A nurse is educating a pregnant client about normal vaginal changes during pregnancy. Which statement by the client indicates a need for further teaching?

I should report any pain, burning, or itching associated with the vaginal discharge.

I understand that an increase in vaginal discharge is normal during pregnancy.

I should be concerned if I experience a white, odorless vaginal discharge.

My vaginal walls may appear bluish due to increased blood flow.

Answer and Explanation

The Correct Answer is C

A. I should report any pain, burning, or itching associated with the vaginal discharge: Pain, itching, or burning are signs of possible infection and should be reported promptly. These symptoms are not typical of normal pregnancy changes. Reporting them helps prevent complications. This statement reflects appropriate understanding.

B. I understand that an increase in vaginal discharge is normal during pregnancy: Hormonal changes during pregnancy lead to increased vaginal secretions. This discharge, known as leukorrhea, is usually clear or white and non-irritating. Recognizing this as normal indicates correct learning.

C. I should be concerned if I experience a white, odorless vaginal discharge: White, odorless discharge is considered normal in pregnancy and does not require concern. Thinking it is abnormal shows a misunderstanding of physiological changes. This indicates a need for further education about normal discharge patterns.

D. My vaginal walls may appear bluish due to increased blood flow: Increased vascularization causes a bluish discoloration of the vaginal mucosa, known as Chadwick’s sign. It is a normal early sign of pregnancy. The client’s awareness of this change reflects accurate knowledge.

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Correct Answer is D

Explanation

A. Hypotension and preterm labor: Gestational diabetes is more commonly associated with hypertension rather than hypotension. Although preterm labor can occur, it is not a direct or primary complication of GDM. These conditions are not typically linked with poor glucose control.

B. Placenta previa and fetal growth restriction: Placenta previa is related to abnormal placental implantation, not glucose regulation. Fetal growth restriction is more common in placental insufficiency, while GDM is often associated with fetal macrosomia due to excess glucose availability.

C. Hyperemesis gravidarum and anemia: Hyperemesis gravidarum usually occurs in early pregnancy and is related to hormonal changes, not diabetes. Anemia is common in pregnancy but is not directly caused by GDM. These are not typical maternal complications of gestational diabetes.

D. Polyhydramnios and hypertension: GDM can lead to polyhydramnios due to increased fetal urination in response to hyperglycemia. Hypertension is also more prevalent in clients with GDM due to vascular changes and increased metabolic stress. These are well-established maternal risks.

A. There is an elevated level of alpha-fetoprotein (AFP) in the amniotic fluid. B. The fetus is likely to have a congenital anomaly, be growth restricted, or demonstrate fetal distress during labor. C. The client is carrying more than one fetus. D. An excessive amount of amniotic fluid is present.

Correct Answer is D

Explanation

A. There is an elevated level of alpha-fetoprotein (AFP) in the amniotic fluid: Elevated AFP may indicate neural tube defects or abdominal wall defects but is not the defining feature of polyhydramnios. While such defects can coexist with polyhydramnios, elevated AFP is not diagnostic of it.

B. The fetus is likely to have a congenital anomaly, be growth restricted, or demonstrate fetal distress during labor: These are potential complications or associations of polyhydramnios but not the definition itself. The condition refers specifically to excessive amniotic fluid, which may lead to or signal anomalies, not confirm them.

C. The client is carrying more than one fetus: Multiple gestation can cause increased amniotic fluid levels, but polyhydramnios can occur in singleton pregnancies as well. Twin pregnancy is a risk factor, not a definition of polyhydramnios.

D. An excessive amount of amniotic fluid is present: Polyhydramnios is defined as an amniotic fluid index (AFI) greater than 24 cm or a single deepest pocket over 8 cm. This is the most accurate and direct definition of the condition.

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A nurse is educating a pregnant client about normal vaginal changes during pregnancy. Which statement by the client indicates a need for further teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A pregnant client with gestational diabetes mellitus (GDM) is at risk for which of the following maternal complications?

Correct Answer is D

Explanation

A nurse is caring for a client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios. The nurse should recognize that this diagnosis means which of the following?

Correct Answer is D

Explanation

A nurse is caring for a pregnant client who is diagnosed with hyperemesis gravidarum. Which of the following interventions should the nurse prioritize for the pregnant client with hyperemesis gravidarum?

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