A nurse is caring for a client.

Exhibits

For each assessment finding, click to specify if the finding is consistent with placenta previa or abruptio placenta. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

Pain score

Vaginal bleeding characteristics

Hematocrit

Abdominal assessment

Hemoglobin

Blood pressure

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"B"},"E":{"answers":"A,B"},"F":{"answers":"A,B"}}

Assessment findings	Placenta previa	Abruptio placenta
Pain score		✅
Vaginal bleeding characteristics		✅
Hematocrit	✅	✅
Abdominal assessment		✅
Hemoglobin	✅	✅
Blood pressure	✅	✅

Rationale:

Pain: The client has abdominal pain, rated 7/10, which is sharp and associated with uterine hypertonicity and tenderness in the left upper quadrant. Placenta previa typically presents with painless bleeding and minimal to no abdominal pain, while abruptio placenta involves severe pain due to placental separation.

Vaginal bleeding: Dark red vaginal bleeding was reported. Placenta previa results in painless bright red bleeding, while abruptio placenta presents with dark red bleeding often accompanied by clots and associated pain.

Hemoglobin: Hemoglobin is 8.1 g/dL, which is low (normal range: 12 to 16 g/dL), indicating blood loss or hemorrhage. Both conditions can lead to low hematocrit and hemoglobin, but abruptio placenta may cause more significant blood loss, leading to a greater decrease in these values.

Hematocrit: The hematocrit is 24%, which is also low (normal range: 36% to 47%), further suggesting blood loss. Both conditions can lead to low hematocrit and hemoglobin, but abruptio placenta may cause more significant blood loss, leading to a greater decrease in these values.

Abdominal assessment: Placenta previa tends to show a soft abdomen with no tenderness, while abruptio placenta causes rigid, board-like abdominal muscles with tenderness, often localized.

Blood Pressure: Blood pressure is 95/62 mm Hg, which is on the lower side but not critically low. Placenta previa typically has normal or slightly low blood pressure, while abruptio placenta can cause hypotension due to significant blood loss and shock.

Fetal Heart Rate: FHR is 116/min, with minimal variability noted, which may indicate fetal distress which can be seen in both conditions.

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Correct Answer is D

Explanation

A. Schedule the client for retesting in 1 week: Retesting is typically done after 3 months, not 1 week.

B. Administer ceftriaxone via intermittent IV bolus: Ceftriaxone is used for gonorrhea, not chlamydia.

C. Instruct the client to abstain from sexual intercourse for 1 month: Abstinence is recommended until treatment is completed and partners are treated, not necessarily for 1 month.

D. Report the infection to the state department of health: Reporting is required by law to help track and reduce the spread of STIs.

A. Complete an incident report and place it in the client's medical record. B. Compare the current infusion with the prescription in the client's medication record. C. Contact the charge nurse to see if the prescription was changed. D. Submit a written warning for the nurse involved in the incident.

Correct Answer is B

Explanation

A. An incident report is appropriate but should not be placed in the client’s medical record.

B. The nurse should first compare the current infusion with the prescription in the client's medication record to ensure the client is receiving the correct medication and dosage.

C. The nurse should verify the prescription before contacting the charge nurse.

D. Submitting a written warning is not the nurse's responsibility and is not appropriate in this situation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a new diagnosis of Chlamydia trachomatis. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is conducting an initial assessment of a client and notices a discrepancy between the client's current IV infusion and the report received during the shift report. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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