A nurse is caring for a 22-year-old female client who is experiencing lower abdominal pelvic pain. The client is at risk of developing a condition due to a finding.

Condition: Ovarian cysts, Finding: Ultrasound shows a fluid-filled sac in the ovary.

Condition: Appendicitis, Finding: Pain localized in the lower right quadrant.

Condition: Endometriosis, Finding: Patient reports cyclical pain.

Condition: Pelvic inflammatory disease, Finding: Elevated white blood cell count.

Answer and Explanation

The Correct Answer is A

Choice A rationale:
Ovarian cysts are fluid-filled sacs that form on or within an ovary. They are a common condition, affecting up to 1 in 5 women at some point in their lives. While most ovarian cysts are benign (non-cancerous), they can sometimes cause symptoms, including pelvic pain.
Ultrasound is a common imaging test that uses sound waves to create pictures of internal organs. It can be used to detect ovarian cysts, which often appear as fluid-filled sacs on the ovary.
The presence of an ovarian cyst on ultrasound, combined with the patient's symptoms of lower abdominal pelvic pain, suggests that the patient is at risk of developing complications from the cyst. These complications can include: Rupture: A ruptured ovarian cyst can cause sudden, severe pain and bleeding.
Torsion: This is when a cyst twists on its stalk, cutting off its blood supply. Torsion can also cause severe pain and may require emergency surgery.

Choice B rationale:
Appendicitis is an inflammation of the appendix, a small, finger-shaped organ located in the lower right abdomen. It is a common cause of abdominal pain, especially in young adults.

However, the patient in this scenario is experiencing pain in the lower abdominal pelvic region, not specifically in the lower right quadrant. This makes appendicitis less likely.
Additionally, the patient does not have any other symptoms that are typically associated with appendicitis, such as fever, nausea, or vomiting.

Choice C rationale:
Endometriosis is a condition in which tissue that normally lines the uterus grows outside of the uterus. It can cause pain, especially during menstruation.
However, the patient in this scenario does not report cyclical pain, which is a hallmark symptom of endometriosis. Additionally, endometriosis is not typically associated with the presence of fluid-filled sacs on the ovaries.

Choice D rationale:
Pelvic inflammatory disease (PID) is an infection of the upper genital tract, including the uterus, fallopian tubes, and ovaries. It is often caused by sexually transmitted infections (STIs).
PID can cause pelvic pain, but it is also typically associated with other symptoms, such as fever, vaginal discharge, and irregular bleeding.
The patient in this scenario does not have any of these other symptoms, and her white blood cell count is not elevated, which makes PID less likely.

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Correct Answer is C

Explanation

The correct answer is choice C, Abruptio placentae.

Choice A rationale:

A prolapsed cord is an obstetric emergency where the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby. It’s a rare condition but can occur during labor if the baby is not yet engaged, and the water breaks. The main concern is that the cord can become compressed, cutting off the baby’s oxygen supply. However, it does not typically present with continuous abdominal pain and vaginal bleeding without labor.

Choice B rationale:

Premature rupture of membranes (PROM) refers to a patient whose membranes have ruptured before the onset of labor. While PROM can lead to complications, it is not typically associated with continuous abdominal pain and vaginal bleeding. PROM is more often characterized by the sudden release of fluid from the vagina.

Choice C rationale:

Abruptio placentae, also known as placental abruption, is the premature separation of the placenta from the uterus. It is a serious condition that can occur in the third trimester and is associated with continuous abdominal pain and vaginal bleeding, which are the symptoms described in the question. This condition poses significant risks to both the mother and the fetus, including fetal distress, preterm birth, and maternal hemorrhage.

Choice D rationale:

Placenta previa is a condition where the placenta covers the cervix either completely or partially. It can cause painless, bright red vaginal bleeding but is not typically associated with abdominal pain. The bleeding with placenta previa is usually not continuous but rather occurs in episodes.

In this scenario, the continuous abdominal pain and vaginal bleeding are classic signs of abruptio placentae, making Choice C the most likely diagnosis.

A. Heart rate of 60/min. B. Respiratory rate of 16/min. C. Urine output of 50 ml in 4 hr. D. Diminished deep-tendon reflexes.

Correct Answer is B

Explanation

Choice A rationale:

A heart rate of 60/min is a sign of bradycardia, which can be a side effect of magnesium sulfate toxicity. Magnesium sulfate slows down neuromuscular transmission, which can lead to a decrease in heart rate. If the heart rate drops too low, it can compromise blood flow to vital organs, including the brain and heart. Therefore, a heart rate of 60/min is not a safe finding that would indicate the nurse should continue the infusion.

Choice C rationale:

A urine output of 50 ml in 4 hours is indicative of oliguria, which is a decreased urine output. Oliguria can be a sign of magnesium sulfate toxicity, as magnesium is primarily excreted through the kidneys. If the kidneys are not functioning properly, magnesium can build up in the body and lead to toxic levels. Therefore, a urine output of 50 ml in 4 hours is not a safe finding that would indicate the nurse should continue the infusion.

Choice D rationale:

Diminished deep-tendon reflexes are another sign of magnesium sulfate toxicity. Magnesium sulfate suppresses the nervous system, which can lead to decreased reflexes. If the reflexes are too diminished, it can indicate that the magnesium level in the body is too high. Therefore, diminished deep-tendon reflexes are not a safe finding that would indicate the nurse should continue the infusion.

Choice B rationale:

A respiratory rate of 16/min is within the normal range for an adult. It does not indicate any respiratory depression, which can be a side effect of magnesium sulfate toxicity. Therefore, a respiratory rate of 16/min is a safe finding that would indicate the nurse can continue the infusion.

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A nurse is caring for a 22-year-old female client who is experiencing lower abdominal pelvic pain. The client is at risk of developing a condition due to a finding.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in the antepartum unit is assisting with the care of a client who is at 36 weeks of gestation and reports continuous abdominal pain and vaginal bleeding. The nurse should identify that the client is likely experiencing which of the following complications?

Correct Answer is C

Explanation

A nurse is assisting with the care of a client who has severe preeclampsia and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?

Correct Answer is B

Explanation

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