A nurse is admitting a client at 33 weeks gestation who experienced PPROM 4 hours ago.
The client is asking when her next vaginal exam will be since her first exam revealed she is 2 cm dilated.
Which of the following reasons does the nurse explain for not performing another vaginal exam?
Increases labor progress.
Increases pain.
Increases bleeding.
Increases risk for infection.
The Correct Answer is D
Choice A rationale
Performing another vaginal exam does not directly influence labor progress. Labor can progress naturally without repeated exams, which can introduce unnecessary risk.
Choice B rationale
While vaginal exams can be uncomfortable, pain is not the primary reason to avoid multiple exams, especially when managing potential complications.
Choice C rationale
Vaginal exams might lead to minor bleeding due to irritation, but the risk of bleeding is not a primary concern in this context.
Choice D rationale
The most significant reason to avoid frequent vaginal exams after PPROM is the increased risk of infection. Each exam provides a potential pathway for bacteria to ascend, leading to complications like chorioamnionitis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Placenta previa involves painless vaginal bleeding due to the placenta covering the cervical opening. It does not typically cause significant abdominal pain or the hemodynamic instability described in the scenario.
Choice B rationale
Abruptio placentae is the premature separation of the placenta from the uterine wall, causing severe abdominal pain, vaginal bleeding, and can lead to shock, consistent with the assessment findings.
Choice C rationale
Uterine rupture, often a complication in women with a previous cesarean section, involves the tearing of the uterine wall, causing sudden, severe abdominal pain and bleeding. However, it is less common than placental abruption.
Choice D rationale
Amniotic fluid embolism is a rare but life-threatening condition where amniotic fluid enters the mother's bloodstream, causing cardiovascular collapse and severe respiratory distress, which is less consistent with the described findings.
Correct Answer is A
Explanation
Choice A rationale
Pruritus of the palms of the hands is a hallmark symptom of cholestasis of pregnancy, a liver disorder causing bile acid accumulation.
Choice B rationale
Back pain and pelvic pressure are common pregnancy symptoms but are not specific to cholestasis.
Choice C rationale
Nausea and vomiting can be due to many conditions in pregnancy and are not indicative of cholestasis.
Choice D rationale
Headaches and blurred vision are associated with preeclampsia, not cholestasis.
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