A nurse is reviewing laboratory results of a pregnant patient.Which result will require further assessment?

Rubella titer 1:33.

Serologic test for syphilis (STS) - non-reactive.

Blood type A-negative.

Hemoglobin 12.2 gm/dL.

Answer and Explanation

The Correct Answer is A

A rubella titer of 1:33 indicates a low level of immunity to rubella, which can be dangerous for a pregnant woman and her fetus.

Rubella is a viral infection that can cause birth defects or miscarriage if contracted during pregnancy. A rubella titer of 1:10 or higher is considered protective.

Choice B is wrong because a non-reactive serologic test for syphilis (STS) means that the patient does not have syphilis, which is a bacterial infection that can also harm the fetus if untreated.

Choice C is wrong because blood type A-negative does not require further assessment unless the patient has antibodies to the Rh factor, which can cause hemolytic disease of the newborn if the fetus is Rh-positive.

This can be prevented by giving the patient Rh immunoglobulin injections during pregnancy and after delivery.

Choice D is wrong because hemoglobin 12.2 gm/dL is within the normal range for a pregnant woman, which is 11 to 14 gm/dL.

Hemoglobin is the protein in red blood cells that carries oxygen.

A low hemoglobin level can indicate anemia, which can affect the oxygen delivery to the fetus and increase the risk of preterm labor or low birth weight.

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Correct Answer is D

Explanation

The correct answer is choice D. If the client feels like she has butterflies in her stomach, it means her baby is moving.

This is a normal and expected change during pregnancy, especially in the second and third trimesters.The baby’s movements can be felt as flutters, kicks, or rolls.

Choice A is wrong because spotting of blood on the underwear is not a normal change during pregnancy.

It can indicate a problem such as placenta previa, placental abruption, or miscarriage.Any bleeding during pregnancy should be reported to the health care provider.

Choice B is wrong because clear fluid leaking from the vagina is not a normal change during pregnancy.

It can indicate that the membranes have ruptured and amniotic fluid is escaping.

This can lead to infection and preterm labor if not treated promptly.Any fluid leakage during pregnancy should be reported to the health care provider.

Choice C is wrong because dark patches on the face are not a sign of high blood pressure during pregnancy.

They are called melasma or chloasma and are caused by increased pigmentation due to hormonal changes.They usually fade after delivery and are not harmful.High blood pressure during pregnancy can cause symptoms such as headache, blurred vision, swelling, and protein in the urine.

A. A 23-year-old primigravida with a history of endometriosis. B. A 40-year-old multigravida with a history of condyloma acuminata. C. A 27-year-old primigravida with a bicornuate uterus. D. A 36-year-old multigravida who has had two previous cesarean deliveries.

Correct Answer is A

Explanation

The correct answer is choice A. A 23-year-old primigravida with a history of endometriosis.Endometriosis is a condition where the tissue that normally lines the uterus grows outside of it, sometimes affecting the fallopian tubes.This can cause scarring and damage to the tubes, which can increase the risk of ectopic pregnancy.

Choice B is wrong because condyloma acuminata, also known as genital warts, are caused by human papillomavirus (HPV) infection.HPV infection does not directly increase the risk of ectopic pregnancy, although it may be associated with other sexually transmitted infections (STIs) that can cause pelvic inflammatory disease (PID), which is a risk factor.

Choice C is wrong because a bicornuate uterus is a congenital anomaly where the uterus has two horns or chambers instead of one.This does not affect the fallopian tubes or the implantation of the fertilized egg in the uterus.

Choice D is wrong because previous cesarean deliveries do not increase the risk of ectopic pregnancy.However, previous tubal surgery, such as tubal ligation or salpingectomy, can damage the fallopian tubes and increase the risk.

Other risk factors for ectopic pregnancy include previous ectopic pregnancy, smoking, age older than 35 years, history of infertility, and use of assisted reproductive technology.

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A nurse is reviewing laboratory results of a pregnant patient.Which result will require further assessment?

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Naxlex Comprehensive Predictor Exams

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