Maternity, Newborn, and Women's Health Nursing: A Case-Based
Approach First Edition
by Dr. Amy O'Meara
, MATERNITY NEWBORN AND WOMEN’S HEALTH NURSING A CASE-BASED
APPROACH 1ST EDITION
O’MEARA
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 Postprocedural 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
c. The Client Will Need To Make Arrangements For Care At Home, Because Her Activity Level W
Be Restri
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 Bestresponse By The Nurse?
If You Get Pregnant Within 1 Year, The Chance Of A Successful Pregnancy Is Very Small.
Therefore, If
a. Pregnancy, It Would Be Better For You To Use The Most Reliable Method Of Contraception
Available.
, 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 Mak
b. This Cancer More Difficult.
If You Can Avoid A Pregnancy For The Next Year, The Chance Of Developing A Second Mola
Pregnancy
c. 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 Preg 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
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
