A nurse in a prenatal clinic is caring for a client who is at 1 week of pregnancy and has noticed bleeding without contractions.
She is in no distress and states that she can feel the baby moving. Which of the following might be the cause?

Premature maturity.

Incompetency.

Location of the placenta.

Frequency and duration of contractions.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Premature maturity is not a plausible cause of bleeding without contractions at 1 week of pregnancy. Premature maturity, or preterm labor, refers to labor that begins before 37 weeks of gestation. It is characterized by contractions and cervical changes, often accompanied by other symptoms such as lower back pain, pelvic pressure, or a change in vaginal discharge. At 1 week of pregnancy, the fetus is still in the very early stages of development, and premature labor is not possible.

Choice C rationale:

The location of the placenta can sometimes cause bleeding in pregnancy, but it is typically associated with later stages of gestation, such as the second or third trimester. Placental conditions like placenta previa, where the placenta lies low in the uterus and partially or completely covers the cervix, can lead to bleeding, but this is unlikely to occur at 1 week of pregnancy. Moreover, placenta previa is usually accompanied by pain or cramping, which is not present in the client's case.

Choice D rationale:

The frequency and duration of contractions are relevant in assessing labor progression, but they are not a primary cause of bleeding without contractions. Contractions are the rhythmic tightening and relaxing of the uterine muscles that help to dilate the cervix and move the baby through the birth canal. Bleeding without contractions at 1 week of pregnancy suggests a different underlying issue.

Choice B rationale:

Incompetency, also known as cervical insufficiency or cervical incompetence, is the most likely cause of bleeding without contractions at 1 week of pregnancy. It occurs when the cervix is weak and begins to open prematurely, even without the presence of contractions. This can lead to bleeding and potential miscarriage or preterm birth. The fact that the client can feel the baby moving does not rule out cervical insufficiency, as fetal movement can sometimes be felt as early as 13-16 weeks of pregnancy.

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Correct Answer is A

Explanation

Choice A rationale:
It’s normal to have a white vaginal discharge during pregnancy. This is due to increased estrogen levels, which stimulate the production of cervical mucus. The mucus is typically white or clear, and has a mild odor. It helps to maintain a healthy vaginal environment and protect against infection.
Increased vaginal discharge is one of the earliest signs of pregnancy, and it typically continues throughout the pregnancy. While it may be bothersome at times, it is not a cause for concern unless it has a strong odor, is yellow or green in color, or is accompanied by itching or burning.
It is important for pregnant women to keep the vaginal area clean and dry to prevent infection. This can be done by wearing cotton underwear, avoiding tight-fitting clothing, and showering or bathing regularly.

Choice B rationale:
Most women do not recognize fetal movement until 16 to 22 weeks of pregnancy. This is because the fetus is still very small and its movements are not strong enough to be felt.
Some women may feel fluttering or "butterflies" in their abdomen as early as 12 weeks, but this is not always a reliable indication of fetal movement. It is more likely to be caused by gas or intestinal activity.

Choice C rationale:
The nipples and areola typically become darker, not paler, during pregnancy. This is due to increased levels of melanin, a pigment that is also responsible for skin color.
The darkening of the nipples and areola may be more pronounced in women with darker skin.

Choice D rationale:
The fundus is the top of the uterus. It does not cause swelling in the ankles.
Swelling in the ankles is a common symptom of pregnancy, especially in the third trimester. It is caused by a combination of factors, including increased blood volume, fluid retention, and pressure from the growing uterus on the veins in the legs.

A. Rh incompatibility. B. Neural tube defects. C. Fetal gender. D. Cephalopelvic disproportion. E. Chromosomal defects.

Correct Answer is ["B","C","E"]

Explanation

Choice A:
Rh incompatibility is not directly identified through amniocentesis. Instead, it's typically assessed through blood tests that determine a woman's Rh factor and screen for Rh antibodies.
However, amniocentesis can provide information that might be relevant to Rh incompatibility, such as the fetal Rh type. If the mother is Rh-negative and the fetus is Rh-positive, there's a risk of Rh incompatibility.

Choice B:
Amniocentesis can detect neural tube defects (NTDs) like spina bifida and anencephaly.
It does this by measuring the levels of alpha-fetoprotein (AFP) in the amniotic fluid. AFP is a protein produced by the fetal liver, and elevated levels in the amniotic fluid can indicate an NTD.

Choice C:
Amniocentesis can accurately determine the fetal gender by examining the sex chromosomes present in the cells of the amniotic fluid.

Choice D:
Cephalopelvic disproportion (CPD) is a condition where the baby's head is too large to fit through the mother's pelvis. It's not diagnosed through amniocentesis.
CPD is usually suspected based on clinical findings like a slow progression of labor or a high fetal station, and it might be confirmed with imaging techniques like X-ray or ultrasound.

Choice E:
Amniocentesis is a valuable tool for diagnosing chromosomal defects, such as Down syndrome, Trisomy 18, and Trisomy 13. It does this by analyzing the chromosomes of the fetal cells present in the amniotic fluid.

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A nurse in a prenatal clinic is caring for a client who is at 1 week of pregnancy and has noticed bleeding without contractions. She is in no distress and states that she can feel the baby moving. Which of the following might be the cause?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with a client who is pregnant about expected changes related to pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who is 15 weeks pregnant about to undergo amniocentesis. This test can identify which traits or problems? Select all that apply.

Correct Answer is ["B","C","E"]

Explanation

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A nurse in a prenatal clinic is caring for a client who is at 1 week of pregnancy and has noticed bleeding without contractions.
She is in no distress and states that she can feel the baby moving. Which of the following might be the cause?