A client in her third trimester reports abdominal pain. She is restless and has a small amount of dark red vaginal bleeding. Which actions should the nurse implement first?

Obtain a urine specimen and determine blood type.

Palpate the fundus and check the fetal heart rate.

Complete a vaginal exam and test for ruptured membranes.

Start IV fluid bolus and obtain a complete blood count.

Answer and Explanation

The Correct Answer is B

Rationale:

A. Obtain a urine specimen and determine blood type: While obtaining a urine specimen and knowing the blood type are important for baseline assessment, these actions do not immediately address the acute maternal and fetal risks associated with third-trimester bleeding.

B. Palpate the fundus and check the fetal heart rate: Assessing the uterine fundus and fetal heart rate is the highest priority because it provides critical information about maternal bleeding, uterine tone, and fetal well-being. These assessments help determine if the client is experiencing placental abruption or another emergent complication.

C. Complete a vaginal exam and test for ruptured membranes: A vaginal exam is contraindicated in cases of unknown third-trimester bleeding until placental location is confirmed, as it may worsen bleeding.

D. Start IV fluid bolus and obtain a complete blood count: Administering IV fluids and obtaining labs are necessary for stabilizing the client and assessing blood loss, but these interventions follow immediate assessment of maternal and fetal status.

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Correct Answer is A

Explanation

Rationale:

A. Ultrasound: Ultrasound provides the most accurate assessment of fetal position at 29 weeks, as it allows visualization of the fetus, placenta, and amniotic fluid. It is especially useful when Leopold’s maneuvers are inconclusive due to maternal obesity, uterine shape, or fetal movement.

B. Doppler: Doppler is primarily used to assess fetal heart rate and blood flow, not the position of the fetus. While it can confirm fetal presence, it does not provide reliable information about orientation or lie.

C. Leopold’s maneuvers: Leopold’s maneuvers can help estimate fetal position through abdominal palpation. However, at 29 weeks, the fetus is still relatively small and mobile, making this method less precise than ultrasound.

D. Vaginal examination: Vaginal examination can detect fetal presentation only when the fetus is low in the pelvis, usually near labor. At 29 weeks, the fetus is typically high in the uterus, so a vaginal exam would not accurately determine fetal position.

A. Does the toddler experience choking or gagging after eating? B. Has the toddler been treated for these symptoms before? C. Does the toddler follow a strict daily routine? D. Does the toddler attend daycare? E. Does the toddler eat table food? F. Does smoking occur in the home?

Correct Answer is ["A","B","D","F"]

Explanation

Rationale:

A. Does the toddler experience choking or gagging after eating?: Asking about choking or gagging helps identify possible swallowing difficulties or risk of aspiration, which may complicate upper respiratory infections.

B. Has the toddler been treated for these symptoms before?: Knowing prior treatments or recurrent infections provides context for chronicity, helps identify resistant infections, and guides current care decisions.

C. Does the toddler follow a strict daily routine?: While routines affect behavior and sleep, this information is not directly relevant to assessing the current respiratory illness or risk factors.

D. Does the toddler attend daycare?: Attendance at daycare increases exposure to infectious agents and helps evaluate risk for contagious illness or recurrent upper respiratory infections.

E. Does the toddler eat table food?: Diet details are not immediately relevant to the acute assessment of respiratory symptoms and infection risk.

F. Does smoking occur in the home?: Exposure to secondhand smoke increases the risk of respiratory infections and may exacerbate symptoms, making it an important factor in assessment.

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A client in her third trimester reports abdominal pain. She is restless and has a small amount of dark red vaginal bleeding. Which actions should the nurse implement first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a client at 29-weeks gestation. Which assessment method would provide the most accurate determination of fetal position?

Correct Answer is A

Explanation

Patient Data Exhibits The healthcare provider initiates prescriptions. Select the additional 4 questions the nurse should include in the assessment.

Correct Answer is ["A","B","D","F"]

Explanation

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