Maternity, Newborn, and Women’s Health Nursing: A Case-Based Approach – 2nd Edition by O’Meara (Complete Test Bank)

, MaternityNewborn and Women’s Health Nursing A Case-Based Approach 1st Edition Il̀ Il` Il` Il` Il` Il` Il` Il` Il` Il`




O’Meara Test Bank Il` Il` Il`




Chapter 1 Immediate Postpartum Hemorrhage Il` Il` Il` Il`




MULTIPLE CHOICE I l`




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. Il` Il` Il` Il` Il` Il ` Il` Il` Il` til til




b. The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure
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c. The client will need to make arrangements for care at home, because her activitylevel will be
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restriIl`




d. The client will be scheduled for a cesarean Il` Il` Il` Il` Il` Il` Il`




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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I the womans need for visits and to monitor her status safely at home. The cerclage can be
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removed at 37 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 Il` Il` til Il` Il`




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, i Il` til Il` Il ` Il` Il` Il ` Il` Il ` Il` Il` Il` Il` Il` Il` Il ` Il `




a. pregnancy, it would be better for you to use the most reliable method of contraception available. Il` Il` Il` Il` Il` Il` Il` Il ` Il` Il` Il` Il` Il` Il` Il`




The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by me
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hormone that your body produces during pregnancy. If you were to get pregnant, then it would mak Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




b. this cancer more difficult. Il` Il` Il`




If you can avoid a pregnancy for the next year, the chance of developing a second molar pregnancy
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c. improve your chance of a successful pregnancy, not getting pregnant at this time is best. Il` Il` Il ` Il` Il` Il` Il ` Il` Il` Il` Il ` Il` Il` Il`




d. Oral contraceptives are the only form of birth control that will prevent a recurrence of a molar Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il`




preg ANS: B
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Betahuman chorionic gonadotropin (beta-hCG) hormone levels are drawn for 1 year to ensureIl` Il` Il` Il` Il` Il ` Il` Il` Il` Il ` Il` Il`




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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,obscure the presence of the potentially carcinogenic cells. Women should be instructed to use birth
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control for 1 year after treatment for a hydatidiform mole. The rationale for avoiding pregnancy
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, for 1 year is to ensure that carcinogenic cells are not present. Any contraceptive method except an
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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 Il` Il` Il` Il`




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 Il` Il`




b. Missed abortion Il`




c. Unruptured ectopic pregnancy Il` Il`




d. Abruptio
placentae ANS: C
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Methotrexate is an effective nonsurgical treatment option for a hemodynamically stable woman Il` Il` Il` Il` Il` Il` Il` Il` Il` Il` Il `




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 Il` Il` Il` Il`




b. Transvaginal ultrasound for placental location Il` Il ` til Il `




c. Contraction stress test (CST) Il` Il` Il`




d. Internalfetal Il̀




monitoring ANS: 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 Il`




b. Vasa previa Il`




c. Severe abruptio placentae Il` Il`