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Test Bank for Maternity Newborn and Women’s Health Nursing: A Case-Based Approach 2nd Edition O’Meara

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Maternity Newborn And Women’s Health Nursing

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Maternity Newborn And Women’s Health Nursing

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womens
test bank for maternity newborn and womens health
test bank
test bank for maternity newborn and womens health
based approach 2nd edition omeara
test bank for maternity newborn and womens health

Institution Maternity Newborn And Women’s Health Nursing
Course Maternity Newborn And Women’s Health Nursing

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, MaternityNewbornandWomen’sHealthNursingACase-BasedApproach1stEditionO’Meara b b b b b b b b b

TestBank b b

Chapter1ImmediatePostpartumHemorrhage b b b b

MULTIPLECHOICE b

1. Apregnantwomanisbeingdischargedfromthehospitalaftertheplacementofacervical
b b b b b b b b b b b b b b

cerclage becauseofa history ofrecurrent pregnancy loss,secondarytoanincompetent cervix.
b b b b v

Which informationregardingpostprocedural careshould thenurseemphasizein thedischarg
b v v

e teaching?
b

a. Anyvaginaldischarge shouldbeimmediately reported toherhealthcareprovider. b b b b b

b. Thepresenceofanycontractions,ruptureofmembranes(ROM),orsevereperinealpressureshould b b b b b b b b b b

c. Theclientwillneedtomakearrangementsforcareathome,becauseheractivitylevelwillberestri b b b b b b b b b b b

d. Theclientwillbescheduledforacesareanbirth.
bANS:B b

Nursing careshouldstress theimportance ofmonitoring forthe signsandsymptoms ofpreterm
b b b b b b

labor. Vaginal bleeding needs to be reported to her primary health careprovider. Bed rest is an
b b b b b b b b b b b b b b b

belementofcare.However,thewomanmaystandforperiodsofupto90minutes,whichallowsherthe
b b b b b b b b b b b b b b b b b

freedom to see her physician. Home uterine activitymonitoring may be used to limit the womans
b b b b b b b b b b b b b b b

needforvisitsandtomonitorherstatussafely at home. Thecerclage can beremoved at 37 weeks of
b b b b b b b b b b

bgestation(toprepareforavaginalbirth),oracesareanbirthcanbeplanned.
b b b b b b b b b b b

DIF:CognitiveLevel:ApplyREF:dm.675
b b b b b b

TOP:Nursing Process:Planning|NursingProcess: Implementation v

bMSC:ClientNeeds:HealthPromotionandMaintenance
b b b b b

2. Aperinatalnurseisgivingdischargeinstructionstoawoman, statuspostsuction, andcurettage b b

bsecondarytoahydatidiformmole.Thewomanaskswhyshemusttakeoralcontraceptivesfor thenext
b b b b b b b b b b b b bb b

12months.Whatisthebestresponsebythenurse?
b b b b b b b b

Ifyougetpregnantwithin1year,thechanceofasuccessfulpregnancyisverysmall.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

Themajorrisktoyouafteramolarpregnancyisatypeofcancerthatcanbediagnosedonlybyme hormone
b b b b b b b b b b b b b b b b

that yourbodyproduces during pregnancy. If youweretoget pregnant, thenitwouldmak
b b b b b b b b b

b. thiscancermoredifficult.b b b

Ifyoucanavoidapregnancyforthenextyear,thechanceofdevelopingasecondmolarpregnancy
b b b b b b b b b b b b

c. improveyourchanceofasuccessfulpregnancy,notgettingpregnantatthistimeisbest. b b b b b b b b b b

d. Oralcontraceptivesaretheonlyformofbirthcontrolthatwillpreventarecurrence ofamolarpreg ANS: bb b bb b

B
Betahumanchorionicgonadotropin(beta-hCG)hormonelevelsaredrawnfor1yeartoensure b b b b b b b b b

thatthemoleiscompletelygone.Thechanceofdevelopingchoriocarcinomaafterthedevelopment 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

thepotentiallycarcinogeniccells.Womenshouldbeinstructedtousebirthcontrolfor1yearafter
b b b b b b b b b b b b b b b

btreatmentforahydatidiformmole.Therationaleforavoidingpregnancy b b b b b b b

,for1 yearistoensurethatcarcinogeniccellsarenotpresent. Anycontraceptivemethodexcept an
b b b

intrauterinedevice(IUD)isacceptable.
b b b b b

DIF:CognitiveLevel:ApplyREF:dm.679
b b b b b b

TOP:Nursing Process:Planning|NursingProcess:Implementation v b

bMSC:ClientNeeds:PhysiologicIntegrity
b b b b

3. Thenurseispreparingtoadministermethotrexatetotheclient. Thishazardousdrug is b b

mostoftenusedforwhichobstetriccomplication?
b b b b

a. Completehydatidiformmole
b. Missedabortion
c. Unrupturedectopicpregnancy b

d. Abruptioplacentae v

ANS:C
b b

Methotrexateis aneffective nonsurgicaltreatmentoptionforahemodynamically stable woman b b b b b

whoseectopic pregnancyisunrupturedand measures less than 4cmindiameter.Methotrexate isnot 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,orforabruptioplacentae.
b b b b

DIF:CognitiveLevel:ApplyREF:dm.677TOP:NursingProcess:PlanningMSC:Client
b b b b b b b b b b b b

Needs:PhysiologicIntegrity
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,painless vaginal bleeding.Onher arrivalatthehospital,whichdiagnostic
b v b b b b b b

procedurewilltheclientmostlikelyhaveperformed?
b b b b b b b

a. Amniocentesisforfetallungmaturity b b

b. Transvaginalultrasoundforplacentallocation b b b

c. Contractionstresstest(CST) b b

d. Internalfetalmonitoring
ANS:B
b b

Thepresenceofpainlessbleedingshouldalwaysalertthehealthcareteamtothepossibilityof
b b b b b b b b b

placentaprevia,whichcanbeconfirmedthroughultrasonography.Amniocentesisisnotperformed ona
b b b b b b b b b b b b b

womanwhoisexperiencingbleeding.Intheeventofanimminentdelivery,thefetusispresumedtohave
b b b b b b b b b b b b b b b b b

immaturelungsatthisgestationalage,andthemotherisgivencorticosteroidstoaidinfetal lung maturity.
b b b b b b b b b b b b b

A CST is not performed at apreterm gestationalage.Furthermore,bleedingisa contraindication to a
b v v b b b b b b b b b

CST. Internal fetal monitoringis also contraindicated in the presence of bleeding.
b b b b b b b b b b b

DIF:CognitiveLevel:ApplyREF: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 ofbright red blood.Her contractions areconsistent with hercurrent stageoflabor.No
b v b b

changeinuterinerestingtonehasoccurred.Thefetalheartrate(FHR)beginstodeclinerapidlyafterthe
b b b b b b b b b b b b b b b b b b

ROM.Thenurseshouldsuspectthepossibilityofwhatcondition?
b b b b b b b b b

a. Placentaprevia b

b. Vasaprevia b

c. Severeabruptioplacentae b

, d. Disseminated intravascularcoagulation(DIC) v

ANS:B
b b

Vasapreviaistheresultofavelamentousinsertionoftheumbilicalcord.Theumbilicalvessels
b b b b b b b b b

arenotsurroundedbyWhartonjellyandhavenosupportivetissue.Theumbilicalbloodvesselsthusare
b b b b b b b b b b b b b b b

at riskforlacerationatany time,but laceration occurs most frequently duringROM.Thesudden
b v b b b b b b b

appearanceofbrightredbloodatthe timeofROMandasuddenchangeintheFHR withoutother known
b b b b b b b b b b b b b b b b v b b

riskfactorsshouldimmediatelyalertthenursetothepossibilityofvasaprevia.Thepresenceofplacenta
b b b b b b b b b b b b b b b

previamostlikelywouldbeascertainedbeforelaborandisconsideredariskfactorfor this pregnancy. In
b b b b b b b b b b b b b b b b b b

addition, if the woman had aplacenta previa, it is unlikely that she would be allowed to pursuelabor
b b b b b b b b b b b b b b b b b

and a vaginal birth. Withthepresence of severeabruptioplacentae, the uterinetonicitytypically is
b b b b b b b b b b

tetanus(i.e., aboardlikeuterus). DICis a pathologic form of diffuse clotting that consumes large
b b b b b b b b b b b b

amounts of clotting factors, causing widespread external bleeding, internalbleeding,orboth.DICis
b b b b b b b b b b b b b b

alwaysasecondarydiagnosis,oftenassociatedwithobstetricrisk factors such as the hemolysis,
b b b b b b b b b b b b b b

elevated liver enzyme levels, and low platelet levels (HELLP) syndrome.Thiswomandidnothave
b b b b b b b b b b b b b b

anypriorriskfactors.
b b b b

DIF:CognitiveLevel:AnalyzeREF:dm.684TOP:NursingProcess:Diagnosis
b b b b b b b b b b

MSC:ClientNeeds:PhysiologicIntegrity
b b b b b

6. Awomanarrivesforevaluationofsignsandsymptomsthatincludeamissedperiod, adnexal b

fullness, tenderness, and dark red vaginal bleeding. On examination, the nursenotices an
b b b b b b b b b b b b

ecchymoticbluenessaroundthewomansumbilicus.Whatdoesthisfindingindicate?
b b b b b b b b b

a. Normalintegumentarychangesassociatedwithpregnancy b b b b

b. Turnersignassociatedwithappendicitis b b b b

c. Cullensignassociatedwitharupturedectopicpregnancy b b b b

d. Chadwicksignassociated withearlypregnancy v

ANS:C
b b

Cullensign,theblueecchymosisobservedintheumbilicalarea,indicateshematoperitoneum b b b b b b

associatedwithanundiagnosedrupturedintraabdominalectopicpregnancy.Lineanigraonthe
b b b b b b b b b b b

abdomenisthenormalintegumentarychangeassociatedwithpregnancyandexhibitsabrown
b b b b b b b b b b b b b

pigmented,verticallineon thelowerabdomen.Turnersign isecchymosis intheflank area,often
b b b v b

associatedwithpancreatitis.AChadwicksignisablue-purplecervixthatmaybeseenduringor
b b b b b b b b b b b b b b b

aroundtheeighthweekofpregnancy.
b b b b b

DIF:CognitiveLevel:AnalyzeREF:dm.676
b b b b b b

TOP:NursingProcess:AssessmentMSC:ClientNeeds:PhysiologicIntegrity
b b b b b b b b

7. Thenursewhoelectstopracticeintheareaofwomenshealthmusthaveathorough
b b b b b b b b b b b b b b

understandingofmiscarriage.Whichstatement regarding thiscondition ismostaccurate?
b b v v b

a. Amiscarriageisanaturalpregnancy loss beforelaborbegins. b b b b b

b. Itoccursinfewerthan5%ofallclinicallyrecognizedpregnancies.
b b b b b b b b

c. Carelessmaternalbehavior,suchaspoornutritionorexcessiveexercise,canbeafactorincausingIfa
b b b b b b b b b b b b b b b b b

miscarriageoccurs before the12th week ofpregnancy,thenit maybeobserved onlyasmodera
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

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Test Bank for Maternity Newborn and Women’s Health Nursing: A Case-Based Approach 2nd Edition O’Meara

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