A nurse is assessing a client for pre-term labor.

Which assessment finding would be most concerning and require immediate intervention?

Infection on speculum examination

Bleeding on speculum examination

Positive fetal fibronectin test (FFN)

Normal fetal heart rate and activity

Answer and Explanation

The Correct Answer is A

Infection on speculum examination.

Infection is a major cause of preterm labor and can lead to serious complications for the mother and the fetus.

Infection can be detected by a speculum examination that shows signs of inflammation, such as erythema, edema, discharge, or odor.

Infection can also be confirmed by laboratory tests, such as culture, gram stain, or polymerase chain reaction. Infection should be treated promptly with antibiotics and other supportive measures.

Choice B. Bleeding on speculum examination is wrong because bleeding is not a direct cause of preterm labor, but rather a sign of other conditions that may increase the risk of preterm labor, such as placenta previa, placental abruption, or cervical trauma. Bleeding should be evaluated further to determine the source and severity of the hemorrhage and to manage any complications.

Choice C. Positive fetal fibronectin test (FFN) is wrong because a positive FFN test indicates the presence of fetal fibronectin in the cervical or vaginal secretions, which is a marker of increased risk of preterm labor, but not a definitive marker.

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Correct Answer is A

Explanation

Leukocoria (white pupils) is a symptom of retinopathy of prematurity (ROP), an eye disease that can happen in premature babies.ROP happens when abnormal blood vessels grow on the retina, the light-sensitive layer of tissue in the back of the eye.

Choice B is wrong because strabismus (crossed eyes) is not a symptom of ROP, but a possible complication that can occur later in life.

Choice C is wrong because nystagmus (involuntary eye movements) is not a symptom of ROP, but another possible complication that can occur later in life.

Choice D is wrong because it includes choices B and C, which are incorrect.

Normal ranges for gestational age and birth weight are 38 to 42 weeks and 5.5 to 10 pounds, respectively.Babies born before 31 weeks or weighing less than 3 pounds are at risk for ROP.

A. “This medication can cause premature closure of your baby’s ductus arteriosus.” B. “This medication can increase your risk of postpartum hemorrhage.” C. “This medication can cause your baby to have jaundice after birth.” D. “This medication can increase your blood pressure during labor.”

Correct Answer is A

Explanation

“This medication can cause premature closure of your baby’s ductus arteriosus.”

Indomethacin is a NSAID that can prevent the synthesis of prostaglandins, which are involved in preterm contractions.However, it can also cause constrictive effects on the fetal ductus arteriosus, which can lead to cardiac complications and oligohydramnios.The dosage and duration of indomethacin treatment should be carefully monitored.

Choice B is wrong because indomethacin does not increase the risk of postpartum hemorrhage.In fact, it may reduce the risk of bleeding by inhibiting platelet aggregation.

Choice C is wrong because indomethacin does not cause jaundice in the baby.

Jaundice is caused by high levels of bilirubin in the blood, which can be due to various factors such as blood group incompatibility, infection, or liver problems.

Choice D is wrong because indomethacin does not increase blood pressure during labor.It may actually lower blood pressure by dilating blood vessels.

Normal ranges for indomethacin dosage are 25 to 50 mg orally every 6 hours or 100 mg rectally every 12 hours for up to 48 hours.

Normal ranges for fetal ductus arteriosus diameter are 1.5 to 4 mm before 28 weeks of gestation and 1 to 3 mm after 28 weeks of gestation.

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A nurse is assessing a client for pre-term labor. Which assessment finding would be most concerning and require immediate intervention?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a pre-term newborn who has retinopathy of prematurity (ROP). Which of the following manifestations should the nurse expect to observe?

Correct Answer is A

Explanation

A nurse is providing education to a client who had pre-term labor and was prescribed indomethacin. Which of the following information should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is preparing to administer betamethasone (Celestone) to a client who is at 31 weeks of gestation and has pre-term labor. What is the purpose of this medication?

A nurse is caring for a client who is receiving magnesium sulfate for pre-term labor. Which of the following assessments should the nurse perform to evaluate the therapeutic effect of the medication?

A nurse is caring for a client who is at 32 weeks of gestation and reports lower abdominal cramping. Which of the following actions should the nurse take first?

A nurse is evaluating a client who is at 28 weeks of gestation and has pre-term labor. Which of the following findings indicates that the client’s condition is improving?

A nurse is teaching a client who is at risk for pre-term labor about the signs and symptoms to report to the provider. Which of the following should the nurse include in the teaching?

A nurse is caring for a client who is experiencing pre-term labor at 32 weeks of gestation and has been prescribed betamethasone. Which of the following outcomes should the nurse expect from this medication?

A nurse is assessing a client for pre-term labor. Which assessment finding would be most concerning and require immediate intervention?

A nurse is performing a digital examination on a client who is at 34 weeks of gestation and has pre-term labor. Which of the following findings indicates cervical effacement?

A nurse is assessing a client for pre-term labor.

Which assessment finding would be most concerning and require immediate intervention?