Test Bank For Foundations of Maternal Newborn and Women
Health Nursing 8th Edition By Murray Sharon (),
9780323827386, Chapter 1-28 , All Chapters with Answers and
Rationals
1. A patient with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The
drug classification of this medication is a
a.
diuretic.
b.
tocolytic.
c.
anticonvulsant.
d.
antihypertensive. - ANSWER: ANS: C
Anticonvulsant drugs act by blocking neuromuscular transmission and depress the central nervous
system to control seizure activity. Diuresis is a therapeutic response to magnesium sulfate. A tocolytic
drug slows the frequency and intensity of uterine contractions but is not used for that purpose in this
scenario. Decreased peripheral blood pressure is a therapeutic response (side effect) of the
anticonvulsant magnesium sulfate.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
2. Which clinical intervention is the only known cure for preeclampsia?
a.
Magnesium sulfate
b.
Delivery of the fetus
c.
Antihypertensive medications
d.
Administration of aspirin (ASA) every day of the pregnancy - ANSWER: ANS: B
Delivery of the infant is the only known intervention to halt the progression of preeclampsia.
Magnesium sulfate is one of the medications used to treat but not cure preeclampsia.
Antihypertensive medications are used to lower the dangerously elevated blood pressures in
preeclampsia and eclampsia. Low doses of aspirin (81 mg/day) have been administered to women at
high risk for developing preeclampsia. This intervention appears to have little benefit.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
3. The clinic nurse is performing a prenatal assessment on a pregnant patient at risk for preeclampsia.
Which clinical sign would not present as a symptom of preeclampsia?
a.
Edema
b.
Proteinuria
c.
Glucosuria
d.
Hypertension - ANSWER: ANS: C
Glucose into the urine is not one of the three classic symptoms of preeclampsia. The first sign noted
by the pregnant patient is rapid weight gain and edema of the hands and face. Proteinuria usually
develops later than the edema and hypertension. The first indication of preeclampsia is usually an
increase in the maternal blood pressure.
,DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
4. Which intrapartal assessment should be avoided when caring for a patient with HELLP syndrome?
a.
Abdominal palpation
b.
Venous sample of blood
c.
Checking deep tendon reflexes
d.
Auscultation of the heart and lungs - ANSWER: ANS: A
Palpation of the abdomen and liver could result in a sudden increase in intraabdominal pressure,
leading to rupture of the subcapsular hematoma. Assessment of heart and lungs is performed on
every patient. Checking reflexes is not contraindicated. Venous blood is checked frequently to
observe for thrombocytopenia.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
5. A nurse is explaining to the nursing students working on the antepartum unit how to assess for
edema. Which edema assessment score indicates edema of the lower extremities, face, hands, and
sacral area?
a.
+1
b.
+2
c.
+3
d.
+4 - ANSWER: ANS: C
Edema of the extremities, face, and sacral area is classified as +3 edema. Edema classified as +1
indicates minimal edema of the lower extremities. Marked edema of the lower extremities is +2
edema. Generalized massive edema (+4) includes the accumulation of fluid in the peritoneal cavity.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
6. Which maternal condition always necessitates delivery by cesarean birth?
a.
Partial abruptio placentae
b.
Total placenta previa
c.
Ectopic pregnancy
d.
Eclampsia - ANSWER: ANS: B
In total placenta previa, the placenta completely covers the cervical os. The fetus would die if a
vaginal birth occurred. If the patient has stable vital signs and the fetus is alive, a vaginal birth can be
attempted. If the fetus has already expired, a vaginal birth is preferred. The most common ectopic
pregnancy is a tubal pregnancy, which is usually detected and treated in the first trimester. Labor can
be safely induced if the eclampsia is under control.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
7. Spontaneous termination of a pregnancy is considered to be an abortion if
a.
the pregnancy is less than 20 weeks.
b.
, the fetus weighs less than 1000 g.
c.
the products of conception are passed intact.
d.
there is no evidence of intrauterine infection. - ANSWER: ANS: A
An abortion is the termination of pregnancy before the age of viability (20 weeks). The weight of the
fetus is not considered because some fetuses of an older age may have a low birth weight. A
spontaneous abortion may be complete or incomplete. A spontaneous abortion may be caused by
many problems, one being intrauterine infection.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion and Maintenance
8. An abortion when the fetus dies but is retained in the uterus is called
a.
inevitable.
b.
missed.
c.
incomplete.
d.
threatened - ANSWER: ANS: B
A missed abortion refers to a dead fetus being retained in the uterus. An inevitable abortion means
that the cervix is dilating with the contractions. An incomplete abortion means that not all the
products of conception were expelled. With a threatened abortion, the patient has cramping and
bleeding but not cervical dilation.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
9. A placenta previa when the placental edge just reaches the internal os is called
a.
total.
b.
partial.
c.
low-lying.
d.
marginal. - ANSWER: ANS: D
A placenta previa that does not cover any part of the cervix is termed marginal. With a total placenta
previa, the placenta completely covers the os. With a partial previa, the lower border of the placenta
is within 3 cm of the internal cervical os but does not completely cover the os. A complete previa is
termed total. The placenta completely covers the internal cervical os.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
10. Which finding would indicate concealed hemorrhage in abruptio placentae?
a.
Bradycardia
b.
Hard boardlike abdomen
c.
Decrease in fundal height
d.
Decrease in abdominal pain - ANSWER: ANS: B
Concealed hemorrhage occurs when the edges of the placenta do not separate. The formation of a
hematoma behind the placenta and subsequent infiltration of the blood into the uterine muscle
results in a very firm, boardlike abdomen. The patient will have shock symptoms that include
Health Nursing 8th Edition By Murray Sharon (),
9780323827386, Chapter 1-28 , All Chapters with Answers and
Rationals
1. A patient with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The
drug classification of this medication is a
a.
diuretic.
b.
tocolytic.
c.
anticonvulsant.
d.
antihypertensive. - ANSWER: ANS: C
Anticonvulsant drugs act by blocking neuromuscular transmission and depress the central nervous
system to control seizure activity. Diuresis is a therapeutic response to magnesium sulfate. A tocolytic
drug slows the frequency and intensity of uterine contractions but is not used for that purpose in this
scenario. Decreased peripheral blood pressure is a therapeutic response (side effect) of the
anticonvulsant magnesium sulfate.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
2. Which clinical intervention is the only known cure for preeclampsia?
a.
Magnesium sulfate
b.
Delivery of the fetus
c.
Antihypertensive medications
d.
Administration of aspirin (ASA) every day of the pregnancy - ANSWER: ANS: B
Delivery of the infant is the only known intervention to halt the progression of preeclampsia.
Magnesium sulfate is one of the medications used to treat but not cure preeclampsia.
Antihypertensive medications are used to lower the dangerously elevated blood pressures in
preeclampsia and eclampsia. Low doses of aspirin (81 mg/day) have been administered to women at
high risk for developing preeclampsia. This intervention appears to have little benefit.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
3. The clinic nurse is performing a prenatal assessment on a pregnant patient at risk for preeclampsia.
Which clinical sign would not present as a symptom of preeclampsia?
a.
Edema
b.
Proteinuria
c.
Glucosuria
d.
Hypertension - ANSWER: ANS: C
Glucose into the urine is not one of the three classic symptoms of preeclampsia. The first sign noted
by the pregnant patient is rapid weight gain and edema of the hands and face. Proteinuria usually
develops later than the edema and hypertension. The first indication of preeclampsia is usually an
increase in the maternal blood pressure.
,DIF: Cognitive Level: Application OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
4. Which intrapartal assessment should be avoided when caring for a patient with HELLP syndrome?
a.
Abdominal palpation
b.
Venous sample of blood
c.
Checking deep tendon reflexes
d.
Auscultation of the heart and lungs - ANSWER: ANS: A
Palpation of the abdomen and liver could result in a sudden increase in intraabdominal pressure,
leading to rupture of the subcapsular hematoma. Assessment of heart and lungs is performed on
every patient. Checking reflexes is not contraindicated. Venous blood is checked frequently to
observe for thrombocytopenia.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
5. A nurse is explaining to the nursing students working on the antepartum unit how to assess for
edema. Which edema assessment score indicates edema of the lower extremities, face, hands, and
sacral area?
a.
+1
b.
+2
c.
+3
d.
+4 - ANSWER: ANS: C
Edema of the extremities, face, and sacral area is classified as +3 edema. Edema classified as +1
indicates minimal edema of the lower extremities. Marked edema of the lower extremities is +2
edema. Generalized massive edema (+4) includes the accumulation of fluid in the peritoneal cavity.
DIF: Cognitive Level: Application OBJ: Nursing Process Step: Implementation
MSC: Patient Needs: Physiologic Integrity
6. Which maternal condition always necessitates delivery by cesarean birth?
a.
Partial abruptio placentae
b.
Total placenta previa
c.
Ectopic pregnancy
d.
Eclampsia - ANSWER: ANS: B
In total placenta previa, the placenta completely covers the cervical os. The fetus would die if a
vaginal birth occurred. If the patient has stable vital signs and the fetus is alive, a vaginal birth can be
attempted. If the fetus has already expired, a vaginal birth is preferred. The most common ectopic
pregnancy is a tubal pregnancy, which is usually detected and treated in the first trimester. Labor can
be safely induced if the eclampsia is under control.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
7. Spontaneous termination of a pregnancy is considered to be an abortion if
a.
the pregnancy is less than 20 weeks.
b.
, the fetus weighs less than 1000 g.
c.
the products of conception are passed intact.
d.
there is no evidence of intrauterine infection. - ANSWER: ANS: A
An abortion is the termination of pregnancy before the age of viability (20 weeks). The weight of the
fetus is not considered because some fetuses of an older age may have a low birth weight. A
spontaneous abortion may be complete or incomplete. A spontaneous abortion may be caused by
many problems, one being intrauterine infection.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Health Promotion and Maintenance
8. An abortion when the fetus dies but is retained in the uterus is called
a.
inevitable.
b.
missed.
c.
incomplete.
d.
threatened - ANSWER: ANS: B
A missed abortion refers to a dead fetus being retained in the uterus. An inevitable abortion means
that the cervix is dilating with the contractions. An incomplete abortion means that not all the
products of conception were expelled. With a threatened abortion, the patient has cramping and
bleeding but not cervical dilation.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
9. A placenta previa when the placental edge just reaches the internal os is called
a.
total.
b.
partial.
c.
low-lying.
d.
marginal. - ANSWER: ANS: D
A placenta previa that does not cover any part of the cervix is termed marginal. With a total placenta
previa, the placenta completely covers the os. With a partial previa, the lower border of the placenta
is within 3 cm of the internal cervical os but does not completely cover the os. A complete previa is
termed total. The placenta completely covers the internal cervical os.
DIF: Cognitive Level: Understanding OBJ: Nursing Process Step: Assessment
MSC: Patient Needs: Physiologic Integrity
10. Which finding would indicate concealed hemorrhage in abruptio placentae?
a.
Bradycardia
b.
Hard boardlike abdomen
c.
Decrease in fundal height
d.
Decrease in abdominal pain - ANSWER: ANS: B
Concealed hemorrhage occurs when the edges of the placenta do not separate. The formation of a
hematoma behind the placenta and subsequent infiltration of the blood into the uterine muscle
results in a very firm, boardlike abdomen. The patient will have shock symptoms that include
