A nurse is reviewing the different signs of pregnancy with a client who is in her first trimester. Which of the following symptoms should the nurse classify as a positive sign of pregnancy?
Fetal movement felt by provider
Positive pregnancy test
Hegar's sign
Breast tenderness and nausea
The Correct Answer is A
A. Fetal movement felt by provider
This is correct because fetal movement confirmed by a healthcare provider is a positive sign of pregnancy, as it directly confirms fetal presence.
B. Positive pregnancy test
This is incorrect because a positive pregnancy test is a probable sign, not a positive sign. It detects hCG, which can also be produced in conditions like gestational trophoblastic disease (molar pregnancy).
C. Hegar’s sign
This is incorrect because Hegar’s sign (softening of the lower uterus) is a probable sign, not a positive sign, as it can occur due to other physiological changes.
D. Breast tenderness and nausea
This is incorrect because breast tenderness and nausea are presumptive signs of pregnancy, meaning they are subjective symptoms that could be caused by other conditions (e.g., PMS, stress, illness).
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Related Questions
Correct Answer is C
Explanation
A. "There is an increased risk of introducing infection." – While infections can occur, the primary concern with internal examinations in placenta previa is hemorrhage rather than infection.
B. "There is an increased risk of rupture of the membranes." – While membrane rupture is a risk with any vaginal examination, it is not the primary concern in placenta previa.
C. "This could result in profound bleeding." – With placenta previa, the placenta partially or completely covers the cervix. Digital or speculum exams can disrupt the placenta, causing significant hemorrhage, which is why they are contraindicated.
D. "This could initiate preterm labor." – While stimulation of the cervix could lead to contractions, the primary risk with an internal exam in placenta previa is significant bleeding, not preterm labor.
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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