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 B

Explanation

A. Generativity vs. Self-absorption is the stage for adults in middle adulthood (ages 40-65), where individuals focus on contributing to society and guiding the next generation.

B. According to Erikson’s stages of psychosocial development, adolescents (ages 12-18) are in the stage of Identity vs. Role Confusion. During this stage, they work to develop a sense of personal identity and to explore different roles and beliefs.

C. Intimacy vs. Isolation occurs in young adulthood (ages 18-40), where individuals seek to form intimate relationships.

D. Trust vs. Mistrust is the first stage of Erikson’s theory, occurring during infancy (0-18 months), where infants develop a sense of trust when their needs are consistently met.

A. Wear sterile gloves to collect the specimen from the client. B. Obtain the specimen immediately upon the client waking up. C. Wait 1 day to collect the specimen if the client cannot provide sputum. D. Ask the client to provide 15 to 20 mL of sputum into the container.

Correct Answer is B

Explanation

A. Clean gloves (not sterile) are sufficient for collecting a sputum sample.

B. The best time to collect a sputum specimen is immediately upon waking because secretions accumulate overnight, making it easier to obtain a sample.

C. Waiting a day delays diagnosis and treatment; other techniques can help induce sputum production.

D. Typically, 5 to 10 mL of sputum is sufficient for diagnostic testing.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an outpatient mental health clinic is assessing an adolescent client. The nurse should expect the adolescent to be in which of the following of Erikson's stages of psychosocial development?

Correct Answer is B

Explanation

A nurse is preparing to collect a sputum specimen from a client. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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