, TEST BANK FOR MATERNITY NEWBORN AND
WOMEN'S HEALTH NURSING A CASE-BASED
APPROACH 1ST EDITION O'MEARA
Maternity Newborn and Women's Health Nursing A Case-
Based Approach 1st Edition O'Meara Test Bank
ISBN-10:1496368215iISBN-
i13:9781496368218
TableiofiContents
Chapteri1iImmediateiPostpartumiHemorrhagei
Chapteri2iLateriPostpartumiHemorrhage
Chapteri3iGestationaliDiabetes,iDeepiVeiniThrombosis,iandiPostpartumiPulmonaryiEmbolismiCh
apteri4iPreeclampsia
Chapteri5iCordiProlapseiandiNonreassuringiFetaliStatusiChap
teri6iPlacentaliAbruptioniandiFetaliLoss
Chapteri7iChorioamnionitisiandiNeonataliSepsis
Chapteri8iPretermiPrematureiRuptureiofiMembranesiandiNeonataliRespiratoryiDistressiSyndrome
Chapteri9iGestationaliDiabetes,iMacrosomia,iandiNeonataliCephalhematoma
Chapteri10iAdvancediMaternaliAge,iHELLPiSyndrome,iandiNeonataliNecrotizingiEnterocolitisiC
hapteri11iMigraineiWithiAura,iShoulderiDystocia,iandiBrachialiPlexusiPalsy
Chapteri12iIntimateiPartneriViolence,iFormulaiFeeding,iandiPostpartumiDepression
Chapteri13iGestationaliTrophoblasticiDiseasei(MolariPregnancy)iandiAdvancediMaternaliAgeiCh
apteri14iBeforeiConception
Chapteri15iPregnancy
Chapteri16iLaboriandiDeliveryi
Chapteri17iAfteriDelivery
,Chapteri18iTheiNewborn
Chapteri19iConditionsiExistingiBeforeiConceptioniChapte
ri20iConditionsiOccurringiDuringiPregnancy
Chapteri21iComplicationsiOccurringiBeforeiLaboriandiDeliveryiChapte
ri22iComplicationsiOccurringiDuringiLaboriandiDeliveryiChapteri23iCo
nditionsiOccurringiAfteriDelivery
Chapteri24iConditionsiinitheiNewborniRelateditoiGestationaliAge,iSize,iInjury,iandiPainiChapteri
25iAcquirediConditionsiandiCongenitaliAbnormalitiesiinitheiNewborn
Chapteri26iWellnessiandiHealthiPromotioniChapteri27
iCommoniGynecologiciConditionsChapteri28iInfectio
ns
Chapteri29iFamilyiPlanningiChapteri30iVulnera
bleiPopulations
, MaternityiNewborniandiWomen’siHealthiNursingiAiCase-
BasediApproachi1stiEditioniO’MearaiTestiBank
Chapteri1iImmediateiPostpartumiHemorrhage
MULTIPLEiCHOICE
1. Aipregnantiwomaniisibeingidischargedifromitheihospitaliafteritheiplacementiofiaicervicalice
rclageibecauseiofiaihistoryiofirecurrentipregnancyiloss,isecondaryitoianiincompetenticervix.iWhichii
nformationiregardingipostproceduralicareishoulditheinurseiemphasizeiinitheidischargeiteaching?
a. Anyivaginalidischargeishouldibeiimmediatelyireporteditoiherihealthicareiprovider.
b. Theipresenceiofianyicontractions,iruptureiofimembranesi(ROM),iorisevereiperinealipressureisho
c. Theiclientiwillineeditoimakeiarrangementsiforicareiatihome,ibecauseiheriactivityileveliwillibeire
d. Theiclientiwillibeischedulediforiaicesareanibirth.i
ANS:iB
Nursingicareishouldistressitheiimportanceiofimonitoringiforitheisignsiandisymptomsiofipreterm
labor.iVaginalibleedingineedsitoibeireporteditoiheriprimaryihealthicareiprovider.iBedirestiisianielementio
ficare.iHowever,itheiwomanimayistandiforiperiodsiofiupitoi90iminutes,iwhichiallowsiheritheifreedomitois
eeiheriphysician.iHomeiuterineiactivityimonitoringimayibeiuseditoilimititheiwomansineediforivisitsiandit
oimonitoriheristatusisafelyiatihome.iTheicerclageicanibeiremovediat37iweeksiofigestationi(toiprepareifori
aivaginalibirth),ioriaicesareanibirthicanibeiplanned.
DIF:iCognitiveiLevel:iApplyiREF:idm.i675
TOP:iNursingiProcess:iPlanningi|iNursingiProcess:iImplementationMSC:
ClientiNeeds:iHealthiPromotioniandiMaintenance
2. Aiperinatalinurseiisigivingidischargeiinstructionsitoiaiwoman,istatusipostsuction,iandicurettageise
condaryitoiaihydatidiformimole.iTheiwomaniasksiwhyisheimustitakeioralicontraceptivesiforitheinexti12im
onths.iWhatiisitheibestresponseibyitheinurse?
Ifi youigetipregnantiwithini1iyear,itheichanceiofiaisuccessfulipregnancyiisiveryismall.iTherefore,
a. pregnancy,iitiwouldibeibetteriforiyouitoiuseitheimostireliableimethodioficontraceptioniavailable.
Theimajoririskitoiyouiafteriaimolaripregnancyiisiaitypeioficancerithaticanibeidiagnosedionlyibyhormoneitha
tiyouribodyiproducesiduringipregnancy.i Ifi youiwereitoigetipregnant,itheniitiwould
b. thisicancerimoreidifficult.
Ifi youicaniavoidiaipregnancyiforitheinexti year,itheichanceiofidevelopingiaisecondimolaripregna
c. improveiyourichanceiofiaisuccessfulipregnancy,inotigettingipregnantiatithisitimeiisibest.
d. OralicontraceptivesiareitheionlyiformiofibirthicontrolithatiwillipreventiairecurrenceiofiaimolaripiA
NS:iB
Betahumanichorionicigonadotropini(beta-hCG)ihormoneilevelsiareidrawnifori1iyearitoiensure
thatitheimoleiisicompletelyigone.iTheichanceiofidevelopingichoriocarcinomaiafteritheidevelopmentiofiai
hydatidiformimoleiisiincreased.iTherefore,itheigoaliisitoiachieveiaizeroihumanchorionicigonadotropini(
hCG)ilevel.iIfitheiwomaniwereitoibecomeipregnant,itheniitimayiobscuretheipresenceiofitheipotentiallyica
rcinogenicicells.iWomenishouldibeiinstructeditoiuseibirthicontrolifori1iyeariafteritreatmentiforiaihydatidi
formimole.iTheirationaleiforiavoidingipregnancy
,fori1iyeariisitoiensureithaticarcinogenicicellsiareinotipresent.iAnyicontraceptiveimethodiexceptaniin
trauterineidevicei(IUD)iisiacceptable.
DIF:iCognitiveiLevel:iApplyiREF:idm.i679
TOP:iNursingiProcess:iPlanningi|iNursingiProcess:iImplementationMSC:iClienti
Needs:iPhysiologiciIntegrity
3. Theinurseiisipreparingitoiadministerimethotrexateitoitheiclient.iThisihazardousidrugiis
imostiofteniusediforiwhichiobstetricicomplication?
a. Completeihydatidiformimole
b. Missediabortion
c. Unrupturediectopicipregnancy
d. Abruptioiplacentae
iANS:iC
Methotrexateiisianieffectiveinonsurgicalitreatmentioptioniforiaihemodynamicallyistableiwoman
whoseiectopicipregnancyiisiunrupturediandimeasuresilessithani4icmiinidiameter.iMethotrexateiisnotiindi
catediorirecommendediasiaitreatmentioptioniforiaicompleteihydatidiformimole,iforiaimissediabortion,iori
foriabruptioiplacentae.
DIF:iCognitiveiLevel:iApplyiREF:idm.i677iTOP:iNursingiProcess:iPlanningMSC:iClienti
Needs:iPhysiologiciIntegrity
4. Ai26-year-oldipregnantiwoman,igravidai2,iparai1-0-0-
1,iisi28iweeksipregnantiwhenisheiexperiencesibrightired,ipainlessivaginalibleeding.iOniheriarrivalia
titheihospital,iwhichidiagnosticiprocedureiwillitheiclientimostilikelyihaveiperformed?
a. Amniocentesisiforifetalilungimaturity
b. Transvaginaliultrasoundiforiplacentalilocation
c. Contractionistressitesti(CST)
d. Internalifetalimonitoringi
ANS:iB
Theipresenceiofipainlessibleedingishouldialwaysialertitheihealthicareiteamitoitheipossibilityiof
placentaiprevia,iwhichicanibeiconfirmedithroughiultrasonography.iAmniocentesisiisinotiperformedioniai
womaniwhoiisiexperiencingibleeding.iInitheieventiofianiimminentidelivery,itheifetusiisipresumeditoihave
iimmatureilungsiatithisigestationaliage,ianditheimotheriisigivenicorticosteroidsitoiaidiinifetalilungimaturit
y.iAiCSTiisinotiperformediatiaipretermigestationaliage.Furthermore,ibleedingiisiaicontraindicationitoiaiC
ST.iInternalifetalimonitoringiisialsoicontraindicatediinitheipresenceiofibleeding.iDIF:iCognitiveiLevel:iA
pplyiREF:idm.i680
TOP:iNursingiProcess:iAssessmentiMSC:iClientiNeeds:iHealthiPromotioniandiMaintenance
5. AilaboringiwomaniwithinoiknowniriskifactorsisuddenlyiexperiencesispontaneousiROM.iTheifl
uidiconsistsiofibrightirediblood.iHericontractionsiareiconsistentiwithihericurrentistageiofilabor.Noichan
geiiniuterineirestingitoneihasioccurred.iTheifetaliheartiratei(FHR)ibeginsitoideclineirapidlyiafteritheiRO
M.iTheinurseishouldisuspectitheipossibilityiofiwhaticondition?
a. Placentaiprevia
b. Vasaiprevia
c. Severeiabruptioiplacentae
, d. Disseminatediintravascularicoagulationi(DIC)i
ANS:iB
Vasaipreviaiisitheiresultiofiaivelamentousiinsertioniofitheiumbilicalicord.iTheiumbilicalivessels
areinotisurroundedibyiWhartonijellyiandihaveinoisupportiveitissue.iTheiumbilicalibloodivesselsithusiareia
tiriskiforilacerationiatianyitime,ibutilacerationioccursimostifrequentlyiduringiROM.iThesuddeniappearanc
eiofibrightiredibloodiatitheitimeiofiROMiandiaisuddenichangeiinitheiFHRiwithoutiotheriknowniriskifactor
sishouldiimmediatelyialertitheinurseitoitheipossibilityiofivasaiprevia.iTheipresenceiofiplacentaipreviaimos
tilikelyiwouldibeiascertainedibeforeilaboriandiisiconsiderediairiskifactoriforithisipregnancy.iIniaddition,iifi
theiwomanihadiaiplacentaiprevia,iitiisiunlikelyithatisheiwouldibeialloweditoipursueilaboriandiaivaginalibir
th.iWithitheipresenceiofisevereiabruptioiplacentae,itheiuterineitonicityitypicallyiisitetanusi(i.e.,iaiboardlik
eiuterus).iDICiisaipathologiciformiofidiffuseiclottingithaticonsumesilargeiamountsioficlottingifactors,icau
singiwidespreadiexternalibleeding,iinternalibleeding,ioriboth.iDICiisialwaysiaisecondaryidiagnosis,iofteni
associatediwithiobstetriciriskifactorsisuchiasitheihemolysis,ielevatediliverienzymeilevels,iandilowiplateleti
levelsi(HELLP)isyndrome.iThisiwomanididinotihaveianyiprioririskifactors.
DIF:iCognitiveiLevel:iAnalyzeiREF:idm.i684iTOP:iNursingiProcess:iDiagnosisMSC:iCli
entiNeeds:iPhysiologiciIntegrity
6. Aiwomaniarrivesiforievaluationiofisignsiandisymptomsithatiincludeiaimissediperiod,iadnexalifu
llness,itenderness,iandidarkiredivaginalibleeding.iOniexamination,itheinurseinoticesianiecchymoticiblue
nessiarounditheiwomansiumbilicus.iWhatidoesithisifindingiindicate?
a. Normaliintegumentaryichangesiassociatediwithipregnancy
b. Turnerisigniassociatediwithiappendicitis
c. Cullenisigniassociatediwithiairupturediectopicipregnancy
d. Chadwickisigniassociatediwithiearlyipregnancyi
ANS:iC
Cullenisign,itheiblueiecchymosisiobservediinitheiumbilicaliarea,iindicatesihematoperitoneum
associatediwithianiundiagnosedirupturediintraabdominaliectopicipregnancy.iLineainigraionitheiabd
omeniisitheinormaliintegumentaryichangeiassociatediwithipregnancyiandiexhibitsiaibrownipigment
ed,iverticalilineionitheiloweriabdomen.iTurnerisigniisiecchymosisiinitheiflankiarea,iofteniassociated
iwithipancreatitis.iAiChadwickisigniisiaiblue-
purpleicervixithatimayibeiseeniduringioriarounditheieighthiweekiofipregnancy.
DIF:iCognitiveiLevel:iAnalyzeiREF:idm.i676
TOP:iNursingiProcess:iAssessmentiMSC:iClientiNeeds:iPhysiologiciIntegrity
7. Theinurseiwhoielectsitoipracticeiinitheiareaiofiwomensihealthimustihaveiaithoroughiun
derstandingiofimiscarriage.iWhichistatementiregardingithisiconditioniisimostiaccurate?
a. Aimiscarriageiisiainaturalipregnancyilossibeforeilaboribegins.
b. Itioccursiinifewerithani5%iofialliclinicallyirecognizedipregnancies.
c. Carelessimaternalibehavior,isuchiasipoorinutritionioriexcessiveiexercise,icanibeiaifactoriinicausiIfiaim
iscarriageioccursibeforeithei12thiweekiofipregnancy,itheniitimayibeiobservedionlyiasimod
d. bloodiloss.
ANS:iD
Beforeitheisixthiweek,itheionlyievidenceimightibeiaiheavyimenstrualiflow.iAfterithei12thiweek,moreisev
ereipain,isimilaritoithatiofilabor,iisilikely.iMiscarriageiisiainaturalipregnancyiloss,ibutiit
, occurs,ibyidefinition,ibeforei20iweeksiofigestation,ibeforeitheifetusiisiviable.iMiscarriagesioccuriniappro
ximatelyi10%itoi15%iofialliclinicallyirecognizedipregnancies.iMiscarriagesicanibeicausedibyiainumberio
fidisordersioriillnessesioutsideitheimothersicontrolioriknowledge.
DIF:iCognitiveiLevel:iUnderstandiREF:idm.i670
TOP:iNursingiProcess:iAssessmentiMSC:iClientiNeeds:iPhysiologiciIntegrity
8. Aiwomaniwhoiisi30iweeksiofigestationiarrivesiatitheihospitaliwithibleeding.iWhichidi
fferentialidiagnosisiwouldinotibeiapplicableiforithisiclient?
a. Placentaiprevia
b. Abruptioiplacentae
c. Spontaneousiabortion
d. Cordiinsertion
iANS:iC
Spontaneousiabortioniisianotherinameiforimiscarriage;iitioccurs,ibyidefinition,iearlyiin
pregnancy.iPlacentaipreviaiisiaiwell-
knownireasoniforibleedingilateiinipregnancy.iTheiprematureiseparationiofitheiplacentai(abruptioiplacent
ae)iisiaibleedingidisorderithaticanioccurilateiinipregnancy.iCordiinsertionimayicauseiaibleedingidisorderit
haticanialsoioccurilateiinipregnancy.
DIF:iCognitiveiLevel:iUnderstandiREF:idm.i669TOP:
NursingiProcess:iAssessment
MSC:iClientiNeeds:iPhysiologiciIntegrity,iPhysiologiciAdaptation
9. Withiregarditoihemorrhagicicomplicationsithatimayioccuriduringipregnancy,iwhatiinformationiis
imostiaccurate?
a. Aniincompetenticervixiisiusuallyinotidiagnosediuntilitheiwomanihasilostioneioritwoipregnancies
b. Incidencesiofiectopicipregnancyiareidecliningiasiairesultiofiimprovedidiagnosticitechniques.
c. Oneiectopicipregnancyidoesinotiaffectiaiwomansifertilityioriherilikelihoodiofihavingiainormalip
d. Gestationalitrophoblasticineoplasiai(GTN)iisioneiofitheipersistentlyiincurableigynecologicimaliiA
NS:iA
Shortilaborsiandirecurringilossesiofipregnancyiatiprogressivelyiearlierigestationaliagesiare
characteristicsiofireducedicervicalicompetence.iBecauseidiagnosticitechnologyiisiimproving,moreiec
topicipregnanciesiareibeingidiagnosed.iOneiectopicipregnancyiplacesitheiwomaniatiincreasediriskifor
ianotherione.iEctopicipregnancyiisiaileadingicauseiofiinfertility.iOnceiinvariablyifatal,iGTNinowiisith
eimosticurableigynecologicimalignancy.
DIF:iCognitiveiLevel:iUnderstandiREF:idm.i675
TOP:iNursingiProcess:iAssessmentiMSC:iClientiNeeds:iHealthiPromotioniandiMaintenance
10. Theimanagementiofitheipregnanticlientiwhoihasiexperiencediaipregnancyilossidependsionitheity
peiofimiscarriageianditheisignsiandisymptoms.iWhileiplanningicareiforiaiclientiwhoidesiresi outpatientima
nagementiafteriaifirst-trimesteriloss,iwhatiwoulditheinurseiexpectitheiplanitoiinclude?
a. Dilationiandicurettagei(D&C)
b. Dilationiandievacuationi(D&E)
c. Misoprostol
d. Ergotiproducts
iANS:iC
WOMEN'S HEALTH NURSING A CASE-BASED
APPROACH 1ST EDITION O'MEARA
Maternity Newborn and Women's Health Nursing A Case-
Based Approach 1st Edition O'Meara Test Bank
ISBN-10:1496368215iISBN-
i13:9781496368218
TableiofiContents
Chapteri1iImmediateiPostpartumiHemorrhagei
Chapteri2iLateriPostpartumiHemorrhage
Chapteri3iGestationaliDiabetes,iDeepiVeiniThrombosis,iandiPostpartumiPulmonaryiEmbolismiCh
apteri4iPreeclampsia
Chapteri5iCordiProlapseiandiNonreassuringiFetaliStatusiChap
teri6iPlacentaliAbruptioniandiFetaliLoss
Chapteri7iChorioamnionitisiandiNeonataliSepsis
Chapteri8iPretermiPrematureiRuptureiofiMembranesiandiNeonataliRespiratoryiDistressiSyndrome
Chapteri9iGestationaliDiabetes,iMacrosomia,iandiNeonataliCephalhematoma
Chapteri10iAdvancediMaternaliAge,iHELLPiSyndrome,iandiNeonataliNecrotizingiEnterocolitisiC
hapteri11iMigraineiWithiAura,iShoulderiDystocia,iandiBrachialiPlexusiPalsy
Chapteri12iIntimateiPartneriViolence,iFormulaiFeeding,iandiPostpartumiDepression
Chapteri13iGestationaliTrophoblasticiDiseasei(MolariPregnancy)iandiAdvancediMaternaliAgeiCh
apteri14iBeforeiConception
Chapteri15iPregnancy
Chapteri16iLaboriandiDeliveryi
Chapteri17iAfteriDelivery
,Chapteri18iTheiNewborn
Chapteri19iConditionsiExistingiBeforeiConceptioniChapte
ri20iConditionsiOccurringiDuringiPregnancy
Chapteri21iComplicationsiOccurringiBeforeiLaboriandiDeliveryiChapte
ri22iComplicationsiOccurringiDuringiLaboriandiDeliveryiChapteri23iCo
nditionsiOccurringiAfteriDelivery
Chapteri24iConditionsiinitheiNewborniRelateditoiGestationaliAge,iSize,iInjury,iandiPainiChapteri
25iAcquirediConditionsiandiCongenitaliAbnormalitiesiinitheiNewborn
Chapteri26iWellnessiandiHealthiPromotioniChapteri27
iCommoniGynecologiciConditionsChapteri28iInfectio
ns
Chapteri29iFamilyiPlanningiChapteri30iVulnera
bleiPopulations
, MaternityiNewborniandiWomen’siHealthiNursingiAiCase-
BasediApproachi1stiEditioniO’MearaiTestiBank
Chapteri1iImmediateiPostpartumiHemorrhage
MULTIPLEiCHOICE
1. Aipregnantiwomaniisibeingidischargedifromitheihospitaliafteritheiplacementiofiaicervicalice
rclageibecauseiofiaihistoryiofirecurrentipregnancyiloss,isecondaryitoianiincompetenticervix.iWhichii
nformationiregardingipostproceduralicareishoulditheinurseiemphasizeiinitheidischargeiteaching?
a. Anyivaginalidischargeishouldibeiimmediatelyireporteditoiherihealthicareiprovider.
b. Theipresenceiofianyicontractions,iruptureiofimembranesi(ROM),iorisevereiperinealipressureisho
c. Theiclientiwillineeditoimakeiarrangementsiforicareiatihome,ibecauseiheriactivityileveliwillibeire
d. Theiclientiwillibeischedulediforiaicesareanibirth.i
ANS:iB
Nursingicareishouldistressitheiimportanceiofimonitoringiforitheisignsiandisymptomsiofipreterm
labor.iVaginalibleedingineedsitoibeireporteditoiheriprimaryihealthicareiprovider.iBedirestiisianielementio
ficare.iHowever,itheiwomanimayistandiforiperiodsiofiupitoi90iminutes,iwhichiallowsiheritheifreedomitois
eeiheriphysician.iHomeiuterineiactivityimonitoringimayibeiuseditoilimititheiwomansineediforivisitsiandit
oimonitoriheristatusisafelyiatihome.iTheicerclageicanibeiremovediat37iweeksiofigestationi(toiprepareifori
aivaginalibirth),ioriaicesareanibirthicanibeiplanned.
DIF:iCognitiveiLevel:iApplyiREF:idm.i675
TOP:iNursingiProcess:iPlanningi|iNursingiProcess:iImplementationMSC:
ClientiNeeds:iHealthiPromotioniandiMaintenance
2. Aiperinatalinurseiisigivingidischargeiinstructionsitoiaiwoman,istatusipostsuction,iandicurettageise
condaryitoiaihydatidiformimole.iTheiwomaniasksiwhyisheimustitakeioralicontraceptivesiforitheinexti12im
onths.iWhatiisitheibestresponseibyitheinurse?
Ifi youigetipregnantiwithini1iyear,itheichanceiofiaisuccessfulipregnancyiisiveryismall.iTherefore,
a. pregnancy,iitiwouldibeibetteriforiyouitoiuseitheimostireliableimethodioficontraceptioniavailable.
Theimajoririskitoiyouiafteriaimolaripregnancyiisiaitypeioficancerithaticanibeidiagnosedionlyibyhormoneitha
tiyouribodyiproducesiduringipregnancy.i Ifi youiwereitoigetipregnant,itheniitiwould
b. thisicancerimoreidifficult.
Ifi youicaniavoidiaipregnancyiforitheinexti year,itheichanceiofidevelopingiaisecondimolaripregna
c. improveiyourichanceiofiaisuccessfulipregnancy,inotigettingipregnantiatithisitimeiisibest.
d. OralicontraceptivesiareitheionlyiformiofibirthicontrolithatiwillipreventiairecurrenceiofiaimolaripiA
NS:iB
Betahumanichorionicigonadotropini(beta-hCG)ihormoneilevelsiareidrawnifori1iyearitoiensure
thatitheimoleiisicompletelyigone.iTheichanceiofidevelopingichoriocarcinomaiafteritheidevelopmentiofiai
hydatidiformimoleiisiincreased.iTherefore,itheigoaliisitoiachieveiaizeroihumanchorionicigonadotropini(
hCG)ilevel.iIfitheiwomaniwereitoibecomeipregnant,itheniitimayiobscuretheipresenceiofitheipotentiallyica
rcinogenicicells.iWomenishouldibeiinstructeditoiuseibirthicontrolifori1iyeariafteritreatmentiforiaihydatidi
formimole.iTheirationaleiforiavoidingipregnancy
,fori1iyeariisitoiensureithaticarcinogenicicellsiareinotipresent.iAnyicontraceptiveimethodiexceptaniin
trauterineidevicei(IUD)iisiacceptable.
DIF:iCognitiveiLevel:iApplyiREF:idm.i679
TOP:iNursingiProcess:iPlanningi|iNursingiProcess:iImplementationMSC:iClienti
Needs:iPhysiologiciIntegrity
3. Theinurseiisipreparingitoiadministerimethotrexateitoitheiclient.iThisihazardousidrugiis
imostiofteniusediforiwhichiobstetricicomplication?
a. Completeihydatidiformimole
b. Missediabortion
c. Unrupturediectopicipregnancy
d. Abruptioiplacentae
iANS:iC
Methotrexateiisianieffectiveinonsurgicalitreatmentioptioniforiaihemodynamicallyistableiwoman
whoseiectopicipregnancyiisiunrupturediandimeasuresilessithani4icmiinidiameter.iMethotrexateiisnotiindi
catediorirecommendediasiaitreatmentioptioniforiaicompleteihydatidiformimole,iforiaimissediabortion,iori
foriabruptioiplacentae.
DIF:iCognitiveiLevel:iApplyiREF:idm.i677iTOP:iNursingiProcess:iPlanningMSC:iClienti
Needs:iPhysiologiciIntegrity
4. Ai26-year-oldipregnantiwoman,igravidai2,iparai1-0-0-
1,iisi28iweeksipregnantiwhenisheiexperiencesibrightired,ipainlessivaginalibleeding.iOniheriarrivalia
titheihospital,iwhichidiagnosticiprocedureiwillitheiclientimostilikelyihaveiperformed?
a. Amniocentesisiforifetalilungimaturity
b. Transvaginaliultrasoundiforiplacentalilocation
c. Contractionistressitesti(CST)
d. Internalifetalimonitoringi
ANS:iB
Theipresenceiofipainlessibleedingishouldialwaysialertitheihealthicareiteamitoitheipossibilityiof
placentaiprevia,iwhichicanibeiconfirmedithroughiultrasonography.iAmniocentesisiisinotiperformedioniai
womaniwhoiisiexperiencingibleeding.iInitheieventiofianiimminentidelivery,itheifetusiisipresumeditoihave
iimmatureilungsiatithisigestationaliage,ianditheimotheriisigivenicorticosteroidsitoiaidiinifetalilungimaturit
y.iAiCSTiisinotiperformediatiaipretermigestationaliage.Furthermore,ibleedingiisiaicontraindicationitoiaiC
ST.iInternalifetalimonitoringiisialsoicontraindicatediinitheipresenceiofibleeding.iDIF:iCognitiveiLevel:iA
pplyiREF:idm.i680
TOP:iNursingiProcess:iAssessmentiMSC:iClientiNeeds:iHealthiPromotioniandiMaintenance
5. AilaboringiwomaniwithinoiknowniriskifactorsisuddenlyiexperiencesispontaneousiROM.iTheifl
uidiconsistsiofibrightirediblood.iHericontractionsiareiconsistentiwithihericurrentistageiofilabor.Noichan
geiiniuterineirestingitoneihasioccurred.iTheifetaliheartiratei(FHR)ibeginsitoideclineirapidlyiafteritheiRO
M.iTheinurseishouldisuspectitheipossibilityiofiwhaticondition?
a. Placentaiprevia
b. Vasaiprevia
c. Severeiabruptioiplacentae
, d. Disseminatediintravascularicoagulationi(DIC)i
ANS:iB
Vasaipreviaiisitheiresultiofiaivelamentousiinsertioniofitheiumbilicalicord.iTheiumbilicalivessels
areinotisurroundedibyiWhartonijellyiandihaveinoisupportiveitissue.iTheiumbilicalibloodivesselsithusiareia
tiriskiforilacerationiatianyitime,ibutilacerationioccursimostifrequentlyiduringiROM.iThesuddeniappearanc
eiofibrightiredibloodiatitheitimeiofiROMiandiaisuddenichangeiinitheiFHRiwithoutiotheriknowniriskifactor
sishouldiimmediatelyialertitheinurseitoitheipossibilityiofivasaiprevia.iTheipresenceiofiplacentaipreviaimos
tilikelyiwouldibeiascertainedibeforeilaboriandiisiconsiderediairiskifactoriforithisipregnancy.iIniaddition,iifi
theiwomanihadiaiplacentaiprevia,iitiisiunlikelyithatisheiwouldibeialloweditoipursueilaboriandiaivaginalibir
th.iWithitheipresenceiofisevereiabruptioiplacentae,itheiuterineitonicityitypicallyiisitetanusi(i.e.,iaiboardlik
eiuterus).iDICiisaipathologiciformiofidiffuseiclottingithaticonsumesilargeiamountsioficlottingifactors,icau
singiwidespreadiexternalibleeding,iinternalibleeding,ioriboth.iDICiisialwaysiaisecondaryidiagnosis,iofteni
associatediwithiobstetriciriskifactorsisuchiasitheihemolysis,ielevatediliverienzymeilevels,iandilowiplateleti
levelsi(HELLP)isyndrome.iThisiwomanididinotihaveianyiprioririskifactors.
DIF:iCognitiveiLevel:iAnalyzeiREF:idm.i684iTOP:iNursingiProcess:iDiagnosisMSC:iCli
entiNeeds:iPhysiologiciIntegrity
6. Aiwomaniarrivesiforievaluationiofisignsiandisymptomsithatiincludeiaimissediperiod,iadnexalifu
llness,itenderness,iandidarkiredivaginalibleeding.iOniexamination,itheinurseinoticesianiecchymoticiblue
nessiarounditheiwomansiumbilicus.iWhatidoesithisifindingiindicate?
a. Normaliintegumentaryichangesiassociatediwithipregnancy
b. Turnerisigniassociatediwithiappendicitis
c. Cullenisigniassociatediwithiairupturediectopicipregnancy
d. Chadwickisigniassociatediwithiearlyipregnancyi
ANS:iC
Cullenisign,itheiblueiecchymosisiobservediinitheiumbilicaliarea,iindicatesihematoperitoneum
associatediwithianiundiagnosedirupturediintraabdominaliectopicipregnancy.iLineainigraionitheiabd
omeniisitheinormaliintegumentaryichangeiassociatediwithipregnancyiandiexhibitsiaibrownipigment
ed,iverticalilineionitheiloweriabdomen.iTurnerisigniisiecchymosisiinitheiflankiarea,iofteniassociated
iwithipancreatitis.iAiChadwickisigniisiaiblue-
purpleicervixithatimayibeiseeniduringioriarounditheieighthiweekiofipregnancy.
DIF:iCognitiveiLevel:iAnalyzeiREF:idm.i676
TOP:iNursingiProcess:iAssessmentiMSC:iClientiNeeds:iPhysiologiciIntegrity
7. Theinurseiwhoielectsitoipracticeiinitheiareaiofiwomensihealthimustihaveiaithoroughiun
derstandingiofimiscarriage.iWhichistatementiregardingithisiconditioniisimostiaccurate?
a. Aimiscarriageiisiainaturalipregnancyilossibeforeilaboribegins.
b. Itioccursiinifewerithani5%iofialliclinicallyirecognizedipregnancies.
c. Carelessimaternalibehavior,isuchiasipoorinutritionioriexcessiveiexercise,icanibeiaifactoriinicausiIfiaim
iscarriageioccursibeforeithei12thiweekiofipregnancy,itheniitimayibeiobservedionlyiasimod
d. bloodiloss.
ANS:iD
Beforeitheisixthiweek,itheionlyievidenceimightibeiaiheavyimenstrualiflow.iAfterithei12thiweek,moreisev
ereipain,isimilaritoithatiofilabor,iisilikely.iMiscarriageiisiainaturalipregnancyiloss,ibutiit
, occurs,ibyidefinition,ibeforei20iweeksiofigestation,ibeforeitheifetusiisiviable.iMiscarriagesioccuriniappro
ximatelyi10%itoi15%iofialliclinicallyirecognizedipregnancies.iMiscarriagesicanibeicausedibyiainumberio
fidisordersioriillnessesioutsideitheimothersicontrolioriknowledge.
DIF:iCognitiveiLevel:iUnderstandiREF:idm.i670
TOP:iNursingiProcess:iAssessmentiMSC:iClientiNeeds:iPhysiologiciIntegrity
8. Aiwomaniwhoiisi30iweeksiofigestationiarrivesiatitheihospitaliwithibleeding.iWhichidi
fferentialidiagnosisiwouldinotibeiapplicableiforithisiclient?
a. Placentaiprevia
b. Abruptioiplacentae
c. Spontaneousiabortion
d. Cordiinsertion
iANS:iC
Spontaneousiabortioniisianotherinameiforimiscarriage;iitioccurs,ibyidefinition,iearlyiin
pregnancy.iPlacentaipreviaiisiaiwell-
knownireasoniforibleedingilateiinipregnancy.iTheiprematureiseparationiofitheiplacentai(abruptioiplacent
ae)iisiaibleedingidisorderithaticanioccurilateiinipregnancy.iCordiinsertionimayicauseiaibleedingidisorderit
haticanialsoioccurilateiinipregnancy.
DIF:iCognitiveiLevel:iUnderstandiREF:idm.i669TOP:
NursingiProcess:iAssessment
MSC:iClientiNeeds:iPhysiologiciIntegrity,iPhysiologiciAdaptation
9. Withiregarditoihemorrhagicicomplicationsithatimayioccuriduringipregnancy,iwhatiinformationiis
imostiaccurate?
a. Aniincompetenticervixiisiusuallyinotidiagnosediuntilitheiwomanihasilostioneioritwoipregnancies
b. Incidencesiofiectopicipregnancyiareidecliningiasiairesultiofiimprovedidiagnosticitechniques.
c. Oneiectopicipregnancyidoesinotiaffectiaiwomansifertilityioriherilikelihoodiofihavingiainormalip
d. Gestationalitrophoblasticineoplasiai(GTN)iisioneiofitheipersistentlyiincurableigynecologicimaliiA
NS:iA
Shortilaborsiandirecurringilossesiofipregnancyiatiprogressivelyiearlierigestationaliagesiare
characteristicsiofireducedicervicalicompetence.iBecauseidiagnosticitechnologyiisiimproving,moreiec
topicipregnanciesiareibeingidiagnosed.iOneiectopicipregnancyiplacesitheiwomaniatiincreasediriskifor
ianotherione.iEctopicipregnancyiisiaileadingicauseiofiinfertility.iOnceiinvariablyifatal,iGTNinowiisith
eimosticurableigynecologicimalignancy.
DIF:iCognitiveiLevel:iUnderstandiREF:idm.i675
TOP:iNursingiProcess:iAssessmentiMSC:iClientiNeeds:iHealthiPromotioniandiMaintenance
10. Theimanagementiofitheipregnanticlientiwhoihasiexperiencediaipregnancyilossidependsionitheity
peiofimiscarriageianditheisignsiandisymptoms.iWhileiplanningicareiforiaiclientiwhoidesiresi outpatientima
nagementiafteriaifirst-trimesteriloss,iwhatiwoulditheinurseiexpectitheiplanitoiinclude?
a. Dilationiandicurettagei(D&C)
b. Dilationiandievacuationi(D&E)
c. Misoprostol
d. Ergotiproducts
iANS:iC
