Maternity Newborn and Women’s Health Nursing A Case-Based Approach 1st Edition O’Meara Test Bank ALL CHAPTERS

Maternity Newborn and Women’s Health Nursing A Case-Based Approach 1st Edition
O’Meara Test Bank
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 be reported.
c. The client will need to make arrangements for care at home, because her activity level will be restricted.
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?
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, then 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, 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 pregnancy.
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
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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