A nurse is caring for a client who is at 38 weeks of gestation and is experiencing continuous abdominal pain and vaginal bleeding. The client has a history of cocaine use. The nurse should identify that the client is likely experiencing which of the following complications?
Abruptio placentae.
Hydatidiform mole.
Preterm labor.
Placenta previa.
The Correct Answer is A
Choice A rationale:
Continuous abdominal pain and vaginal bleeding in a client with a history of cocaine use are indicative of abruptio placentae. Abruptio placentae is a medical emergency where the placenta detaches from the uterine wall before delivery, leading to severe bleeding and abdominal pain. Immediate medical intervention is necessary to prevent complications for both the mother and the baby.
Choice B rationale:
Hydatidiform mole is a gestational trophoblastic disease that occurs due to an abnormal pregnancy. It is not associated with continuous abdominal pain and vaginal bleeding. Instead, clients with this condition often present with vaginal bleeding and a grape-like cluster of cysts in the uterus.
Choice C rationale:
Preterm labor involves regular uterine contractions and cervical changes before 37 weeks of gestation. While preterm labor can cause abdominal discomfort, it is not usually described as continuous abdominal pain. Vaginal bleeding is not a typical symptom of preterm labor.
Choice D rationale:
Placenta previa is a condition where the placenta covers the opening of the cervix. It can cause painless vaginal bleeding, but it is not usually associated with continuous abdominal pain. Clients with placenta previa often experience sudden, painless bleeding later in pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
When late decelerations are noted in the fetal heart rate (FHR) tracing, it indicates that the fetal oxygen supply may be compromised. The nurse should first change the client's position, such as moving her to the left lateral position or a hands-and-knees position, to improve uteroplacental blood flow and relieve pressure on the vena cava.
Choice B rationale:
Palpating the uterus to assess for tachysystole is not the priority action when late decelerations are observed. Tachysystole refers to excessively frequent uterine contractions and may contribute to fetal distress, but the immediate concern is addressing the decelerations.
Choice C rationale:
Increasing the client's IV infusion rate may not address the underlying cause of late decelerations. While maintaining hydration is important, it's not the first action to take in this situation.
Choice D rationale:
Administering oxygen at 10 L/min via a non-rebreather mask may be beneficial for the client and fetus, but it is not the first action to take. The nurse should address the position change first to improve oxygenation through better blood flow before considering supplemental oxygen.
Correct Answer is C
Explanation
Choice A rationale:
Tamoxifen is not used to treat Non-Hodgkin's lymphoma. Tamoxifen is a selective estrogen
receptor modulator (SERM) and is primarily used in breast cancer treatment. It functions by
binding to estrogen receptors, blocking estrogen's effects, and inhibiting the growth of
hormone-sensitive breast cancer cells.
Choice B rationale:
Tamoxifen is not used to treat endometriosis. Endometriosis is a condition in which tissue
similar to the lining of the uterus grows outside the uterus, and it is typically managed with
hormonal therapies, pain medications, or surgical interventions, but not tamoxifen.
Choice C rationale:
This is the correct choice. Tamoxifen is widely used in the treatment of breast cancer,
especially in cases of estrogen receptor-positive breast cancer. It helps prevent cancer
recurrence and is often prescribed for both early-stage and advanced breast cancer patients.
Choice D rationale:
Tamoxifen is not used to treat polycystic ovary syndrome (PCOS). PCOS is a hormonal
disorder characterized by enlarged ovaries with small cysts, and it is typically managed with
lifestyle changes, hormonal contraceptives, and medications to regulate menstrual cycles and
manage symptoms like hirsutism and acne.
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