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A nurse is assessing a client who is at 12 weeks of gestation. The nurse should report which of the following findings to the provider as an indication of an imminent spontaneous abortion?

A.

Scant, bright red spotting.

B.

Elevated hCG.

C.

Cervical dilation.

D.

Slight abdominal cramps.

Answer and Explanation

The Correct Answer is C

Choice A rationale: 

Scant, bright red spotting during early pregnancy can be a normal finding known as implantation bleeding, which occurs when the embryo attaches to the uterus. It is generally not a cause for concern unless it becomes heavy and is accompanied by severe pain. 

Choice B rationale: 

Elevated hCG (human chorionic gonadotropin) levels during the first trimester are a normal part of a healthy pregnancy. hCG levels peak around 10-12 weeks of gestation and then gradually decrease. A consistent increase in hCG levels is usually a positive sign of a  progressing pregnancy. 

Choice C rationale: 

Cervical dilation during the first trimester, especially when the client is only at 12 weeks of gestation, is not normal and may indicate an imminent spontaneous abortion (miscarriage). This finding should be reported promptly to the healthcare provider for further assessment and management. 

Choice D rationale: 

Slight abdominal cramps can be a normal symptom during early pregnancy as the uterus undergoes changes and expands. However, unless they are severe and accompanied by other concerning signs such as heavy bleeding, they are not necessarily indicative of an imminent spontaneous abortion.


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Related Questions

Correct Answer is C

Explanation

The correct answer is choice C: Verify that informed consent is obtained prior to administration. Choice A rationale: Placing the client in a semi-Fowler’s position is not specifically related to the administration of dinoprostone. This position is often used post-administration to promote comfort and labor progression, but it is not a required action prior to the administration of dinoprostone. Choice B rationale: Instructing the client to avoid urinary elimination until after administration is not necessary. There is no evidence to suggest that retaining urine affects the efficacy or safety of dinoprostone administration. Choice C rationale: Verifying that informed consent is obtained prior to administration is crucial. Dinoprostone, like any medication used to induce labor, carries potential risks and side effects. It is essential that the client is informed about these risks and consents to the procedure before the medication is administered. Choice D rationale: Allowing the medication to reach room temperature prior to administration is not a standard requirement for dinoprostone inserts. Medications have specific storage and administration guidelines that should be followed according to the manufacturer’s instructions and facility protocols.

Correct Answer is A

Explanation

The correct answer is choiceA. Continue to monitor the client.

Choice A rationale:

Early decelerations are typically benign and are caused by fetal head compression during contractions.They usually do not require any specific intervention other than continued monitoring to ensure they remain early decelerations and do not progress to more concerning patterns.

Choice B rationale:

Discontinuing oxytocin is not necessary for early decelerations, as they are not indicative of fetal distress.Oxytocin would be discontinued if there were signs of more severe decelerations or other complications.

Choice C rationale:

Assisting the client to lay on her right side is not specifically required for early decelerations.This position change is more commonly used for variable or late decelerations to improve uteroplacental blood flow.

Choice D rationale:

Administering oxygen at 8 L/min per mask is not needed for early decelerations.Oxygen is typically reserved for situations where there is evidence of fetal hypoxia or distress.

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