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.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Location of the placenta: Heavy, painless vaginal bleeding without contractions is a classic sign of placenta previa, where the placenta is abnormally positioned near or over the cervix. An ultrasound is used to determine placental location.

B. Rh incompatibility: Rh incompatibility is not associated with heavy vaginal bleeding, and ultrasound is not used to diagnose it. A blood test is required to assess Rh status.

C. Fetal lung maturity: Fetal lung maturity may be assessed in certain situations, but this is not related to the client's bleeding. The immediate concern is placental location.

D. Frequency and duration of contractions: The client has no contractions, and contractions are not the cause of heavy bleeding in this case. The priority is identifying placental issues.

A. Encourage the client to limit carbohydrate intake to 40% of their daily calories. B. Instruct the client to check a random blood glucose level once daily C. Anticipate a prescription for metformin. D. Conduct a non-stress test twice per week.

Correct Answer is ["A","C","D"]

Explanation

A. Encourage the client to limit carbohydrate intake to 40% of their daily calories. For clients with gestational diabetes, dietary modifications are a critical intervention. Limiting carbohydrate intake to 40% of daily calories can help regulate blood glucose levels.

B. Instruct the client to check a random blood glucose level once daily. The client should check fasting and postprandial blood glucose levels regularly (usually multiple times per day) to manage glucose control more effectively.

C. Anticipate a prescription for metformin. Given the elevated fasting blood glucose levels and high HbA1C (12%), this client may require pharmacological management to control blood sugar levels. Metformin is a common oral hypoglycemic agent used during pregnancy when diet and lifestyle changes are insufficient.

D. Conduct a non-stress test twice per week. Clients with uncontrolled gestational diabetes or poorly controlled blood sugar levels are at increased risk of fetal complications such as macrosomia, stillbirth, and preterm labor. A non-stress test (NST) twice a week helps monitor fetal well-being and detect early signs of distress.

E. Tell the client to refrain from exercise until after delivery. Exercise is generally recommended for clients with gestational diabetes unless contraindicated. Regular physical activity can help lower blood glucose levels and improve insulin sensitivity.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is caring for a client who is pregnant. Exhibits Select the 3 actions that the nurse should plan to take

Correct Answer is ["A","C","D"]

Explanation

A nurse is assisting with the admission of a client who is at 10 weeks of gestation and reports abdominal pain and moderate vaginal bleeding. Incomplete abortion is the initial diagnosis. Which of the following actions should the nurse contribute to the client's plan of care?

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?

A nurse is reinforcing teaching with a newly licensed nurse about the administration of depot medroxyprogesterone. Which of the following instructions should the nurse include in the teaching?

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?

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 assisting in the plan of care for a client who is pregnant and has phenylketonuria (PKU). Which of the following actions should the nurse include in the plan of care?

A nurse is reinforcing teaching with a client about checking her basal temperature to identify when ovulation occurs. The nurse should instruct the client to check her temperature at which of the following times?