MATERNITY NEWBORN AND WOMEN’S HEALTH
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NURSING A CASE-BASED APPROACH 2ND
vv vv vv vv vv
EDITIONO’MEARA’S TEST BANK
vv v v v vv
Chapter: 1 Immediate Postpartum Hemorrhage
vv vv vv vv
MULTIPLE CHOICE vv
,1. An expectant woman is being discharged from the health center after the
vv vv vv vv vv vv vv vv vv vv vv
placementof a cervical cerclage because of a history of recurrent
vv v vv vv vv vv vv vv vv vv vv
gestation/pregnancy loss, secondary to an incompetent cervix. Which information
vv vv vv vv vv vv vv vv vv
regarding post procedural care should the nursing attendantemphasize in the
vv vv vv vv vv vv vv vv v vv vv
discharge teaching?
vv vv
a. Any vaginal discharge should be immediately reported to her health care
vv vv vv vv vv vv vv vv vv vv
provider.b. The presence of any contractions, rupture of membranes (ROM), or severe
vv v vv vv vv vv vv vv vv vv vv vv
perineal pressure should be reported
vv vv vv vv vv
c. The client will need to make arrangements for care at home, because her
vv vv vv vv vv vv vv vv vv vv vv vv
activitylevel will be restricted
vv v vv vv vv
d. The client will be scheduled for a cesareanvv vv vv vv vv vv vv
birth.ACCURATE CHOICE:-B
vv v vv
Reasoning:->>>>Nursing care should stress the importance of monitoring for the signs vv vv vv vv vv vv vv vv vv vv
and symptoms of preterm labor. Vaginal bleeding needs to be reported to her primary
vv vv vv vv vv vv vv vv vv vv vv vv vv vv
health care provider. Bed rest is an element of care. However, the woman may stand
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
for periods of up to 90 minutes, which allows her the freedom to see her physician.
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
Home uterine activity monitoring may be used to limit the womans need for visits
vv vv vv vv vv vv v v vv vv vv vv vv vv vv
and to monitor her status safely at home. The cerclage can be removed at 37 weeks
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
of gestation (to prepare for a vaginal birth), or a cesarean birth can be planned.
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
DIF: Cognitive Level: Apply REF: dm. 675
vv vv vv vv vv vv
TOPIC Nursing Process: Planning | Nursing Process: Implementation MSC: Client
vv vv vv vv vv vv vv vv vv
Needs:HealthPromotion and Maintenance
vv v vv vv
2. A perinatal nursing attendant is giving discharge instructions to a woman,
vv vv vv vv vv vv vv vv vv vv
vvstatus postsuction,and curettage secondary to a hydatidiform mole. The woman asks
vv v vv vv vv vv vv vv vv vv vv
why she must take oral contraceptives for the next 12 months. What is the best
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
response by the nursing attendant?
vv vv vv vv vv
a. If you get expectant within 1 year, the chance of a successful
vv vv vv vv vv vv vv vv vv v v v v
v vgestation/pregnancy is very small. Therefore, if gestation/pregnancy, it would vv v v vv vv vv vv vv vv
be better for you to use the most reliable methodof contraception available.
vv vv vv vv vv vv vv vv vv vv v vv vv
b. The major risk to you after a molar gestation/pregnancy is a type of cancer that can
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
be diagnosed only by me hormone that your body produces during
vv vv vv vv vv vv vv vv vv vv vv
gestation/pregnancy. If you were to get expectant, then itwould make this cancer
vv vv vv vv vv vv vv vv vv vv vv vv
more difficult.
vv vv
c. If you can avoid a gestation/pregnancy for the next year, the chance of developing
vv vv vv vv vv vv vv vv vv vv vv vv vv
a second molar gestation/pregnancy improve your chance of a successful
vv vv vv vv vv vv vv vv vv vv
gestation/pregnancy, not getting expectant at this timeisbest.
vv vv vv vv vv vv vv v
d. Oral contraceptives are the only form of birth control that will prevent a
vv vv vv vv vv vv vv vv vv vv vv vv
recurrence of amolar gestation/pregnancy
vv vv vv v vv
ACCURATE CHOICE:-B vv
Reasoning:->>>>Betahuman chorionic gonadotropin (beta-hCG) hormone levels are v v vv vv vv vv vv
vvdrawn for1 year to ensure that the mole is completely gone. The chance of developing
vv v vv vv vv vv vv vv vv vv vv vv vv vv vv
choriocarcinomaafter the development of a hydatidiform mole is increased. Therefore,
vv v vv vv vv vv vv vv vv vv vv
the goal is to achieve azero
vv vv vv vv vv vv v
,human chorionic gonadotropin (hCG) level. If the woman were to become expectant,
vv vv vv vv vv v v vv vv v v vv vv
then it may obscure the presence of the potentially carcinogenic cells. Women
vv v v vv vv vv vv vv vv vv vv vv vv
should be instructed to use birth control for 1 year after treatment for a hydatidiform
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
mole. The rationale for avoiding gestation/pregnancy for 1 year is to ensure that
vv vv vv vv vv vv vv vv vv vv vv vv vv
carcinogenic cells are not present. Any contraceptive method except an intrauterine
vv vv vv vv vv vv vv vv vv vv vv
device (IUD) is acceptable.
vv vv vv vv
DIF: Cognitive Level: Apply REF: dm. 679
vv vv vv vv vv vv
TOPIC Nursing Process: Planning | Nursing Process: Implementation MSC: Client
vv vv vv vv vv vv vv vv vv
Needs:Physiologic Integrity
vv v vv
3. The nursing attendant is preparing to administer methotrexate to the client.
vv vv vv vv vv vv vv vv vv vv
This hazardousdrug is most often used for which obstetric complication?
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a. Complete hydatidiform mole vv vv
b. Missed abortion vv
c. Unruptured ectopic gestation/pregnancy vv vv
d. Abruptio
placentaeACCURATE
vv v
CHOICE:-C
vv
Reasoning:->>>>Methotrexate is an effective nonsurgical treatment option for a vv vv vv vv vv vv vv vv
hemodynamically stable woman whose ectopic gestation/pregnancy is unruptured and
vv vv vv v v vv vv vv vv vv
vvmeasures less than 4 cm in diameter. Methotrexate is not indicated or recommended as a
vv vv vv vv vv vv vv vv vv vv vv vv vv vv
treatment option for a complete hydatidiform mole, for amissed abortion, or for
vv vv vv vv vv vv vv vv vv vv vv vv
abruptio placentae.
vv vv
DIF: Cognitive Level: Apply REF: dm. 677 TOPIC Nursing Process: Planning MSC: Client
vv vv vv vv vv vv vv vv vv vv vv vv
Needs: Physiologic Integrity
vv vv vv
4. A 26-year-old expectant woman, gravida 2, para 1-0-0-1, is 28 weeks
vv vv vv vv vv vv vv vv vv vv
expectant whenshe experiences bright red, painless vaginal bleeding. On her arrival
vv vv v vv vv vv vv vv vv vv vv vv
at the health center, which diagnostic procedure will the client most likely have
vv vv vv vv vv vv vv vv vv vv vv vv vv
performed?
vv
a. Amniocentesis for fetal lung maturity vv vv vv vv
b. Transvaginal ultrasound for placental location vv vv vv vv
c. Contraction stress test (CST) vv vv vv
d. Internal fetal vv
monitoringACCURATE
vv v
CHOICE:-B
vv
Reasoning:->>>>The presence of painless bleeding should always alert the health care vv vv vv vv vv vv vv vv vv vv
teamto the possibility ofplacenta previa, which can be confirmed through
vv v vv vv vv vv vv vv vv vv vv
ultrasonography.
vv
Amniocentesis is not performed on a woman who is experiencing bleeding. In the event
vv vv vv vv vv vv vv vv vv vv vv vv vv
of animminent delivery, the fetus is presumed to have immature lungs at this
vv vv v vv vv vv vv vv vv vv vv vv vv vv
gestational age, andthe mother is given corticosteroids to aid in fetal lung maturity. A
vv vv vv v vv vv vv vv vv vv vv vv vv vv vv
CST is not performed at a preterm gestational age. Furthermore, bleeding is a
vv vv vv vv vv vv vv vv vv vv vv vv vv
contraindication to a CST. Internal fetal monitoring is also contraindicated in the
vv vv vv vv vv vv vv vv vv vv vv vv
presence of bleeding.
vv vv vv
DIF: Cognitive Level: Apply REF: dm. 680
vv vv vv vv vv vv
TOPIC Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
vv vv vv vv vv vv vv vv vv vv
5. A laboring woman with no known risk factors suddenly experiences spontaneous
vv vv vv vv vv vv vv vv vv vv
ROM. The fluid consists of bright red blood. Her contractions are consistent with her
vv vv vv vv vv vv vv vv vv vv vv vv vv vv
current stage oflabor. No change in uterine resting tone has occurred. The fetal heart
vv vv vv v vv vv vv vv vv vv vv vv vv vv vv
rate (FHR) begins to decline rapidly after the ROM. The nursing attendant should
vv vv vv vv vv vv vv vv vv vv vv vv vv
suspect the possibility of what condition?
vv vv vv vv vv vv
, a. Placenta previa
vv
vv vv vv vv
NURSING A CASE-BASED APPROACH 2ND
vv vv vv vv vv
EDITIONO’MEARA’S TEST BANK
vv v v v vv
Chapter: 1 Immediate Postpartum Hemorrhage
vv vv vv vv
MULTIPLE CHOICE vv
,1. An expectant woman is being discharged from the health center after the
vv vv vv vv vv vv vv vv vv vv vv
placementof a cervical cerclage because of a history of recurrent
vv v vv vv vv vv vv vv vv vv vv
gestation/pregnancy loss, secondary to an incompetent cervix. Which information
vv vv vv vv vv vv vv vv vv
regarding post procedural care should the nursing attendantemphasize in the
vv vv vv vv vv vv vv vv v vv vv
discharge teaching?
vv vv
a. Any vaginal discharge should be immediately reported to her health care
vv vv vv vv vv vv vv vv vv vv
provider.b. The presence of any contractions, rupture of membranes (ROM), or severe
vv v vv vv vv vv vv vv vv vv vv vv
perineal pressure should be reported
vv vv vv vv vv
c. The client will need to make arrangements for care at home, because her
vv vv vv vv vv vv vv vv vv vv vv vv
activitylevel will be restricted
vv v vv vv vv
d. The client will be scheduled for a cesareanvv vv vv vv vv vv vv
birth.ACCURATE CHOICE:-B
vv v vv
Reasoning:->>>>Nursing care should stress the importance of monitoring for the signs vv vv vv vv vv vv vv vv vv vv
and symptoms of preterm labor. Vaginal bleeding needs to be reported to her primary
vv vv vv vv vv vv vv vv vv vv vv vv vv vv
health care provider. Bed rest is an element of care. However, the woman may stand
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
for periods of up to 90 minutes, which allows her the freedom to see her physician.
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
Home uterine activity monitoring may be used to limit the womans need for visits
vv vv vv vv vv vv v v vv vv vv vv vv vv vv
and to monitor her status safely at home. The cerclage can be removed at 37 weeks
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
of gestation (to prepare for a vaginal birth), or a cesarean birth can be planned.
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
DIF: Cognitive Level: Apply REF: dm. 675
vv vv vv vv vv vv
TOPIC Nursing Process: Planning | Nursing Process: Implementation MSC: Client
vv vv vv vv vv vv vv vv vv
Needs:HealthPromotion and Maintenance
vv v vv vv
2. A perinatal nursing attendant is giving discharge instructions to a woman,
vv vv vv vv vv vv vv vv vv vv
vvstatus postsuction,and curettage secondary to a hydatidiform mole. The woman asks
vv v vv vv vv vv vv vv vv vv vv
why she must take oral contraceptives for the next 12 months. What is the best
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
response by the nursing attendant?
vv vv vv vv vv
a. If you get expectant within 1 year, the chance of a successful
vv vv vv vv vv vv vv vv vv v v v v
v vgestation/pregnancy is very small. Therefore, if gestation/pregnancy, it would vv v v vv vv vv vv vv vv
be better for you to use the most reliable methodof contraception available.
vv vv vv vv vv vv vv vv vv vv v vv vv
b. The major risk to you after a molar gestation/pregnancy is a type of cancer that can
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
be diagnosed only by me hormone that your body produces during
vv vv vv vv vv vv vv vv vv vv vv
gestation/pregnancy. If you were to get expectant, then itwould make this cancer
vv vv vv vv vv vv vv vv vv vv vv vv
more difficult.
vv vv
c. If you can avoid a gestation/pregnancy for the next year, the chance of developing
vv vv vv vv vv vv vv vv vv vv vv vv vv
a second molar gestation/pregnancy improve your chance of a successful
vv vv vv vv vv vv vv vv vv vv
gestation/pregnancy, not getting expectant at this timeisbest.
vv vv vv vv vv vv vv v
d. Oral contraceptives are the only form of birth control that will prevent a
vv vv vv vv vv vv vv vv vv vv vv vv
recurrence of amolar gestation/pregnancy
vv vv vv v vv
ACCURATE CHOICE:-B vv
Reasoning:->>>>Betahuman chorionic gonadotropin (beta-hCG) hormone levels are v v vv vv vv vv vv
vvdrawn for1 year to ensure that the mole is completely gone. The chance of developing
vv v vv vv vv vv vv vv vv vv vv vv vv vv vv
choriocarcinomaafter the development of a hydatidiform mole is increased. Therefore,
vv v vv vv vv vv vv vv vv vv vv
the goal is to achieve azero
vv vv vv vv vv vv v
,human chorionic gonadotropin (hCG) level. If the woman were to become expectant,
vv vv vv vv vv v v vv vv v v vv vv
then it may obscure the presence of the potentially carcinogenic cells. Women
vv v v vv vv vv vv vv vv vv vv vv vv
should be instructed to use birth control for 1 year after treatment for a hydatidiform
vv vv vv vv vv vv vv vv vv vv vv vv vv vv vv
mole. The rationale for avoiding gestation/pregnancy for 1 year is to ensure that
vv vv vv vv vv vv vv vv vv vv vv vv vv
carcinogenic cells are not present. Any contraceptive method except an intrauterine
vv vv vv vv vv vv vv vv vv vv vv
device (IUD) is acceptable.
vv vv vv vv
DIF: Cognitive Level: Apply REF: dm. 679
vv vv vv vv vv vv
TOPIC Nursing Process: Planning | Nursing Process: Implementation MSC: Client
vv vv vv vv vv vv vv vv vv
Needs:Physiologic Integrity
vv v vv
3. The nursing attendant is preparing to administer methotrexate to the client.
vv vv vv vv vv vv vv vv vv vv
This hazardousdrug is most often used for which obstetric complication?
vv vv v vv vv vv vv vv vv vv vv
a. Complete hydatidiform mole vv vv
b. Missed abortion vv
c. Unruptured ectopic gestation/pregnancy vv vv
d. Abruptio
placentaeACCURATE
vv v
CHOICE:-C
vv
Reasoning:->>>>Methotrexate is an effective nonsurgical treatment option for a vv vv vv vv vv vv vv vv
hemodynamically stable woman whose ectopic gestation/pregnancy is unruptured and
vv vv vv v v vv vv vv vv vv
vvmeasures less than 4 cm in diameter. Methotrexate is not indicated or recommended as a
vv vv vv vv vv vv vv vv vv vv vv vv vv vv
treatment option for a complete hydatidiform mole, for amissed abortion, or for
vv vv vv vv vv vv vv vv vv vv vv vv
abruptio placentae.
vv vv
DIF: Cognitive Level: Apply REF: dm. 677 TOPIC Nursing Process: Planning MSC: Client
vv vv vv vv vv vv vv vv vv vv vv vv
Needs: Physiologic Integrity
vv vv vv
4. A 26-year-old expectant woman, gravida 2, para 1-0-0-1, is 28 weeks
vv vv vv vv vv vv vv vv vv vv
expectant whenshe experiences bright red, painless vaginal bleeding. On her arrival
vv vv v vv vv vv vv vv vv vv vv vv
at the health center, which diagnostic procedure will the client most likely have
vv vv vv vv vv vv vv vv vv vv vv vv vv
performed?
vv
a. Amniocentesis for fetal lung maturity vv vv vv vv
b. Transvaginal ultrasound for placental location vv vv vv vv
c. Contraction stress test (CST) vv vv vv
d. Internal fetal vv
monitoringACCURATE
vv v
CHOICE:-B
vv
Reasoning:->>>>The presence of painless bleeding should always alert the health care vv vv vv vv vv vv vv vv vv vv
teamto the possibility ofplacenta previa, which can be confirmed through
vv v vv vv vv vv vv vv vv vv vv
ultrasonography.
vv
Amniocentesis is not performed on a woman who is experiencing bleeding. In the event
vv vv vv vv vv vv vv vv vv vv vv vv vv
of animminent delivery, the fetus is presumed to have immature lungs at this
vv vv v vv vv vv vv vv vv vv vv vv vv vv
gestational age, andthe mother is given corticosteroids to aid in fetal lung maturity. A
vv vv vv v vv vv vv vv vv vv vv vv vv vv vv
CST is not performed at a preterm gestational age. Furthermore, bleeding is a
vv vv vv vv vv vv vv vv vv vv vv vv vv
contraindication to a CST. Internal fetal monitoring is also contraindicated in the
vv vv vv vv vv vv vv vv vv vv vv vv
presence of bleeding.
vv vv vv
DIF: Cognitive Level: Apply REF: dm. 680
vv vv vv vv vv vv
TOPIC Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
vv vv vv vv vv vv vv vv vv vv
5. A laboring woman with no known risk factors suddenly experiences spontaneous
vv vv vv vv vv vv vv vv vv vv
ROM. The fluid consists of bright red blood. Her contractions are consistent with her
vv vv vv vv vv vv vv vv vv vv vv vv vv vv
current stage oflabor. No change in uterine resting tone has occurred. The fetal heart
vv vv vv v vv vv vv vv vv vv vv vv vv vv vv
rate (FHR) begins to decline rapidly after the ROM. The nursing attendant should
vv vv vv vv vv vv vv vv vv vv vv vv vv
suspect the possibility of what condition?
vv vv vv vv vv vv
, a. Placenta previa
vv