A client at 8-weeks gestation presents to the office with a report of vaginal bleeding for the last 12 hours without cramping. Which action should the practical nurse (PN) take?
Check serum human chorionic gonadotropin.
Verify the date of the last menstrual cycle.
Repeat a urine pregnancy test.
Inquire about the last occurrence of intercourse.
The Correct Answer is A
The first action the PN should take is to check the client's serum human chorionic gonadotropin (hCG) level. This hormone is produced by the placenta and can provide important information about the viability of the pregnancy.
Option B, verifying the date of the last menstrual cycle, can provide useful information about the gestational age of the pregnancy but is not the first priority.
Option C, repeating a urine pregnancy test, can confirm the presence of a pregnancy but does not provide information about its viability.
Option D, inquiring about the last occurrence of intercourse, is not relevant to addressing the client's immediate concern of vaginal bleeding.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The practical nurse (PN) should first massage the fundus and expel retained lochia and clots to help the uterus contract and prevent postpartum hemorrhage.
Taking the vital signs and opening the IV infusion rate of oxytocin (A) may be necessary but not as urgent as massaging the fundus.
Notifying the registered nurse (RN) that the client's bladder is distended (B) is not relevant to addressing the client's boggy and displaced fundus.
Putting the infant to breast to suckle and stimulate oxytocin secretion (C) is a valid intervention, but it is not the first priority when the client's fundus becomes boggy and displaced above the umbilicus.


Correct Answer is A
Explanation
The screening test that should be scheduled for a client who is gravida 4 para 3 at 16-weeks gestation is **Maternal serum alpha-feto protein (MSAFP)**. Second trimester prenatal screening may include several blood tests, called multiple markers. These markers provide information about a woman's risk of having a baby with certain genetic conditions or birth defects. Screening is usually done by taking a sample of the mother's blood between the 15th and 20th weeks of pregnancy (16th to 18th is ideal)².

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