A client is admitted with a threatened abortion.
Which assessment findings would the nurse expect? Select all that apply.
Severe cramping and pelvic pain.
Closed cervix upon examination.
Mild to moderate lower abdominal cramping.
Passage of fetal tissue.
Bright red vaginal bleeding.
Answer and explanation
The correct answer is Choice B, Choice C, Choice E.
Choice A rationale
Severe cramping and pelvic pain are more indicative of an inevitable or incomplete abortion, where the pregnancy is no longer viable and the body is actively trying to expel the uterine contents. In a threatened abortion, the symptoms are typically milder.
Choice B rationale
A closed cervix upon examination is a key finding in a threatened abortion. It indicates that the uterus is not yet dilating or effacing, suggesting that the pregnancy might still be maintained. Cervical dilation signifies progression towards abortion.
Choice C rationale
Mild to moderate lower abdominal cramping is a common symptom of a threatened abortion. These cramps result from uterine irritability and contractions as the body reacts to potential pregnancy loss. The intensity is less severe than in later stages of abortion.
Choice D rationale
Passage of fetal tissue is a definitive sign of an incomplete or complete abortion, meaning the pregnancy has already been lost and the products of conception are being expelled. This would not be expected in a threatened abortion.
Choice E rationale
Bright red vaginal bleeding is a common symptom of a threatened abortion, indicating disruption at the decidual-trophoblastic interface. The bleeding can range from spotting to light bleeding and suggests a potential threat to the pregnancy.

Bright red vaginal bleeding.

Closed cervix upon examination.

Mild to moderate lower abdominal cramping.

Answer and Explanation

Correct Answer : B,C,E

Choice A rationale

Severe cramping and pelvic pain are more indicative of an inevitable or incomplete abortion, where the pregnancy is no longer viable and the body is actively trying to expel the uterine contents. In a threatened abortion, the symptoms are typically milder.

Choice B rationale

A closed cervix upon examination is a key finding in a threatened abortion. It indicates that the uterus is not yet dilating or effacing, suggesting that the pregnancy might still be maintained. Cervical dilation signifies progression towards abortion.

Choice C rationale

Mild to moderate lower abdominal cramping is a common symptom of a threatened abortion. These cramps result from uterine irritability and contractions as the body reacts to potential pregnancy loss. The intensity is less severe than in later stages of abortion.

Choice D rationale

Passage of fetal tissue is a definitive sign of an incomplete or complete abortion, meaning the pregnancy has already been lost and the products of conception are being expelled. This would not be expected in a threatened abortion.

Choice E rationale

Bright red vaginal bleeding is a common symptom of a threatened abortion, indicating disruption at the decidual-trophoblastic interface. The bleeding can range from spotting to light bleeding and suggests a potential threat to the pregnancy.

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Correct Answer is A

Explanation

Choice A rationale

A pre-pregnancy BMI of 23.5 falls within the normal weight range (18.5 to 24.9 kg/m²). For individuals with a normal pre-pregnancy BMI, the recommended total weight gain during pregnancy is 25 to 35 pounds (11.3 to 15.9 kg). This range supports optimal fetal growth without significantly increasing the risk of maternal or fetal complications associated with excessive weight gain.

Choice B rationale

While a gradual weight gain is generally recommended, stating "about 1 pound per week" is an oversimplification and doesn't account for the varying rates of weight gain throughout pregnancy. The rate of weight gain is typically lower in the first trimester and higher in the second and third trimesters. Focusing solely on a weekly gain might cause unnecessary anxiety if the client's weight gain fluctuates slightly.

Choice C rationale

A recommended weight gain of 15 to 25 pounds is appropriate for individuals with an overweight pre-pregnancy BMI (25 to 29.9 kg/m²), not a normal BMI. Recommending this lower range to a client with a normal BMI could lead to inadequate weight gain and potentially compromise fetal development due to insufficient nutrient supply.

Choice D rationale

A recommended weight gain of 11 to 20 pounds is typically advised for individuals with an obese pre-pregnancy BMI (30 kg/m² or higher). Suggesting this lower range to a client with a normal BMI could restrict necessary weight gain for a healthy pregnancy and fetal growth.

A. Placenta previa. B. Placental abruption. C. Postpartum hemorrhage. D. Preeclampsia.

Correct Answer is D

Explanation

Choice A rationale

Placenta previa is a condition where the placenta implants in the lower part of the uterus, potentially covering the cervix. This typically presents with painless vaginal bleeding, not the elevated blood pressure seen in this client.

Choice B rationale

Placental abruption involves the premature separation of the placenta from the uterine wall. This often manifests with sudden abdominal pain, vaginal bleeding, and uterine tenderness, which are not the primary findings in this postpartum client.

Choice C rationale

Postpartum hemorrhage is excessive bleeding after childbirth, typically defined as more than 500 mL after vaginal delivery or 1000 mL after cesarean birth. While prolonged labor can increase the risk, the client's current vital signs do not indicate active hemorrhage.

Choice D rationale

Preeclampsia can occur postpartum, characterized by new-onset hypertension (blood pressure ≥ 140/90 mmHg) and proteinuria or other signs of end-organ damage within 4 weeks after delivery. This client's blood pressure of 150/86 mmHg, coupled with a history of prolonged labor and being a primipara (both risk factors for preeclampsia), makes this the most likely condition. Normal postpartum blood pressure typically returns to the client's baseline pre-pregnancy levels.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client at the first prenatal visit who has a BMI of 23.5. The client asks how much weight she should gain during pregnancy.Which of the following responses should the nurse make?

Correct Answer is A

Explanation

Correct Answer is D

Explanation

For each medication below, click to select the appropriate nursing action. (Each category can have zero or more response options selected)

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