A nurse is caring for a client with placenta previa in the labor and delivery unit. Which of the following is not a true statement of placental previa

Cervical exams should not be performed.

Symptoms include painful bleeding that is bright red in color.

The mother is at risk for placental abruption.

Placenta previa is a result of improper placement of the placenta in the uterus.

Answer and Explanation

The Correct Answer is B

A. Cervical exams should not be performed: Performing a cervical exam in placenta previa can trigger severe hemorrhage because the placenta may partially or completely cover the cervical os. Avoiding exams unless the location is confirmed by ultrasound is standard practice.

B. Symptoms include painful bleeding that is bright red in color: Placenta previa typically causes painless, bright red vaginal bleeding during the second or third trimester. Painful bleeding is more characteristic of placental abruption, making this statement inaccurate.

C. The mother is at risk for placental abruption: While placenta previa itself does not cause abruption, patients may still have overlapping risk factors, and any abnormal placental implantation can complicate labor, making monitoring important.

D. Placenta previa is a result of improper placement of the placenta in the uterus: Placenta previa occurs when the placenta implants low in the uterus, partially or completely covering the cervical os, which is considered improper placement relative to normal implantation in the upper uterine segment.

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Correct Answer is B

Explanation

A. "I have an IUD and have had the same boyfriend for 3 years.": Being in a mutually monogamous relationship reduces the risk of acquiring STDs, and the presence of an IUD primarily prevents pregnancy rather than influencing STD risk. This statement indicates lower concern for immediate STD education.

B. “I have never been tested for syphilis or chlamydia.": Lack of screening for common STDs places the patient at increased risk of undiagnosed infections. Chlamydia and syphilis can be asymptomatic but cause long-term complications, highlighting the critical need for patient teaching about routine testing and early detection.

C. "I make an appointment every year for a pelvic exam.": Annual pelvic exams are important for reproductive health and early detection of abnormalities, but they do not guarantee protection against STDs. The patient demonstrates proactive preventive care in this context.

D. "I use the birth control pill because I am not ready to settle down yet.": Using oral contraceptives addresses pregnancy prevention but does not prevent STDs. While additional teaching on barrier protection may be warranted, this statement primarily reflects awareness of contraceptive needs rather than immediate high-risk behavior.

A. Massage the fundus. B. Insert a urinary catheter. C. Have the client urinate. D. Administer an analgesic

Correct Answer is C

Explanation

A. Massage the fundus: Fundal massage is indicated when the uterus is boggy to promote uterine contraction and prevent postpartum hemorrhage. In this case, the fundus is already firm, indicating adequate uterine tone. Massaging a firm uterus is unnecessary and does not address the cause of displacement.

B. Insert a urinary catheter: Bladder distention can displace the uterus to the right and above the expected level. Although catheterization may be needed if the client cannot void, the initial intervention should be less invasive. Encouraging spontaneous voiding is preferred before proceeding to catheter insertion.

C. Have the client urinate: A firm uterus that is displaced from midline and elevated suggests bladder distention. Having the client urinate helps relieve bladder fullness, allowing the uterus to return to the midline and descend appropriately. This intervention directly addresses the likely cause of the abnormal fundal position.

D. Administer an analgesic: Analgesics may help manage postpartum discomfort but do not correct uterine displacement or bladder distention. Pain control does not influence uterine position or fundal height in this situation. Addressing bladder emptying is the priority intervention.

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A nurse is caring for a client with placenta previa in the labor and delivery unit. Which of the following is not a true statement of placental previa

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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