A client at 28 weeks of gestation presents with bleeding from the vagina.

Which assessment finding should the nurse prioritize?

Regular uterine contractions occurring every 15 minutes

Low back pain and pelvic pressure

Change in vaginal discharge

Rupture of membranes

Answer and Explanation

The Correct Answer is A

Regular uterine contractions occurring every 15 minutes.

This finding suggests that the client may have placental abruption, which is a serious complication that requires immediate medical attention. Placental abruption is the premature separation of the placenta from the uterine wall, which can cause heavy bleeding, pain, and fetal distress.

Choice B is wrong because low back pain and pelvic pressure are common symptoms of preterm labor, which is not as urgent as placental abruption.

Choice C is wrong because a change in vaginal discharge is not a specific sign of any complication and may be normal in pregnancy.

Choice D is wrong because rupture of membranes is not a priority finding in this case, unless it is associated with infection or cord prolapse.

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Correct Answer is C

Explanation

Indomethacin is contraindicated for this client because it is a nonsteroidal anti-inflammatory drug (NSAID) that can irritate or inflame the lining of the stomach and small intestine.This can worsen the client’s peptic ulcer disease, which is a condition where open sores develop on the inner surface of the stomach or small intestine due to acid erosion.

Indomethacin can also interact with other medications that the client may be taking for pre-term labor or peptic ulcer disease.

Choice A is wrong because magnesium sulfate is not contraindicated for this client.It is a medication that can relax the smooth muscles of the uterus and prevent pre-term labor contractions.

Choice B is wrong because betamethasone is not contraindicated for this client.It is a corticosteroid that can help mature the fetal lungs and reduce the risk of respiratory distress syndrome in pre-term infants.

Choice D is wrong because terbutaline is not contraindicated for this client.

A. “This medication will help prevent seizures in case I develop preeclampsia.” B. “This medication will help mature my baby’s lungs in case he is born early.” C. “This medication will help relax my uterus and stop contractions.” D. “This medication will help lower my blood pressure in case it gets too high.”

Correct Answer is C

Explanation

This medication will help relax my uterus and stop contractions.

Magnesium sulfate is a tocolytic, a medication used to suppress uterine contractions and delay preterm delivery.The exact mechanism through which magnesium sulfate inhibits contractions is unknown, but researchers believe it likely works by lowering calcium levels in the uterine muscles.

Choice A is wrong because magnesium sulfate is not used to prevent seizures in case of preeclampsia.

Preeclampsia is a condition characterized by high blood pressure and protein in the urine during pregnancy.Magnesium sulfate may be used to treat seizures if they occur with eclampsia, which is a severe complication of preeclampsia.

Choice B is wrong because magnesium sulfate does not help mature the baby’s lungs in case of preterm birth.

Magnesium sulfate may have some neuroprotective effects for the baby, but it does not affect lung development.Steroids are usually given to pregnant women at risk of preterm delivery to help accelerate fetal lung maturation.

Choice D is wrong because magnesium sulfate does not lower blood pressure in case it gets too high.

Magnesium sulfate may have some vasodilatory effects, but it is not used as an antihypertensive agent.Other medications, such as hydralazine or labetalol, are used to treat high blood pressure during pregnancy.

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A client at 28 weeks of gestation presents with bleeding from the vagina. Which assessment finding should the nurse prioritize?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medication history of a client who is in pre-term labor and has a history of peptic ulcer disease. The nurse should recognize that which of the following medications is contraindicated for this client?

Correct Answer is C

Explanation

A nurse is teaching a client who is at 25 weeks of gestation and has pre-term labor about the purpose and side effects of magnesium sulfate therapy. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is C

Explanation

A nurse is admitting a client who is at 30 weeks of gestation and has pre-term labor. Which of the following medications should the nurse anticipate administering to prevent fetal respiratory distress syndrome?

A nurse is evaluating a client who is at 28 weeks of gestation and has pre-term labor. Which of the following findings indicates that the client’s condition is improving?

A nurse is educating a client who is at risk for pre-term labor about measures to prevent it from occurring. Which of the following instructions should the nurse include?

A client in pre-term labor is being discharged from the hospital. What should the nurse include in the client's discharge plan?

A nurse is reviewing the laboratory results of a client who is at 29 weeks of gestation and has pre-term labor. Which of the following results indicates an infection that can trigger pre-term labor?

A nurse is providing discharge instructions to a client who had pre-term labor at 32 weeks of gestation and was prescribed bed rest at home. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is caring for a client who is at 33 weeks of gestation and has pre-term labor. The client reports a sudden gush of fluid from her vagina. Which of the following actions should the nurse take first?

A client at 28 weeks of gestation presents with bleeding from the vagina.

Which assessment finding should the nurse prioritize?