A nurse at an antepartum clinic is caring for a client who is at 4 months of gestation. The client reports continued nausea, vomiting; and scant, prune-colored discharge. The client has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect?

Hyperemesis gravidarum

Preterm labor

Hydatidiform mole

Threatened abortion

Answer and Explanation

The Correct Answer is C

A. Hyperemesis gravidarum: Hyperemesis gravidarum is severe nausea and vomiting that leads to dehydration, electrolyte imbalances, and weight loss. However, this client has not experienced weight loss, and the prune-colored discharge is not a sign of this condition.

B. Preterm labor: Preterm labor typically involves contractions and cervical dilation. At 4 months, preterm labor is not likely, and the prune-colored discharge and larger-than-expected fundal height are not signs of preterm labor.

C. Hydatidiform mole: A hydatidiform mole (molar pregnancy) is characterized by abnormal placental development, leading to larger-than-expected fundal height, continued nausea and vomiting, and prune-colored vaginal discharge due to bleeding from the uterus. These findings align with the client's symptoms.

D. Threatened abortion: A threatened abortion involves vaginal bleeding in early pregnancy without the expulsion of the fetus. This condition is typically associated with cramping and a smaller fundal height, which is not seen in this case.

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Correct Answer is A

Explanation

A. "A client should avoid consuming undercooked meat while pregnant." Toxoplasmosis, one of the TORCH infections, can be contracted by eating undercooked or raw meat. Avoiding undercooked meat helps prevent this infection, which can cause severe complications for the fetus.

B. "Obtain an immunization against rubella early in pregnancy." Rubella vaccine (part of MMR) is a live virus vaccine and is contraindicated during pregnancy due to the risk of harm to the fetus. Rubella vaccination should be administered before conception or postpartum.

C. "Seek prophylactic treatment if cytomegalovirus is detected during pregnancy." Currently, there is no prophylactic treatment for cytomegalovirus (CMV) during pregnancy. Prevention focuses on hygiene practices, such as frequent handwashing, especially after handling bodily fluids, to reduce the risk of transmission.

D. "A client should avoid crowded places during pregnancy." While avoiding crowded places may reduce exposure to certain infections, it is not a specific strategy for preventing TORCH infections. Other preventative measures, like avoiding raw meat and practicing good hygiene, are more effective.

A. Quickening B. Chloasma C. Lightening D. Ballottement

Correct Answer is A

Explanation

A. Quickening: Quickening refers to the first movements of the fetus felt by the mother, which often feels like fluttering or light movements. It typically occurs between 16 and 20 weeks of gestation.

B. Chloasma: Chloasma refers to the darkened patches of skin that can appear on the face during pregnancy, also known as the "mask of pregnancy."

C. Lightening: Lightening refers to the descent of the fetus into the pelvis in preparation for birth, which usually occurs in the third trimester, not at 18 weeks of gestation.

D. Ballottement: Ballottement is a technique used during a pelvic examination where the examiner taps on the cervix and feels the fetus bounce back. It is a clinical sign rather than something the mother feels.

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Naxlex Comprehensive Predictor Exams

A nurse is assisting the nurse manager with an educational session about ways to prevent TORCH infection during pregnancy with a group of newly licensed nurses. Which of the following statements by one of the session participants indicates understanding?

Correct Answer is A

Explanation

A nurse is collecting data from a client who is at 18 weeks of gestation and tells the nurse that she felt light fluttering in her stomach the previous day. The nurse should use which of the following terms to document this finding?

Correct Answer is A

Explanation

A nurse is caring for a client in the prenatal clinic who has a possible ectopic pregnancy at 8 weeks of gestation. Which of the following findings should the nurse expect?

A nurse is caring for a client who is at 34 weeks of gestation and has a suspected placenta previa. Which of the following actions should the nurse take?

A nurse is reinforcing teaching with a newly licensed nurse about the purpose of an indirect Coombs test. Which of the following statements should the nurse include in the teaching?

A nurse is reinforcing teaching with a client who is at 17 weeks of gestation and is scheduled to have a maternal serum alpha-fetoprotein (MSAFP) determination. Which of the following information should the nurse include?

A nurse is caring for a client who tells the nurse that she thinks she might be pregnant because she is able to feel the baby move. Which of the following statements should the nurse make?

A nurse is reinforcing teaching with a client who is pregnant and has a new prescription for ferrous sulfate due to iron-deficiency anemia. The nurse should instruct the client to take this medication with which of the following?

A nurse is reinforcing teaching with a client who is at 30 weeks of gestation and scheduled for a nonstress test (NST). Which of the following statements by the client indicates a need for further teaching?