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. Apply an external fetal monitor. Applying an external fetal monitor is the appropriate action because it allows continuous monitoring of the fetal heart rate and uterine activity without disturbing the placenta, which is important in cases of placenta previa.

B. Complete a vaginal exam. Performing a vaginal exam is contraindicated in cases of suspected placenta previa because it could lead to placental disruption and severe bleeding. The cervix should not be manipulated when placenta previa is suspected.

C. Perform a rectal exam. A rectal exam is not indicated for placenta previa and offers no benefit in this context. This action could also increase discomfort and possibly exacerbate bleeding.

D. Apply ice to the perineal area. Ice to the perineal area is not relevant for placenta previa. Ice is typically used for perineal trauma or swelling, which is not related to this condition.

A. Location of the placenta B. Rh incompatibility C. Fetal lung maturity D. Frequency and duration of contractions

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.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who is at 23 weeks of gestation and will return to the facility the following week for an amniocentesis. Which of the following instructions should the nurse include?

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A nurse in a prenatal clinic is determining a client's estimated date of delivery using Naegele's rule. The first day of her last menstrual period was May 4. Which of the following dates should the nurse tell the client is her estimated date of delivery?

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