A nurse is assessing a client who is at 37 weeks of gestation and reports sudden, severe abdominal pain with moderate vaginal bleeding and persistent uterine contractions. The client's blood pressure is 88/50 mm Hg and her abdomen is rigid. The nurse should identify these findings as Indicating which of the following complications?

Placental abruption

Amniotic fluid embolus

Placenta previa

Uterine rupture

Answer and Explanation

The Correct Answer is A

A. Placental abruption – This is the correct answer because placental abruption occurs when the placenta detaches prematurely from the uterine wall, leading to severe abdominal pain, vaginal bleeding, uterine rigidity, and signs of hypovolemic shock (low blood pressure). The hallmark sign is a painful, rigid abdomen with contractions.

B. Amniotic fluid embolus – This condition presents with sudden respiratory distress, hypotension, and disseminated intravascular coagulation (DIC), but it does not typically cause uterine rigidity or persistent contractions.

C. Placenta previa – Placenta previa typically presents with painless vaginal bleeding rather than severe abdominal pain and a rigid uterus.

D. Uterine rupture – Uterine rupture is usually associated with a history of uterine surgery (e.g., previous cesarean section). It presents with sudden, severe pain followed by cessation of contractions, not persistent contractions.

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Correct Answer is B

Explanation

A. ECT does not typically affect a client’s voice.

B. This is the correct answer. A common side effect of ECT is short-term confusion and memory impairment, which can last for minutes to a few hours after the procedure.

C. Most clients wake up within a few minutes, not 30 minutes.

D. Clients do not typically feel pulsations in the neck during the procedure since they are under anesthesia and muscle relaxants are used.

A. Placental abruption B. Amniotic fluid embolus C. Placenta previa D. Uterine rupture

Correct Answer is A

Explanation

C. Placenta previa – Placenta previa typically presents with painless vaginal bleeding rather than severe abdominal pain and a rigid uterus.

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Correct Answer is B

Explanation

Correct Answer is A

Explanation

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