, Maternity3fNewborn3fand3fWomen’s3fHealth3fNursing3fA3fCase-
Based3fApproach3f1st3fEdition3fO’Meara3fTest3fBank
Chapter3f13fImmediate3fPostpartum3fHemorrhage
MULTIPLE3fCHOICE
1. A3fpregnant3fwoman3fis3fbeing3fdischarged3ffrom3fthe3fhospital3fafter3fthe3fplacement3fof3fa3fce
rvical3fcerclage3fbecause3fof3fa3fhistory3fof3frecurrent3fpregnancy3floss,3fsecondary3fto3fan3fin
competent3fcervix.Which3finformation3fregarding3fpostprocedural3fcare3fshould3fthe3fnurse3fe
mphasize3fin3fthe3fdischargeteaching?
a. Anyvaginal3fdischarge3fshould3fbe3fimmediately3freported3fto3fher3fhealth3fcare3fprovider.
b. The3fpresence3fof3fany3fcontractions,3frupture3fof3fmembranes3f(ROM),3for severe3fperineal3fpressure3fsh
q,
ld
c. The3fclient3fwill3fneed3fto3fmake3farrangements3ffor3fcare3fat3fhome,3fbecause her3factivity3flevel3fwill3fbe3fr
q,
ri
d. The3fclient3fwill3fbe3fscheduled3ffor3fa3fcesar
ean3fbirth.ANS:3fB
q,
Nursing3fcare3fshould3fstress3fthe3fimportance3fof3fmonitoring3ffor3fthe3fsigns3fand3fsymptoms3fof3fpreterm
labor.3fVaginal3fbleeding3fneeds3fto3fbe3freported3fto3fher3fprimary3fhealth care3fprovider.3fBed3frest3fis3
q,
fan3felement3fof3fcare.3fHowever,3fthe3fwoman3fmay3fstand3ffor3fperiods3fof3fup3fto3f903fminutes,3fwhich3fal
lows3fher3fthe3ffreedom3fto3fsee3fher3fphysician.3fHome3futerine3factivity monitoring3fmay3fbe3fused3ft
q,
o3flimit3fthe3fwomans3fneed3ffor3fvisits3fand3fto3fmonitor3fher3fstatus3fsafely at home.3fThe3fcerclage3fcan3fb
q, q,
e3fremoved3fat3 7 3fweeks3fof3fgestation3f(to3fprepare3ffor3fa3fvaginal3fbirth), or a cesarean3fbirth3fcan3fbe
q, q, q, q,
3fplanned.
DIF:3fCognitive3fLevel:3fApply3fREF:3fdm.3f675
TOP:3fNursing3fProcess:3fPlanning3f|3fNursing3fProcess:
ImplementationMSC:3fClient3fNeeds:3fHealth3fPromotion3fand3fMainten
ance
2. A3fperinatal3fnurse3fis3fgiving3fdischarge instructions3fto3fa3fwoman,3fstatus3fpostsuction,3
q,
fand3fcurettages econdary 3fto3fa3fhydatidiform mole.3fThe3fwoman3fasks3fwhy3fshe3fmust
,
q q,
3ftake3foral3fcontraceptives3ffor3fthe3fnext3f123fmonths.3fWhat3fis3fthe3fbestresponse3fbyt
he3fnurse?
If3fyou3fget3fpregnant within3f13fyear,3fthe3fchance3fof3fa3fsuccessful3fpregnancy3fis3fvery3fsmall.3fTherefor
q,
f
a. pregnancy, it would3fbe3fbetter3ffor3fyou3fto3fuse3fthe3fmost3freliable3fmethod3fof3fcontraception3favailable
q, q,
The major3frisk3fto3fyou3fafter3fa3fmolar3fpregnancy3fis3fa3ftype3fof3fcancer3fthat3fcan3fbe3fdiagnosed3fonly
q,
y3fme3fhormone that3fyour3fbodyproduces3fduring3fpregnancy.3fIf3fyou3fwere3fto3fget3fpregnant,3fthen3fit3fw
q,
uld3fmak
b. this3fcancer3fmore3fdifficult.
If you3fcan3favoid3fa3fpregnancy3ffor3fthe3fnext3fyear,3fthe3fchance3fof3fdeveloping3fa3fsecond3fmolar3fpregn
q,
y
c. improve3fyour3fchance3fof3fa3fsuccessful3fpregnancy,3fnot3fgetting3fpregnant3fat3fthis3ftime3fis3fbest.
d. Oral3fcontraceptives3fare3fthe3fonly3fform3fof3fbirth3fcontrol3fthat3fwill3fprevent3fa3frecurrence3fof3fa3
fmolar3fpregA NS: 3fB
q,
Betahuman3fchorionic3fgonadotropin3f(beta-hCG)3fhormone3flevels3fare3fdrawn3ffor3f13fyear3fto3fensure
that3fthe3fmole3fis3fcompletely3fgone.3fThe3fchance3fof3fdeveloping3fchoriocarcinoma3fafter3fthe3fdevelo
pment3fof3fa3fhydatidiform3fmole3fis3fincreased.3fTherefore,3fthe3fgoal3fis3fto3fachieve3fa3fzero3fhuman3f
,chorionic3fgonadotropin3f(hCG)3flevel.3fIf3fthe3fwoman3fwere3fto3fbecome3fpregnant,3fthen3fit3fmay3fobsc
urethe3fpresence3fof3fthe3fpotentially3fcarcinogenic3fcells.3fWomen3fshould3fbe3finstructed3fto3fuse3fbir
q,
th3fcontrol3ffor3f13fyear3fafter3ftreatment3ffor3fa3fhydatidiform3fmole.3fThe3frationale3ffor3favoiding3fpr
egnancy
, for3f13fyear3fis3fto3fensure3fthat3fcarcinogenic3fcells3fare3fnot3fpresent.3fAny3fcontraceptive3fmethod3fexcep
tan3fintrauterine3fdevice3f(IUD)3fis3facceptable.
q,
DIF:3fCognitive3fLevel:3fApply3fREF:3fdm.3f679
TOP:3fNursing3fProcess:3fPlanning3f|3fNursing3fProcess:
ImplementationMSC:3fClient3fNeeds:3fPhysiologic3fIntegrity
3. The3fnurse3fis3fpreparing3fto3fadminister3fmethotrexate3fto3fthe3fclient.3fThis3fhazardous3fdrugisq,
most3foften3fused3ffor3fwhich3fobstetric3fcomplication?
a. Complete3fhydatidiform3fmole
b. Missed3fabortion
c. Unruptured3fectopic3fpregnancy
d. Abruptio
3fplacentaeANS: 3fC q,
Methotrexate3fis3fan3feffective3fnonsurgical3ftreatment3foption3ffor3fa3fhemodynamically stable3fwoman
q,
whose3fectopic3fpregnancy3fis3funruptured3fand3fmeasures3fless3fthan3f43fcm3fin3fdiameter.3fMethotrexate3f
isn ot 3findicated3for3frecommended3fas3fa3ftreatment3foption3ffor3fa3fcomplete3fhydatidiform3fmole,3ffo
q,
r3fa3fmissed3fabortion,3for3ffor3fabruptio3fplacentae.
DIF:3fCognitive3fLevel:3fApply3fREF:3fdm.3f6773fTOP:3fNursing3fProcess:
PlanningMSC:3fClient3fNeeds:3fPhysiologic3fIntegrity
q,
4. A3f26-year-old3fpregnant3fwoman,3fgravida3f2,3fpara3f1-0-0-
1, is 283fweeks3fpregnant3fwhen3fshe3fexperiences3fbright3fred,3fpainless3fvaginal3fbleeding.3
q, q,
fOn her arrival3fat3fthe3fhospital,3fwhich3fdiagnosticp rocedure 3fwill3fthe3fclient3fmost3flikel
q, q, q,
y3fhave3fperformed?
a. Amniocentesis3ffor3ffetal3flung3fmaturity
b. Transvaginal3fultrasound3ffor3fplacental3flocation
c. Contraction3fstress3ftest3f(CST)
d. Internal3ffeta
l3fmonitoringANS:3fB ,
q
The3fpresence3fof3fpainless3fbleeding should3falways3falert3fthe3fhealth3fcare3fteam3fto3fthe3fpossibility3fof
q,
placenta3fprevia,3fwhich3fcan be3fconfirmed3fthrough3fultrasonography.3fAmniocentesis3fis3fnot3fperfor
q,
med3fon3fa3fwoman3fwho3fis3fexperiencing3fbleeding.3fIn3fthe3fevent3fof3fan3fimminent3fdelivery,3fthe3ff
etus3fis3fpresumed3fto3fhave immature3flungs3fat3fthis3fgestational3fage,3fand3fthe3fmother3fis3fgiven3fcorti
q,
costeroids3fto3faid3fin3ffetal3flung maturity.3fA3fCST3fis3fnot3fperformed3fat3fa3fpreterm3fgestational3fag
q,
e.Furthermore,3fbleeding3fis3fa contraindication3fto3fa3fCST.3fInternal3ffetal3fmonitoring3fis3falso3fcont
q,
raindicated3fin3fthe3fpresence3fof bleeding. q,
DIF:3fCognitive3fLevel:3fApply3fREF:3fdm.3f680
TOP:3fNursing3fProcess:3fAssessment3fMSC:3fClient3fNeeds:3fHealth3fPromotion3fand3fMaintenance
5. A3flaboring3fwoman3fwith3fno3fknown3frisk3ffactors3fsuddenly3fexperiences3fspontaneous3fROM
.3fThe3ffluid3fconsists3fof3fbright3fred3fblood.3fHer3fcontractions3fare3fconsistent3fwith3fher3fcurrent3f
stage3fof3flabor.No3fchange3fin3futerine3fresting3ftone3fhas3foccurred.3fThe3ffetal3fheart3frate3f(FHR)3fb
,
q
egins3fto3fdecline3frapidly3fafter3fthe3fROM.3fThe3fnurse3fshould3fsuspect3fthe3fpossibility3fof3fwhat3
fcondition?
a. Placenta3fprevia
b. Vasa3fprevia
c. Severe3fabruptio3fplacentae
Based3fApproach3f1st3fEdition3fO’Meara3fTest3fBank
Chapter3f13fImmediate3fPostpartum3fHemorrhage
MULTIPLE3fCHOICE
1. A3fpregnant3fwoman3fis3fbeing3fdischarged3ffrom3fthe3fhospital3fafter3fthe3fplacement3fof3fa3fce
rvical3fcerclage3fbecause3fof3fa3fhistory3fof3frecurrent3fpregnancy3floss,3fsecondary3fto3fan3fin
competent3fcervix.Which3finformation3fregarding3fpostprocedural3fcare3fshould3fthe3fnurse3fe
mphasize3fin3fthe3fdischargeteaching?
a. Anyvaginal3fdischarge3fshould3fbe3fimmediately3freported3fto3fher3fhealth3fcare3fprovider.
b. The3fpresence3fof3fany3fcontractions,3frupture3fof3fmembranes3f(ROM),3for severe3fperineal3fpressure3fsh
q,
ld
c. The3fclient3fwill3fneed3fto3fmake3farrangements3ffor3fcare3fat3fhome,3fbecause her3factivity3flevel3fwill3fbe3fr
q,
ri
d. The3fclient3fwill3fbe3fscheduled3ffor3fa3fcesar
ean3fbirth.ANS:3fB
q,
Nursing3fcare3fshould3fstress3fthe3fimportance3fof3fmonitoring3ffor3fthe3fsigns3fand3fsymptoms3fof3fpreterm
labor.3fVaginal3fbleeding3fneeds3fto3fbe3freported3fto3fher3fprimary3fhealth care3fprovider.3fBed3frest3fis3
q,
fan3felement3fof3fcare.3fHowever,3fthe3fwoman3fmay3fstand3ffor3fperiods3fof3fup3fto3f903fminutes,3fwhich3fal
lows3fher3fthe3ffreedom3fto3fsee3fher3fphysician.3fHome3futerine3factivity monitoring3fmay3fbe3fused3ft
q,
o3flimit3fthe3fwomans3fneed3ffor3fvisits3fand3fto3fmonitor3fher3fstatus3fsafely at home.3fThe3fcerclage3fcan3fb
q, q,
e3fremoved3fat3 7 3fweeks3fof3fgestation3f(to3fprepare3ffor3fa3fvaginal3fbirth), or a cesarean3fbirth3fcan3fbe
q, q, q, q,
3fplanned.
DIF:3fCognitive3fLevel:3fApply3fREF:3fdm.3f675
TOP:3fNursing3fProcess:3fPlanning3f|3fNursing3fProcess:
ImplementationMSC:3fClient3fNeeds:3fHealth3fPromotion3fand3fMainten
ance
2. A3fperinatal3fnurse3fis3fgiving3fdischarge instructions3fto3fa3fwoman,3fstatus3fpostsuction,3
q,
fand3fcurettages econdary 3fto3fa3fhydatidiform mole.3fThe3fwoman3fasks3fwhy3fshe3fmust
,
q q,
3ftake3foral3fcontraceptives3ffor3fthe3fnext3f123fmonths.3fWhat3fis3fthe3fbestresponse3fbyt
he3fnurse?
If3fyou3fget3fpregnant within3f13fyear,3fthe3fchance3fof3fa3fsuccessful3fpregnancy3fis3fvery3fsmall.3fTherefor
q,
f
a. pregnancy, it would3fbe3fbetter3ffor3fyou3fto3fuse3fthe3fmost3freliable3fmethod3fof3fcontraception3favailable
q, q,
The major3frisk3fto3fyou3fafter3fa3fmolar3fpregnancy3fis3fa3ftype3fof3fcancer3fthat3fcan3fbe3fdiagnosed3fonly
q,
y3fme3fhormone that3fyour3fbodyproduces3fduring3fpregnancy.3fIf3fyou3fwere3fto3fget3fpregnant,3fthen3fit3fw
q,
uld3fmak
b. this3fcancer3fmore3fdifficult.
If you3fcan3favoid3fa3fpregnancy3ffor3fthe3fnext3fyear,3fthe3fchance3fof3fdeveloping3fa3fsecond3fmolar3fpregn
q,
y
c. improve3fyour3fchance3fof3fa3fsuccessful3fpregnancy,3fnot3fgetting3fpregnant3fat3fthis3ftime3fis3fbest.
d. Oral3fcontraceptives3fare3fthe3fonly3fform3fof3fbirth3fcontrol3fthat3fwill3fprevent3fa3frecurrence3fof3fa3
fmolar3fpregA NS: 3fB
q,
Betahuman3fchorionic3fgonadotropin3f(beta-hCG)3fhormone3flevels3fare3fdrawn3ffor3f13fyear3fto3fensure
that3fthe3fmole3fis3fcompletely3fgone.3fThe3fchance3fof3fdeveloping3fchoriocarcinoma3fafter3fthe3fdevelo
pment3fof3fa3fhydatidiform3fmole3fis3fincreased.3fTherefore,3fthe3fgoal3fis3fto3fachieve3fa3fzero3fhuman3f
,chorionic3fgonadotropin3f(hCG)3flevel.3fIf3fthe3fwoman3fwere3fto3fbecome3fpregnant,3fthen3fit3fmay3fobsc
urethe3fpresence3fof3fthe3fpotentially3fcarcinogenic3fcells.3fWomen3fshould3fbe3finstructed3fto3fuse3fbir
q,
th3fcontrol3ffor3f13fyear3fafter3ftreatment3ffor3fa3fhydatidiform3fmole.3fThe3frationale3ffor3favoiding3fpr
egnancy
, for3f13fyear3fis3fto3fensure3fthat3fcarcinogenic3fcells3fare3fnot3fpresent.3fAny3fcontraceptive3fmethod3fexcep
tan3fintrauterine3fdevice3f(IUD)3fis3facceptable.
q,
DIF:3fCognitive3fLevel:3fApply3fREF:3fdm.3f679
TOP:3fNursing3fProcess:3fPlanning3f|3fNursing3fProcess:
ImplementationMSC:3fClient3fNeeds:3fPhysiologic3fIntegrity
3. The3fnurse3fis3fpreparing3fto3fadminister3fmethotrexate3fto3fthe3fclient.3fThis3fhazardous3fdrugisq,
most3foften3fused3ffor3fwhich3fobstetric3fcomplication?
a. Complete3fhydatidiform3fmole
b. Missed3fabortion
c. Unruptured3fectopic3fpregnancy
d. Abruptio
3fplacentaeANS: 3fC q,
Methotrexate3fis3fan3feffective3fnonsurgical3ftreatment3foption3ffor3fa3fhemodynamically stable3fwoman
q,
whose3fectopic3fpregnancy3fis3funruptured3fand3fmeasures3fless3fthan3f43fcm3fin3fdiameter.3fMethotrexate3f
isn ot 3findicated3for3frecommended3fas3fa3ftreatment3foption3ffor3fa3fcomplete3fhydatidiform3fmole,3ffo
q,
r3fa3fmissed3fabortion,3for3ffor3fabruptio3fplacentae.
DIF:3fCognitive3fLevel:3fApply3fREF:3fdm.3f6773fTOP:3fNursing3fProcess:
PlanningMSC:3fClient3fNeeds:3fPhysiologic3fIntegrity
q,
4. A3f26-year-old3fpregnant3fwoman,3fgravida3f2,3fpara3f1-0-0-
1, is 283fweeks3fpregnant3fwhen3fshe3fexperiences3fbright3fred,3fpainless3fvaginal3fbleeding.3
q, q,
fOn her arrival3fat3fthe3fhospital,3fwhich3fdiagnosticp rocedure 3fwill3fthe3fclient3fmost3flikel
q, q, q,
y3fhave3fperformed?
a. Amniocentesis3ffor3ffetal3flung3fmaturity
b. Transvaginal3fultrasound3ffor3fplacental3flocation
c. Contraction3fstress3ftest3f(CST)
d. Internal3ffeta
l3fmonitoringANS:3fB ,
q
The3fpresence3fof3fpainless3fbleeding should3falways3falert3fthe3fhealth3fcare3fteam3fto3fthe3fpossibility3fof
q,
placenta3fprevia,3fwhich3fcan be3fconfirmed3fthrough3fultrasonography.3fAmniocentesis3fis3fnot3fperfor
q,
med3fon3fa3fwoman3fwho3fis3fexperiencing3fbleeding.3fIn3fthe3fevent3fof3fan3fimminent3fdelivery,3fthe3ff
etus3fis3fpresumed3fto3fhave immature3flungs3fat3fthis3fgestational3fage,3fand3fthe3fmother3fis3fgiven3fcorti
q,
costeroids3fto3faid3fin3ffetal3flung maturity.3fA3fCST3fis3fnot3fperformed3fat3fa3fpreterm3fgestational3fag
q,
e.Furthermore,3fbleeding3fis3fa contraindication3fto3fa3fCST.3fInternal3ffetal3fmonitoring3fis3falso3fcont
q,
raindicated3fin3fthe3fpresence3fof bleeding. q,
DIF:3fCognitive3fLevel:3fApply3fREF:3fdm.3f680
TOP:3fNursing3fProcess:3fAssessment3fMSC:3fClient3fNeeds:3fHealth3fPromotion3fand3fMaintenance
5. A3flaboring3fwoman3fwith3fno3fknown3frisk3ffactors3fsuddenly3fexperiences3fspontaneous3fROM
.3fThe3ffluid3fconsists3fof3fbright3fred3fblood.3fHer3fcontractions3fare3fconsistent3fwith3fher3fcurrent3f
stage3fof3flabor.No3fchange3fin3futerine3fresting3ftone3fhas3foccurred.3fThe3ffetal3fheart3frate3f(FHR)3fb
,
q
egins3fto3fdecline3frapidly3fafter3fthe3fROM.3fThe3fnurse3fshould3fsuspect3fthe3fpossibility3fof3fwhat3
fcondition?
a. Placenta3fprevia
b. Vasa3fprevia
c. Severe3fabruptio3fplacentae
