Exam (elaborations)
Test Bank for Maternity Newborn and Women’s Health Nursing: A Case-Based Approach 2nd Edition O’Meara
Test Bank for Maternity Newborn and Women’s Health Nursing: A Case-Based Approach 2nd Edition O’Meara
[Show more]
Connected book
Book Title:
Author(s):
- Edition:
- ISBN:
- Edition:
Seller
Follow
Content preview
, MaternityNewbornandWomen’sHealthNursingACase-BasedApproach1stEdition O’Mearab b b b b b b b b
Test Bank b b
Chapter1 Immediate Postpartum Hemorrhage
b b b b
MULTIPLE CHOICE b
1. A pregnant woman is being discharged from thehospital after the placement of a cervical
b b b b b b b b b b b b b b
cerclagebecauseofahistoryofrecurrentpregnancyloss, secondarytoanincompetentcervix.
b b b b
Whichinformationregardingpostproceduralcareshould thenurseemphasizein thedischarge
b v v b
bteaching?
a. Anyvaginaldischarge shouldbe immediately reported toherhealthcare provider. b b b b b
b. Thepresenceofany contractions,ruptureofmembranes (ROM), orsevere perineal pressureshouldb b b b b b b b b b
c. Theclientwill need tomake arrangements forcare at home, because heractivitylevel will be restri
b b b b b b b b b b b
d. Theclientwillbescheduledforacesareanbirth.
bANS:B b
Nursing careshouldstresstheimportance ofmonitoring forthe signsandsymptoms ofpreterm
b b b b b
labor. Vaginal bleeding needs to be reported to her primary health careprovider. Bed rest is an elementof
b b b b b b b b b b b b b b b b b
care.However,thewomanmaystandforperiodsofupto90minutes,whichallowsherthe freedom to see
b b b b b b b b b b b b b b b b b b b
her physician. Home uterine activitymonitoring may be used to limit the womans
b b b b b b b b b b b b
bneedforvisitsandtomonitorherstatussafely at home. Thecerclage can beremoved at 37 weeks of b b b b b b b b b
bgestation (topreparefor a vaginal birth), or a cesarean birth can be planned.
b b b b b b b b b b b
DIF: Cognitive Level: Apply REF: dm.675
b b b b b b
TOP:Nursing Process:Planning|NursingProcess:Implementation
v
b MSC: Client Needs: Health Promotionand Maintenance
b b b b b
2. Aperinatalnurseisgivingdischargeinstructionstoawoman,statuspostsuction,andcurettage b b
bsecondarytoahydatidiformmole.Thewomanaskswhyshemusttakeoralcontraceptivesfor the
b b b b b b b b b b b b b
bnext 12 months. Whatis the bestresponse by the nurse?
b b b b b b b b
Ifyou get pregnant within1 year,thechanceofasuccessful pregnancy isverysmall. Therefore, if
b b b b b b b b b b b b b
a. pregnancy, it wouldbebetter foryouto usethemost reliablemethod ofcontraception available. b b b b b b b
The major risk to youaftera molar pregnancy isa type ofcancer that can be diagnosed onlyby me hormo
b b b b b b b b b b b b b b b b
that yourbodyproduces during pregnancy. If youweretoget pregnant, then itwouldmak
b b b b b b b b b
b. thiscancermoredifficult.b b b
Ifyou can avoid apregnancy forthenext year, the chance ofdeveloping asecond molar pregnancy
b b b b b b b b b b b b
c. improveyour chance ofa successful pregnancy, notgettingpregnant at this time isbest. b b b b b b b b b b
d. Oralcontraceptivesaretheonlyformofbirthcontrolthatwillpreventarecurrence ofamolarpreg AN b b
B
Betahumanchorionicgonadotropin (beta-hCG)hormonelevels aredrawnfor1yeartoensure
b b b b b b b b b
that the moleis completely gone. The chance of developing choriocarcinoma after the development of a
b b b b b b b b b b b b b b
bhydatidiformmole is increased. Therefore, the goal is toachieve a zero human chorionic b b b b b b b b b b b
bgonadotropin(hCG)level. Ifthe womanweretobecomepregnant, thenitmayobscure the presence of b b b b b b
bthe potentially carcinogenic cells. Women should beinstructed to use birth control for 1 year after
b b b b b b b b b b b b b b
btreatment fora hydatidiform mole. The rationale foravoiding pregnancy
b b b b b b b
,for1 yearistoensurethatcarcinogeniccellsarenotpresent.Anycontraceptivemethodexcept an
b b b
bintrauterine device (IUD) is acceptable. b b b b
DIF: Cognitive Level: Apply REF: dm.679
b b b b b b
TOP:Nursing Process:Planning|NursingProcess:Implementation v b
bMSC: Client Needs: Physiologic Integrity
b b b b
3. Thenurseispreparingtoadministermethotrexatetotheclient. Thishazardousdrug is b b b
most often used forwhichobstetric complication?
b b b b
a. Completehydatidiformmole
b. Missedabortion
c. Unrupturedectopic pregnancy b
d. Abruptio placentae v
ANS:C
b b
Methotrexateis an effective nonsurgicaltreatmentoptionforahemodynamically stable woman b b b b b
whoseectopicpregnancy is unrupturedand measures less than 4 cmin diameter. Methotrexateis not b b v b b b b
indicated or recommended as a treatment optionfora complete hydatidiform mole, fora missed
b b b b b b b b b b b b
abortion, or forabruptio placentae.
b b b b
DIF:CognitiveLevel:ApplyREF:dm.677TOP:NursingProcess:Planning MSC:
b b b b b b b b b b b
Client Needs: Physiologic Integrity
b b b b
4. A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnantwhen she
b b b b b b b b b b b b
experiences bright red, painlessvaginalbleeding. On herarrival at thehospital, whichdiagnostic
b v b b b b b b
procedurewill the client most likely have performed?
b b b b b b b
a. Amniocentesis forfetallung maturity b b
b. Transvaginal ultrasound forplacental location b b b
c. Contractionstress test (CST) b b
d. Internalfetalmonitoring
ANS:B
b b
The presence of painlessbleeding shouldalways alert thehealthcareteamto the possibility of
b b b b b b b b b
placenta previa, which can be confirmed through ultrasonography. Amniocentesis is not performed on
b b b b b b b b b b b b
awomanwhoisexperiencingbleeding.Intheeventofanimminentdelivery,thefetusispresumed to have
b b b b b b b b b b b b b b b b b b
immature lungs at this gestational age, and the mother is given corticosteroidstoaidinfetal
b b b b b b b b b b b b
lungmaturity. ACSTisnotperformed at a pretermgestational age. Furthermore, bleeding is a
b b v v b b b b b b
contraindication to a CST. Internal fetal monitoringis also contraindicated in the presence of bleeding.
b b b b b b b b b b b b b b
DIF: Cognitive Level: Apply REF: dm.680
b b b b b b
TOP:NursingProcess:AssessmentMSC:ClientNeeds:HealthPromotionandMaintenance
b b b b b b b b b
5. A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The
b b b b b b b b b b b b
fluid consists ofbrightred blood.Hercontractionsareconsistentwithhercurrentstageoflabor. No
b v b b
bchangeinuterinerestingtonehas occurred. Thefetal heart rate(FHR)begins todeclinerapidly after the
b b b b b b b b b b b b b b b b b
ROM. The nurseshould suspect the possibility of what condition?
b b b b b b b b b
a. Placenta previa b
b. Vasaprevia b
c. Severeabruptio placentae b
, d. Disseminated intravascularcoagulation(DIC) v
ANS:B
b b
Vasa previais theresult ofa velamentous insertionoftheumbilical cord.The umbilical vessels
b b b b b b b b b
arenotsurroundedbyWhartonjellyandhavenosupportivetissue.Theumbilicalbloodvesselsthus are
b b b b b b b b b b b b b b b
at risk forlaceration at anytime, butlacerationoccursmostfrequentlyduring ROM. The sudden
b v b b b b b b b
appearance of bright red blood at thetime of ROM and a sudden change in the FHR without other
b b b b b b b b b b b b b b b b v b
knownriskfactorsshouldimmediatelyalertthenursetothepossibilityofvasaprevia.Thepresence of
b b b b b b b b b b b b b b b
placenta previa most likely wouldbe ascertained before labor and is considered a risk factor for this
b b b b b b b b b b b b b b b b b
pregnancy. In addition, if the woman had aplacenta previa, it is unlikely that she would be allowed to
b b b b b b b b b b b b b b b b b b
pursuelabor and a vaginal birth. Withthepresence of severeabruptioplacentae, the
b b b b b b b b b
uterinetonicitytypically is tetanus(i.e., aboardlikeuterus). DICis a pathologic form of diffuse
b b b b b b b b b b
clotting that consumes large amounts of clotting factors, causing widespread external bleeding,
b b b b b b b b b b b b
internalbleeding,orboth.DICisalwaysasecondarydiagnosis,oftenassociatedwithobstetricrisk
b b b b b b b b b b b b b b b
factors such as the hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP)
b b b b b b b b b b b b b b
syndrome. This womandid not have any prior risk factors.
b b b b b b b b b
DIF:CognitiveLevel:AnalyzeREF:dm.684TOP:NursingProcess:Diagnosis MSC:
b b b b b b b b b b b
Client Needs: Physiologic Integrity
b b b b
6. Awomanarrivesforevaluationofsignsandsymptomsthatincludeamissedperiod,adnexal b
b fullness, tenderness, and dark red vaginal bleeding. On examination, the nursenotices an
b b b b b b b b b b b
becchymotic blueness around the womans umbilicus. What does thisfindingindicate?
b b b b b b b b
a. Normal integumentary changes associated withpregnancy b b b b
b. Turnersign associated with appendicitis b b b b
c. Cullensignassociated with aruptured ectopic pregnancy b b b b
d. Chadwicksignassociated withearlypregnancy v
ANS:C
b b
Cullensign, theblueecchymosis observed intheumbilical area, indicates hematoperitoneum
b b b b b b
associatedwithanundiagnosedrupturedintraabdominalectopicpregnancy.Lineanigraonthe
b b b b b b b b b b b
babdomenisthenormalintegumentary changeassociated with pregnancy and exhibits abrown
b b b b b b b b b b b b
bpigmented,verticallineonthelowerabdomen. Turnersign isecchymosis intheflank area,often
b b v b
b associatedwithpancreatitis.AChadwicksignisablue-purplecervixthatmaybeseenduringor around
b b b b b b b b b b b b b b b
the eighth week ofpregnancy.
b b b b
DIF: Cognitive Level: AnalyzeREF: dm. 676
b b b b b b
TOP:Nursing Process: Assessment MSC:Client Needs: Physiologic Integrity
b b b b b b b b
7. The nursewho elects to practice in the area of womens health must have a thorough
b b b b b b b b b b b b b b
bunderstandingofmiscarriage. Whichstatement regarding thiscondition ismostaccurate? b v v b
a. Amiscarriage is anaturalpregnancy loss beforelabor begins. b b b b b
b. Itoccursinfewer than5%ofall clinically recognized pregnancies.
b b b b b b b b
c. Careless maternal behavior,such as poornutritionorexcessiveexercise, can beafactorincausing Ifa
b b b b b b b b b b b b b b b b b
miscarriageoccursbeforethe 12thweekofpregnancy, thenitmaybeobserved only as modera
b b b v b b
d. bloodloss. b
ANS: D b
Beforethesixthweek,theonlyevidencemightbeaheavymenstrualflow.Afterthe12thweek,more
b b b b b b b b b b b b b b b b
severepain, similartothatoflabor, islikely. Miscarriageisanaturalpregnancyloss, butit
b b b b b
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Lectdavian. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
52355 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now