Exam (elaborations)
Maternity Newborn and Women’s Health Nursing A Case-Based Approach 1st Edition O’Meara Test Bank
Maternity Newborn and Women’s Health Nursing A Case-Based Approach 1st Edition O’Meara Test Bank
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, Maternity iNewborn iand iWomen’s iHealth iNursing iA iCase-Based iApproach i1st iEditionO’Meara iTest iBank
Chapter i1 iImmediate iPostpartum iHemorrhage
MULTIPLE iCHOICE
1. A ipregnant iwoman iis ibeing idischarged ifrom ithe ihospital iafter ithe iplacement iof ia
i
cervical icerclage ibecause iof ia ihistory iof irecurrent ipregnancy iloss, isecondary ito ian
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incompetent icervix.iWhich iinformation iregarding ipostprocedural icare ishould ithe inurse
i
emphasize iin ithe idischargeiteaching?
a. Any ivaginal idischarge ishould ibe iimmediately ireported ito iher ihealth icare iprovider.
b. The ipresence iof iany icontractions, irupture iof imembranes i(ROM), ior isevere iperineal ipressure
i
should
c. The iclient iwill ineed ito imake iarrangements ifor icare iat ihome, ibecause iher iactivity ilevel iwill ibe
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restri
d. The iclient iwill ibe ischeduled ifor ia icesarean
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birth.iANS: iB
Nursing icare ishould istress ithe iimportance iof imonitoring ifor ithe isigns iand isymptoms iof ipreterm
labor. iVaginal ibleeding ineeds ito ibe ireported ito iher iprimary ihealth icare iprovider. iBed irest iis
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an ielement iof icare. iHowever, ithe iwoman imay istand ifor iperiods iof iup ito i90 iminutes, iwhich
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allows iher ithe ifreedom ito isee iher iphysician. iHome iuterine iactivity imonitoring imay ibe iused
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to ilimit ithe iwomans ineed ifor ivisits iand ito imonitor iher istatus isafely iat ihome. iThe icerclage ican
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be iremoved iati37 iweeks iof igestation i(to iprepare ifor ia ivaginal ibirth), ior ia icesarean ibirth ican ibe
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planned.
DIF: iCognitive iLevel: iApply iREF: idm. i675
TOP: iNursing iProcess: iPlanning i| iNursing iProcess:
i
ImplementationiMSC: iClient iNeeds: iHealth iPromotion iand
i
Maintenance
2. A iperinatal inurse iis igiving idischarge iinstructions ito ia iwoman, istatus ipostsuction, iand
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curettageisecondary ito ia ihydatidiform imole. iThe iwoman iasks iwhy ishe imust itake ioral
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contraceptives ifor ithe inext i12 imonths. iWhat iis ithe ibestresponse iby ithe inurse?
If iyou iget ipregnant iwithin i1 iyear, ithe ichance iof ia isuccessful ipregnancy iis ivery ismall. iTherefo
i
if
a. pregnancy, iit iwould ibe ibetter ifor iyou ito iuse ithe imost ireliable imethod iof icontraception iavailab
The imajor irisk ito iyou iafter ia imolar ipregnancy iis ia itype iof icancer ithat ican ibe idiagnosed ionly i
i
me
hormone ithat iyour ibody iproduces iduring ipregnancy. iIf iyou iwere ito iget ipregnant, ithen iit iwould
i
mak
b. this icancer imore idifficult.
If iyou ican iavoid ia ipregnancy ifor ithe inext iyear, ithe ichance iof ideveloping ia isecond imolar
i
pregnancy
c. improve iyour ichance iof ia isuccessful ipregnancy, inot igetting ipregnant iat ithis itime iis ibest.
d. Oral icontraceptives iare ithe ionly iform iof ibirth icontrol ithat iwill iprevent ia irecurrence iof ia imola
i
pregiANS: iB
Betahuman ichorionic igonadotropin i(beta-hCG) ihormone ilevels iare idrawn ifor i1 iyear ito iensure
that ithe imole iis icompletely igone. iThe ichance iof ideveloping ichoriocarcinoma iafter ithe
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development iof ia ihydatidiform imole iis iincreased. iTherefore, ithe igoal iis ito iachieve ia izero
,i
human ichorionic igonadotropin i(hCG) ilevel. iIf ithe iwoman iwere ito ibecome ipregnant, ithen iit
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may iobscureithe ipresence iof ithe ipotentially icarcinogenic icells. iWomen ishould ibe iinstructed ito
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use ibirth icontrol ifor i1 iyear iafter itreatment ifor ia ihydatidiform imole. iThe irationale ifor iavoiding
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pregnancy
, for i1 iyear iis ito iensure ithat icarcinogenic icells iare inot ipresent. iAny icontraceptive imethod
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exceptian iintrauterine idevice i(IUD) iis iacceptable.
DIF: iCognitive iLevel: iApply iREF: idm. i679
TOP: iNursing iProcess: iPlanning i| iNursing iProcess:
i
ImplementationiMSC: iClient iNeeds: iPhysiologic iIntegrity
3. The inurse iis ipreparing ito iadminister imethotrexate ito ithe iclient. iThis ihazardous
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drugiis imost ioften iused ifor iwhich iobstetric icomplication?
a. Complete ihydatidiform imole
b. Missed iabortion
c. Unruptured iectopic ipregnancy
d. Abruptio
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placentaeANS: iC
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Methotrexate iis ian ieffective inonsurgical itreatment ioption ifor ia ihemodynamically istable iwoman
whose iectopic ipregnancy iis iunruptured iand imeasures iless ithan i4 icm iin idiameter. iMethotrexate
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isinot iindicated ior irecommended ias ia itreatment ioption ifor ia icomplete ihydatidiform imole, ifor ia
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missed iabortion, ior ifor iabruptio iplacentae.
DIF: iCognitive iLevel: iApply iREF: idm. i677 iTOP: iNursing iProcess:
i
PlanningiMSC: iClient iNeeds: iPhysiologic iIntegrity
4. A i26-year-old ipregnant iwoman, igravida i2, ipara i1-0-0-1, iis i28 iweeks ipregnant iwhen ishe
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experiences ibright ired, ipainless ivaginal ibleeding. iOn iher iarrival iat ithe ihospital, iwhich
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diagnosticiprocedure iwill ithe iclient imost ilikely ihave iperformed?
a. Amniocentesis ifor ifetal ilung imaturity
b. Transvaginal iultrasound ifor iplacental ilocation
c. Contraction istress itest i(CST)
d. Internal ifetal
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monitoringiANS: iB
The ipresence iof ipainless ibleeding ishould ialways ialert ithe ihealth icare iteam ito ithe ipossibility iof
placenta iprevia, iwhich ican ibe iconfirmed ithrough iultrasonography. iAmniocentesis iis inot
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performed ion ia iwoman iwho iis iexperiencing ibleeding. iIn ithe ievent iof ian iimminent idelivery,
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the ifetus iis ipresumed ito ihave iimmature ilungs iat ithis igestational iage, iand ithe imother iis igiven
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corticosteroids ito iaid iin ifetal ilung imaturity. iA iCST iis inot iperformed iat ia ipreterm igestational
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age.iFurthermore, ibleeding iis ia icontraindication ito ia iCST. iInternal ifetal imonitoring iis ialso
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contraindicated iin ithe ipresence iof ibleeding.
DIF: iCognitive iLevel: iApply iREF: idm. i680
TOP: iNursing iProcess: iAssessment iMSC: iClient iNeeds: iHealth iPromotion iand iMaintenance
5. A ilaboring iwoman iwith ino iknown irisk ifactors isuddenly iexperiences ispontaneous iROM.
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The ifluid iconsists iof ibright ired iblood. iHer icontractions iare iconsistent iwith iher icurrent istage
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of ilabor.iNo ichange iin iuterine iresting itone ihas ioccurred. iThe ifetal iheart irate i(FHR) ibegins ito
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decline irapidly iafter ithe iROM. iThe inurse ishould isuspect ithe ipossibility iof iwhat icondition?
a. Placenta iprevia
b. Vasa iprevia
c. Severe iabruptio iplacentae
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