpthe $jpdischarge $jpteaching?
a. Any $jpvaginal $jpdischarge $jpshould $jpbe $jpimmediately $jpreported $jpto $jpher $jphealth $jpcare $jpprovider.
b. The $jppresence $jpof $jpany $jpcontractions, $jprupture $jpof $jpmembranes $jp(ROM), $jpor $jpsevere $jpperineal
$jppressure $jpshould
c. The $jpclient $jpwill $jpneed $jpto $jpmake $jparrangements $jpfor $jpcare $jpat $jphome, $jpbecause $jpher $jpactivity $jplev
$jpwill $jpbe $jprestri
d. The $jpclient $jpwill $jpbe $jpscheduled $jpfor $jpa $jpcesarean
$jpbirth. $jpANS: $jpB
Nursing $jpcare $jpshould $jpstress $jpthe $jpimportance $jpof $jpmonitoring $jpfor $jpthe $jpsigns $jpand $jpsymptoms $jpof $jppreterm
labor. $jpVaginal $jpbleeding $jpneeds $jpto $jpbe $jpreported $jpto $jpher $jpprimary $jphealth $jpcare $jpprovider.
$jpBed $jprest $jpis $jpan $jpelement $jpof $jpcare. $jpHowever, $jpthe $jpwoman $jpmay $jpstand $jpfor $jpperiods $jpof $jpup
$jpto $jp90 $jpminutes, $jpwhich $jpallows $jpher $jpthe $jpfreedom $jpto $jpsee $jpher $jpphysician. $jpHome $jputerine
$jpactivity $jpmonitoring $jpmay $jpbe $jpused $jpto $jplimit $jpthe $jpwomans $jpneed $jpfor $jpvisits $jpand $jpto $jpmonitor
$jpher $jpstatus $jpsafely $jpat $jphome. $jpThe $jpcerclage $jpcan $jpbe $jpremoved $jpat $jp37 $jpweeks $jpof $jpgestation $jp(to
$jpprepare $jpfor $jpa $jpvaginal $jpbirth), $jpor $jpa $jpcesarean $jpbirth $jpcan $jpbe $jpplanned.
DIF: $jpCognitive $jpLevel: $jpApply $jpREF: $jpdm. $jp675
TOP: $jpNursing $jpProcess: $jpPlanning $jp| $jpNursing $jpProcess:
$jpImplementation $jpMSC: $jpClient $jpNeeds: $jpHealth $jpPromotion $jpand
$jpMaintenance
2. A $jpperinatal $jpnurse $jpis $jpgiving $jpdischarge $jpinstructions $jpto $jpa $jpwoman, $jpstatus $jppostsuction, $jpand
$jpcurettage $jpsecondary $jpto $jpa $jphydatidiform $jpmole. $jpThe $jpwoman $jpasks $jpwhy $jpshe $jpmust $jptake
$jporal $jpcontraceptives $jpfor $jpthe $jpnext $jp12 $jpmonths. $jpWhat $jpis $jpthe $jpbestresponse $jpby $jpthe $jpnurse?
If $jpyou $jpget $jppregnant $jpwithin $jp1 $jpyear, $jpthe $jpchance $jpof $jpa $jpsuccessful $jppregnancy $jpis $jpvery $jpsma
$jpTherefore, $jpif
a. pregnancy, $jpit $jpwould $jpbe $jpbetter $jpfor $jpyou $jpto $jpuse $jpthe $jpmost $jpreliable $jpmethod $jpof $jpcontraceptio
$jpavailable.
The $jpmajor $jprisk $jpto $jpyou $jpafter $jpa $jpmolar $jppregnancy $jpis $jpa $jptype $jpof $jpcancer $jpthat $jpcan $jpbe
$jpdiagnosed $jponly $jpby $jpme $jphormone $jpthat $jpyour $jpbody $jpproduces $jpduring $jppregnancy. $jpIf $jpyou
$jpwere $jpto $jpget $jppregnant, $jpthen $jpit $jpwould $jpmak
b. this $jpcancer $jpmore $jpdifficult.
If $jpyou $jpcan $jpavoid $jpa $jppregnancy $jpfor $jpthe $jpnext $jpyear, $jpthe $jpchance $jpof $jpdeveloping $jpa $jpsecond
$jpmolar $jppregnancy
c. improve $jpyour $jpchance $jpof $jpa $jpsuccessful $jppregnancy, $jpnot $jpgetting $jppregnant $jpat $jpthis $jptime $jpis
$jpbest.
d. Oral $jpcontraceptives $jpare $jpthe $jponly $jpform $jpof $jpbirth $jpcontrol $jpthat $jpwill $jpprevent $jpa $jprecurrence $jpo
$jpa $jpmolar $jppreg $jpANS: $jpB
TestBanksAdept
,Betahuman $jpchorionic $jpgonadotropin $jp(beta-hCG) $jphormone $jplevels $jpare $jpdrawn $jpfor $jp1 $jpyear $jpto $jpensure
that $jpthe $jpmole $jpis $jpcompletely $jpgone. $jpThe $jpchance $jpof $jpdeveloping $jpchoriocarcinoma $jpafter
$jpthe $jpdevelopment $jpof $jpa $jphydatidiform $jpmole $jpis $jpincreased. $jpTherefore, $jpthe $jpgoal $jpis $jpto
$jpachieve $jpa $jpzero $jphuman $jpchorionic $jpgonadotropin $jp(hCG) $jplevel. $jpIf $jpthe $jpwoman $jpwere $jpto
$jpbecome $jppregnant, $jpthen $jpit $jpmay $jpobscure $jpthe $jppresence $jpof $jpthe $jppotentially $jpcarcinogenic
$jpcells. $jpWomen $jpshould $jpbe $jpinstructed $jpto $jpuse $jpbirth $jpcontrol $jpfor $jp1 $jpyear $jpafter $jptreatment
$jpfor $jpa $jphydatidiform $jpmole. $jpThe $jprationale $jpfor $jpavoiding $jppregnancy
TestBanksAdept
, 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
ANS: 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
ANS: 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
TestBanksAdept
