A nurse is reviewing the history of a client who is pregnant.
Which of the following clinical data indicates the client is at risk for preterm delivery?
Previous delivery at 37 weeks gestation
Previous delivery of a newborn weighing 2.5 kg (5.5 lb)
Previous reactive non-stress test
Previous cervical cerclage
The Correct Answer is D
Choice A rationale
A previous delivery at 37 weeks gestation does not necessarily indicate a risk for preterm delivery. Preterm delivery is defined as delivery before 37 weeks of gestation.
Choice B rationale
A previous delivery of a newborn weighing 2.5 kg (5.5 lb) does not indicate a risk for preterm delivery. Low birth weight can be a result of preterm delivery, but it can also be due to other factors such as intrauterine growth restriction.
Choice C rationale
A previous reactive non-stress test does not indicate a risk for preterm delivery. A reactive non-stress test is a positive sign of fetal well-being.
Choice D rationale
A previous cervical cerclage indicates a risk for preterm delivery. Cervical cerclage is a procedure performed to prevent preterm birth in women with a history of preterm birth and who have a short cervix.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Decreasing the rate of IV fluids would not address the issue of late decelerations, which are a sign of fetal hypoxia.
Choice B rationale
Elevating the client’s head would not address the issue of late decelerations.
Choice C rationale
Performing fetal scalp stimulation is used to assess fetal well-being when the tracing is nonreactive, not when late decelerations are present.
Choice D rationale
Administering oxygen via a face mask is the correct answer. This increases maternal oxygen saturation, which can help increase oxygen delivery to the fetus.
Correct Answer is D
Explanation
Choice A rationale
Administering a 500 mL lactated Ringer’s IV bolus is not the first action to take when a nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage.
Choice B rationale
Documenting urinary output is important, but it is not the first action to take when a nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage.
Choice C rationale
Replacing the surgical dressing is not the first action to take when a nurse notes a steady trickle of vaginal bleeding that does not stop with fundal massage.
Choice D rationale
Notifying the healthcare provider is the correct action. Persistent vaginal bleeding after a cesarean birth could indicate a postpartum hemorrhage, which is a medical emergency
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