A nurse is caring for a client who is at 37 weeks of gestation and diagnosed with placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

"This could result in profound bleeding."

"This could initiate preterm labor."

"There is an increased risk of rupture of the membranes."

"There is an increased risk of introducing infection."

Answer and Explanation

The Correct Answer is A

Explanation:

A. "This could result in profound bleeding."

This is the correct explanation. Placenta previa involves the placenta partially or completely covering the cervix. Performing an internal examination, such as a vaginal exam, can disrupt the placenta and lead to severe bleeding. This bleeding can be dangerous for both the mother and the baby, making it a critical concern to avoid internal exams in placenta previa cases.

B. "This could initiate preterm labor."

While internal examinations may trigger preterm labor in some cases, the primary concern in placenta previa is the risk of significant bleeding. Preterm labor is not typically the primary reason for avoiding internal exams in placenta previa; instead, the focus is on preventing bleeding and its associated complications.

C. "There is an increased risk of rupture of the membranes."

While an internal examination may carry a risk of membrane rupture, especially in situations with low-lying placenta or marginal previa, the primary concern in placenta previa is the potential for severe bleeding if the placenta is disturbed. Rupture of membranes is a consideration but is not the main reason for avoiding internal exams in placenta previa.

D. "There is an increased risk of introducing infection."

While infection is a concern with any invasive procedure, including internal examinations, it is not typically the primary reason for avoiding internal exams in placenta previa. The main focus is on preventing bleeding complications that can arise from disrupting the placenta.

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Correct Answer is D

Explanation

Explanation:

A. This test assesses fetal lung maturity.

The explanation provided is incorrect. The maternal serum alpha-fetoprotein (MSAFP) test is not used to assess fetal lung maturity. Fetal lung maturity is typically assessed through tests such as amniocentesis, which evaluates factors like the lecithin-to-sphingomyelin (L/S) ratio and phosphatidylglycerol (PG) levels in amniotic fluid.

B. This test identifies an Rh incompatibility between the mother and fetus.

The explanation provided is also incorrect. The MSAFP test is not used to identify Rh (Rhesus) incompatibility between the mother and fetus. Rh incompatibility is determined through other tests, such as blood typing (Rh factor) and antibody screening.

C. It assesses various markers of fetal well-being.

This explanation is not accurate. While the MSAFP test does provide information about certain fetal abnormalities, it is primarily used as a screening test for neural tube defects (spinal defects) and abdominal wall defects rather than assessing overall fetal well-being, which involves a comprehensive evaluation of various fetal parameters.

D. It is a screening test for spinal defects in the fetus.

This explanation is correct. The MSAFP test is indeed a screening test specifically used to assess the risk of spinal defects, also known as neural tube defects, in the fetus. These defects include conditions such as spina bifida. The test measures the levels of alpha-fetoprotein in the mother's blood to screen for these abnormalities during pregnancy.

A. Preeclampsia B. Puerperal infection C. Anaphylactoid syndrome of pregnancy D. Disseminated intravascular coagulation

Correct Answer is D

Explanation

Explanation:

A. Preeclampsia: Preeclampsia is a condition characterized by high blood pressure and signs of damage to other organs, typically occurring after 20 weeks of pregnancy. While preeclampsia is a concern during pregnancy, it is not directly related to abruptio placentae or the development of DIC.

B. Puerperal infection: Puerperal infection refers to an infection that occurs after childbirth. Although infections are a concern in the postpartum period, they are not specifically associated with abruptio placentae or the development of DIC unless there are additional risk factors or complications.

C. Anaphylactoid syndrome of pregnancy: Anaphylactoid syndrome of pregnancy (also known as amniotic fluid embolism) is a rare but serious condition where amniotic fluid enters the maternal circulation, potentially causing a severe allergic-like reaction. This condition is not directly related to abruptio placentae or the development of DIC.

D. Disseminated intravascular coagulation (DIC): This is the correct answer. DIC is a serious condition where the body's clotting mechanisms are abnormally activated, leading to widespread clot formation in small blood vessels. It can result from various conditions, including abruptio placentae, especially when there is evidence of bleeding such as petechiae and bleeding around the IV access site. DIC can lead to both bleeding tendencies and clot formation, affecting multiple organs and potentially causing severe complications.

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A nurse is caring for a client who is at 37 weeks of gestation and diagnosed with placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is scheduled for a maternal serum alpha-fetoprotein test at 15 weeks of gestation. The nurse provides which of the following explanations about this test to the client?

Correct Answer is D

Explanation

A nurse on the obstetric unit is caring for a client who experienced abruptio placentae. The nurse observes petechiae and bleeding around the IV access site. The nurse should recognize that this client is at risk for which of the following complications?

Correct Answer is D

Explanation

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A nurse on the obstetric unit is caring for a client who experienced abruptio placentae. The nurse observes petechiae and bleeding around the IV access site. The nurse should recognize that this client is at risk for which of the following complications?

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