A nurse is caring for a client who is at 36 weeks of gestation and has suspected placenta previa. For which of the following findings should the nurse monitor the client?
Abdominal pain with minimal red vaginal bleeding.
A large amount of bright red vaginal bleeding without pain.
Severe abdominal pain with increasing fundal height.
Intermittent abdominal pain following the passage of bloody mucus.
The Correct Answer is B
Choice A rationale:
Abdominal pain with minimal red vaginal bleeding may not be as concerning as other options. While it could be a sign of placenta previa, it is not as specific or significant as the finding in Choice B.
Choice B rationale:
A large amount of bright red vaginal bleeding without pain is a significant finding that is highly suggestive of placenta previa. Placenta previa occurs when the placenta partially or completely covers the cervix, and vaginal bleeding is a common symptom. The bright red colour indicates active bleeding, and the absence of pain is noteworthy as placenta previa bleeding is typically painless.
Choice C rationale:
Severe abdominal pain with increasing fundal height is not a typical sign of placenta previa. While abdominal pain can be associated with various pregnancy complications, it is not a specific finding for this condition.
Choice D rationale:
Intermittent abdominal pain following the passage of bloody mucus could be related to other issues, such as preterm labor or cervical changes. While bleeding may be present in placenta previa, the pain and passage of mucus are not characteristic features of this condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice B rationale:
The correct answer is Choice B, which is "Newborn hypoglycemia.”. Newborn hypoglycemia is a potential complication associated with maternal gestational diabetes. When a pregnant woman has gestational diabetes, her blood glucose levels can be elevated, leading to increased insulin production in the fetus. After birth, the baby's insulin production continues at a high level, which can result in a rapid drop in blood glucose levels, causing hypoglycemia. This condition can be serious and requires close monitoring and timely intervention to prevent complications in the newborn.
Choice A rationale :
Placenta previa is not a complication associated with maternal gestational diabetes. Placenta previa occurs when the placenta partially or completely covers the cervix, which can lead to bleeding during pregnancy and delivery. However, this condition is not directly related to gestational diabetes, and there is no physiological rationale connecting the two.
Choice C rationale
Small for gestational age (SGA) newborn is not a direct complication of maternal gestational diabetes. SGA refers to babies who are smaller in size than expected for their gestational age. While poorly controlled diabetes during pregnancy can lead to large babies (macrosomia), it is not typically associated with small babies.
Choice D rationale
Oligohydramnios, which is a condition characterized by low levels of amniotic fluid, is not a common complication associated with maternal gestational diabetes. Oligohydramnios can be caused by various factors, but it is not specifically linked to gestational diabetes.
Correct Answer is B
Explanation
The correct answer is choice B: “You must be feeling very scared.” This response is an example of therapeutic communication, where the nurse acknowledges the client’s feelings and provides emotional support without making assumptions or giving false reassurances.
Choice A rationale: While it’s true that the presence of a neonatal unit equipped to handle emergencies is reassuring, this response does not address the client’s immediate emotional needs or fears. It’s important for the nurse to recognize and validate the client’s feelings rather than focusing solely on the facilities available.
Choice B rationale: This choice demonstrates empathy and understanding. It allows the client to express their feelings and concerns, which is a crucial aspect of providing emotional support during labor. By acknowledging the client’s potential fear, the nurse opens the door for further communication and support.
Choice C rationale: This response minimizes the client’s individual feelings by suggesting that everyone has the same worries. It can make the client feel that their concerns are not unique or taken seriously, which is not conducive to establishing trust or providing individualized care.
Choice D rationale: This choice provides false reassurance. At 32 weeks of gestation, while the prognosis for the baby is generally good, there are still risks associated with preterm birth. It’s important not to make definitive statements about outcomes that cannot be guaranteed.
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