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Elitestudyvault
,Maternity Newborn and Women’s Health Nursing A Case-Based Approach 1st Edition O’Meara
Test Bank
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 be reported
c. The client will need to make arrangements for care at home, because her activity level
will be restricted
d. The client will be scheduled for a cesarean birth.
ANS: 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 postsuction, 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?
a. If you get pregnant within 1 year, the chance of a successful pregnancy is very small.
Therefore, if pregnancy, it would be better for you to use the most reliable method of
contraception available.
b. 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 make this cancer more difficult.
c. If you can avoid a pregnancy for the next year, the chance of developing a second molar
pregnancy 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 pregnancy
ANS: 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
If you need any other Test Banks or eTextbooks contact us:
, 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
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
If you need any other Test Banks or eTextbooks contact us:
Elitestudyvault
,Maternity Newborn and Women’s Health Nursing A Case-Based Approach 1st Edition O’Meara
Test Bank
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 be reported
c. The client will need to make arrangements for care at home, because her activity level
will be restricted
d. The client will be scheduled for a cesarean birth.
ANS: 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 postsuction, 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?
a. If you get pregnant within 1 year, the chance of a successful pregnancy is very small.
Therefore, if pregnancy, it would be better for you to use the most reliable method of
contraception available.
b. 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 make this cancer more difficult.
c. If you can avoid a pregnancy for the next year, the chance of developing a second molar
pregnancy 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 pregnancy
ANS: 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
If you need any other Test Banks or eTextbooks contact us:
, 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
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
If you need any other Test Banks or eTextbooks contact us:
