Chapter 25: Pregnancy-Related Complications
Test Bank
MULTIPLE CHOICE
1. The perinatal nurse is giving discharge instructions to a woman, status post suction and
curettage secondary to a hydatidiform mole. The woman asks why she must take oral
contraceptives for the next 12 months. The best response from the nurse is
a. “If you get pregnant within 1 year, the chance of a successful pregnancy is very
small. Therefore, if you desire a future 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 measuring the same hormone that your body produces during
pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer
more difficult.”
c. “If you can avoid a pregnancy for the next year, the chance of developing a second
molar pregnancy is rare. Therefore, to improve your chance of a successful
pregnancy, it is better not to get pregnant at this time.”
d. “Oral contraceptives are the only form of birth control that will prevent a
recurrence of a molar pregnancy.”
ANS: B
Feedback
A Women should be instructed to use birth control for 1 year after treatment for a
hydatidiform mole. Pregnancy raises hCG levels which increases the risk for
choriocarcinoma.
B This is an accurate statement. Beta-hCG levels will be drawn for 1 year to ensure
that the mole is completely gone. There is an increased chance of developing
choriocarcinoma after the development of a hydatidiform mole. The goal is to
achieve a “zero” hCG level. If the woman were to become pregnant, it may
obscure the presence of the potentially carcinogenic cells.
C The rationale for avoiding pregnancy for 1 year is to ensure that carcinogenic
cells are not present.
D Any contraceptive method except an IUD is acceptable.
PTS: 1 DIF: Cognitive Level: Application REF: p. 582
OBJ: Nursing Process: Planning and Implementation
MSC: Client Needs: Physiologic Integrity
2. Which maternal condition always necessitates delivery by cesarean section?
a. Partial abruptio placentae
b. Total placenta previa
c. Ectopic pregnancy
d. Eclampsia
ANS: B
, Feedback
A If the mother has stable vital signs and the fetus is alive, a vaginal delivery can
be attempted. If the fetus has died, a vaginal delivery is preferred.
B In total placenta previa, the placenta completely covers the cervical os. The fetus
would die if a vaginal delivery occurred.
C The most common ectopic pregnancy is a tubal pregnancy, which is usually
detected and treated in the first trimester.
D Labor can be safely induced if the eclampsia is under control.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 583, 585
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. 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. No evidence exists of intrauterine infection.
ANS: A
Feedback
A An abortion is the termination of pregnancy before the age of viability (20
weeks).
B The weight of the fetus is not considered because some fetuses of an older age
may have a low birth weight.
C A spontaneous abortion may be complete or incomplete.
D A spontaneous abortion may be caused by many problems, one being
intrauterine infection.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 576
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
4. An abortion in which the fetus dies but is retained in the uterus is called abortion.
a. Inevitable
b. Missed
c. Incomplete
d. Threatened
ANS: B
Feedback
A An inevitable abortion means that the cervix is dilating with the contractions.
B Missed abortion refers to a dead fetus being retained in the uterus.
C An incomplete abortion means that not all of the products of conception were
expelled.
D With a threatened abortion the woman has cramping and bleeding but not
cervical dilation.
, PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 578
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
5. A placenta previa in which the placental edge just reaches the internal os is called
a. Total
b. Partial
c. Complete
d. Marginal
ANS: D
Feedback
A With a total placenta previa the placenta completely covers the os.
B 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.
C A complete previa is termed total. The placenta completely covers the internal
cervical os.
D A placenta previa that does not cover any part of the cervix is termed marginal.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 583
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. What condition indicates concealed hemorrhage in an abruptio placentae?
a. Decrease in abdominal pain
b. Bradycardia
c. Hard, boardlike abdomen
d. Decrease in fundal height
ANS: C
Feedback
A Abdominal pain may increase.
B The patient will have shock symptoms that include tachycardia.
C 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.
D The fundal height will increase as bleeding occurs.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 586
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
7. The priority nursing intervention when admitting a pregnant woman who has experienced
a bleeding episode in late pregnancy is to
a. Assess fetal heart rate (FHR) and maternal vital signs.
b. Perform a venipuncture for hemoglobin and hematocrit levels.
c. Place clean disposable pads to collect any drainage.
d. Monitor uterine contractions.
ANS: A
Test Bank
MULTIPLE CHOICE
1. The perinatal nurse is giving discharge instructions to a woman, status post suction and
curettage secondary to a hydatidiform mole. The woman asks why she must take oral
contraceptives for the next 12 months. The best response from the nurse is
a. “If you get pregnant within 1 year, the chance of a successful pregnancy is very
small. Therefore, if you desire a future 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 measuring the same hormone that your body produces during
pregnancy. If you were to get pregnant, it would make the diagnosis of this cancer
more difficult.”
c. “If you can avoid a pregnancy for the next year, the chance of developing a second
molar pregnancy is rare. Therefore, to improve your chance of a successful
pregnancy, it is better not to get pregnant at this time.”
d. “Oral contraceptives are the only form of birth control that will prevent a
recurrence of a molar pregnancy.”
ANS: B
Feedback
A Women should be instructed to use birth control for 1 year after treatment for a
hydatidiform mole. Pregnancy raises hCG levels which increases the risk for
choriocarcinoma.
B This is an accurate statement. Beta-hCG levels will be drawn for 1 year to ensure
that the mole is completely gone. There is an increased chance of developing
choriocarcinoma after the development of a hydatidiform mole. The goal is to
achieve a “zero” hCG level. If the woman were to become pregnant, it may
obscure the presence of the potentially carcinogenic cells.
C The rationale for avoiding pregnancy for 1 year is to ensure that carcinogenic
cells are not present.
D Any contraceptive method except an IUD is acceptable.
PTS: 1 DIF: Cognitive Level: Application REF: p. 582
OBJ: Nursing Process: Planning and Implementation
MSC: Client Needs: Physiologic Integrity
2. Which maternal condition always necessitates delivery by cesarean section?
a. Partial abruptio placentae
b. Total placenta previa
c. Ectopic pregnancy
d. Eclampsia
ANS: B
, Feedback
A If the mother has stable vital signs and the fetus is alive, a vaginal delivery can
be attempted. If the fetus has died, a vaginal delivery is preferred.
B In total placenta previa, the placenta completely covers the cervical os. The fetus
would die if a vaginal delivery occurred.
C The most common ectopic pregnancy is a tubal pregnancy, which is usually
detected and treated in the first trimester.
D Labor can be safely induced if the eclampsia is under control.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 583, 585
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. 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. No evidence exists of intrauterine infection.
ANS: A
Feedback
A An abortion is the termination of pregnancy before the age of viability (20
weeks).
B The weight of the fetus is not considered because some fetuses of an older age
may have a low birth weight.
C A spontaneous abortion may be complete or incomplete.
D A spontaneous abortion may be caused by many problems, one being
intrauterine infection.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 576
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
4. An abortion in which the fetus dies but is retained in the uterus is called abortion.
a. Inevitable
b. Missed
c. Incomplete
d. Threatened
ANS: B
Feedback
A An inevitable abortion means that the cervix is dilating with the contractions.
B Missed abortion refers to a dead fetus being retained in the uterus.
C An incomplete abortion means that not all of the products of conception were
expelled.
D With a threatened abortion the woman has cramping and bleeding but not
cervical dilation.
, PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 578
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
5. A placenta previa in which the placental edge just reaches the internal os is called
a. Total
b. Partial
c. Complete
d. Marginal
ANS: D
Feedback
A With a total placenta previa the placenta completely covers the os.
B 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.
C A complete previa is termed total. The placenta completely covers the internal
cervical os.
D A placenta previa that does not cover any part of the cervix is termed marginal.
PTS: 1 DIF: Cognitive Level: Knowledge REF: p. 583
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. What condition indicates concealed hemorrhage in an abruptio placentae?
a. Decrease in abdominal pain
b. Bradycardia
c. Hard, boardlike abdomen
d. Decrease in fundal height
ANS: C
Feedback
A Abdominal pain may increase.
B The patient will have shock symptoms that include tachycardia.
C 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.
D The fundal height will increase as bleeding occurs.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 586
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
7. The priority nursing intervention when admitting a pregnant woman who has experienced
a bleeding episode in late pregnancy is to
a. Assess fetal heart rate (FHR) and maternal vital signs.
b. Perform a venipuncture for hemoglobin and hematocrit levels.
c. Place clean disposable pads to collect any drainage.
d. Monitor uterine contractions.
ANS: A
