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A nurse is reviewing the differences between placenta previa and abruptio placentae with a group of nursing students. Which of the following statements accurately differentiates placenta previa from abruptio placentae?

"Placenta previa usually results in a higher risk of maternal hypertension, while abruptio placentae is commonly associated with a low-risk pregnancy."

"Placenta previa is characterized by sudden onset of severe abdominal pain and uterine tenderness, while abruptio placentae is associated with painless bleeding."

"Placenta previa typically presents with severe pain and contractions, whereas abruptio placentae involves painless bleeding without contractions."

"Placenta previa involves the placenta partially or completely covering the cervix, whereas abruptio placentae involves the premature separation of the placenta from the uterine wall."

Answer and Explanation

The Correct Answer is D

A. "Placenta previa usually results in a higher risk of maternal hypertension, while abruptio placentae is commonly associated with a low-risk pregnancy.
This is incorrect because abruptio placentae, not placenta previa, is associated with maternal hypertension (e.g., preeclampsia, chronic hypertension). Placenta previa is not related to blood pressure issues.

B. "Placenta previa is characterized by sudden onset of severe abdominal pain and uterine tenderness, while abruptio placentae is associated with painless bleeding."
This is incorrect because placenta previa presents with painless, bright red vaginal bleeding, while abruptio placentae causes sudden, severe abdominal pain, uterine tenderness, and possibly dark red bleeding.

C. "Placenta previa typically presents with severe pain and contractions, whereas abruptio placentae involves painless bleeding without contractions."
This is incorrect because placenta previa does not cause pain or contractions. In contrast, abruptio placentae often presents with painful contractions and uterine hypertonicity.

D. "Placenta previa involves the placenta partially or completely covering the cervix, whereas abruptio placentae involves the premature separation of the placenta from the uterine wall."
Placenta previa occurs when the placenta covers the cervix (partial or complete), leading to bleeding. Abruptio placentae occurs when the placenta prematurely separates from the uterine wall, which can lead to hemorrhage and fetal distress.

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Correct Answer is B

Explanation

A. Advise the client to seek help from family members to reduce stress and manage the baby's care – While social support is helpful, it does not directly address potential postpartum mood disorders, which require further evaluation.

B. Assess the client for further signs of postpartum mood disorders – These symptoms may indicate postpartum depression, which requires further assessment and potential intervention. Early identification is crucial to ensuring the client's safety and well-being.

C. Reassure the client that these feelings are normal and will subside in a few days – While some mood changes are common postpartum ("baby blues"), the intensity of these symptoms may indicate postpartum depression, which requires assessment.

D. Encourage the client to rest whenever the baby is sleeping to alleviate fatigue – While rest is important, it does not address the client's concerns about anxiety, irritability, and feelings of inadequacy, which may signal a mood disorder.

Correct Answer is []

Explanation

A. Assessment Cues

Unprotected Sexual Activity increases the risk of sexually transmitted infections (STIs). The client has had multiple sexual partners in the past month without protection, making her susceptible to infections such as trichomoniasis, gonorrhea, chlamydia, and bacterial vaginosis. This is a significant risk factor for her symptoms.
Foul-smelling discharge is a common symptom of trichomoniasis, bacterial vaginosis, and other vaginal infections. UTIs primarily cause dysuria, frequency, urgency, and suprapubic pain, not vaginal symptoms. Since the urinalysis does not show leukocytes, nitrates, or bacteria, a UTI is unlikely.

B. Condition – Trichomoniasis

The client's symptoms—green-yellow vaginal discharge, vaginal itching, and foul-smelling odor—are classic signs of trichomoniasis, a sexually transmitted infection caused by Trichomonas vaginalis. The disease is associated with malodorous discharge, vaginal irritation, and possible dysuria.

C. Anticipated Solutions

Oral Metronidazole: The first-line treatment for trichomoniasis is oral metronidazole (Flagyl) 2g as a single dose or 500mg twice daily for 7 days. Metronidazole effectively eliminates the infection. Patients must be educated to avoid alcohol while taking metronidazole due to the risk of a disulfiram-like reaction (severe nausea and vomiting).
Safe sexual behaviors, such as consistent condom use, regular STI screening, mutual monogamy, and open communication about sexual history, are essential for reducing the risk of sexually transmitted infections (STIs), including trichomoniasis.

Incorrect answers:

Human Papillomavirus (HPV): HPV causes genital warts and increases the risk of cervical cancer, but it does not typically cause vaginal discharge, itching, or foul odor. Therefore, HPV is not the most likely condition in this case.

Depression: While multiple sexual partners and STI diagnoses can cause emotional distress, depression is not directly relevant to her current presentation. However, mental health screening may be beneficial if she expresses concerns about her emotional well-being.

Herpes simplex virus (HSV) is a sexually transmitted infection (STI) that can cause genital ulcers, pain, and discomfort. However, based on the client’s symptoms, HSV is not the most likely diagnosis.

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A nurse is reviewing the differences between placenta previa and abruptio placentae with a group of nursing students. Which of the following statements accurately differentiates placenta previa from abruptio placentae?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a postpartum client who reports feeling anxious, irritable, and unable to sleep despite extreme fatigue. The client also expresses feelings of inadequacy as a mother. Which of the following nursing interventions is the most appropriate?

Correct Answer is B

Explanation

Exhibits Select a condition, the assessment cues, and anticipated solutions for this client.

Correct Answer is []

Explanation

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