A nurse in a prenatal client is caring for a client who is at 38 weeks of gestation and has heavy. red vaginal bleeding, without contractions, that started spontaneously. She is in no distress and states that she can "feel the baby moving." The client should undergo an ultrasound to determine which of the following findings?

Location of the placenta

Rh incompatibility

Fetal lung maturity

Frequency and duration of contractions

Answer and Explanation

The Correct Answer is A

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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Correct Answer is A

Explanation

A. Bright red vaginal bleeding without pain: Placenta previa is characterized by painless, bright red vaginal bleeding in the third trimester due to the placenta covering the cervical opening.

B. Intermittent abdominal pain following passage of bloody mucus: This finding is more typical of labor or cervical changes rather than placenta previa.

C. Abdominal pain with minimal red vaginal bleeding: Placenta previa typically causes painless bleeding. Abdominal pain may suggest a different condition, such as placental abruption.

D. Severe abdominal pain with increasing fundal height: Severe abdominal pain and a rapidly increasing fundal height are more indicative of placental abruption rather than placenta previa.

A. Severe nausea and vomiting B. Pelvic pain C. Uterine enlargement greater than expected for gestational age D. Copious vaginal bleeding

Correct Answer is B

Explanation

A. Severe nausea and vomiting: Severe nausea and vomiting are more characteristic of hyperemesis gravidarum, not ectopic pregnancy.

B. Pelvic pain: Ectopic pregnancy typically presents with pelvic pain, which may be sharp and localized due to the implantation of the embryo outside the uterus, commonly in the fallopian tube.

C. Uterine enlargement greater than expected for gestational age: In an ectopic pregnancy, the uterus may not enlarge as expected because the embryo is implanted outside the uterus.

D. Copious vaginal bleeding: Vaginal bleeding can occur, but it is usually minimal rather than copious. Severe bleeding may occur if the ectopic pregnancy ruptures.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is at 36 weeks of gestation and has suspected placenta previa. For which of the following findings should the nurse monitor the client?

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?

Correct Answer is B

Explanation

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