A client reports an intermittent dark brown vaginal discharge for the past three days.
The nurse should assess the client for signs of molar pregnancy.
The nurse should evaluate the risk for hypovolemic shock due to blood loss.
The nurse should ensure appropriate laboratory testing for the diagnosis of choriocarcinoma.
The nurse should prioritize preparing the client for suction and curettage.
The Correct Answer is A
Choice A rationale
Molar pregnancy often manifests as intermittent dark brown vaginal discharge due to trophoblastic tissue expulsion. It warrants assessment as it correlates with hCG elevation and abnormal placental development.
Choice B rationale
Although significant blood loss could occur, dark brown discharge is not indicative of active hemorrhage. Hypovolemic shock typically results from acute red blood loss, not the chronic nature of this presentation.
Choice C rationale
Choriocarcinoma is a concern in cases following molar pregnancies, yet dark brown discharge alone does not confirm malignancy. Laboratory testing may be indicated, but it is not the immediate priority here.
Choice D rationale
Suction and curettage are treatment options for molar pregnancy but are contingent upon confirmed diagnosis. This intervention is premature without comprehensive assessment findings suggesting molar pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Intramuscular ceftriaxone is effective in preventing ophthalmia neonatorum, caused by Neisseria gonorrhoeae. This bacterial prophylaxis inhibits cell wall synthesis, reducing infection transmission from mother to newborn.
Choice B rationale
While ceftriaxone treats bacterial infections broadly, this choice lacks specificity to neonatal risk factors like gonococcal transmission. It’s insufficient for targeted preventative care against ophthalmia neonatorum.
Choice C rationale
Ceftriaxone effectively treats gonorrhea by targeting penicillin-binding proteins. However, this option overlooks preventive measures crucial for neonates, focusing instead on therapeutic intervention for active infections.
Choice D rationale
Postpartum infection prophylaxis might use ceftriaxone, but it fails to address neonatal ophthalmic concerns. The focus here is misplaced, diverging from the stated preventive objective for the newborn.
Correct Answer is C
Explanation
Choice A rationale
Bradycardia, or a heart rate below 60 beats per minute, is inconsistent with decreased cardiac output in this context. Tachycardia is a more typical compensatory response to significant blood loss postpartum.
Choice B rationale
A flushed face is not a physiological indicator of decreased cardiac output. Decreased cardiac output commonly leads to pallor and cool, clammy skin due to reduced peripheral perfusion.
Choice C rationale
Hypotension, defined as blood pressure below 90/60 mmHg, occurs due to reduced blood volume and cardiac output in excessive postpartum bleeding, impairing adequate perfusion to organs and tissues.
Choice D rationale
Polyuria, or excessive urination, does not directly indicate decreased cardiac output. Instead, oliguria or decreased urine output, often below 30 mL/hour, is a common sign of poor perfusion.
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