A woman pregnant with twins comes to the clinic for an evaluation. While assessing the client, the nurse would be especially alert for signs and symptoms for which potential problem?

oligohydramnios

preeclampsia

chorioamnionitis

post-term labor

Answer and Explanation

The Correct Answer is B

A. Oligohydramnios:

Oligohydramnios refers to a condition where there is too little amniotic fluid surrounding the fetus in the womb. It can be concerning because amniotic fluid plays a crucial role in protecting and cushioning the fetus, aiding in lung development, and preventing compression of the umbilical cord. While oligohydramnios can be a complication in pregnancy, it's not necessarily more common or specific to twin pregnancies compared to singleton pregnancies.

B. Preeclampsia:

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, such as the liver and kidneys. It usually develops after 20 weeks of pregnancy and can lead to serious complications for both the mother and the babies if not managed properly. Multiple pregnancies, including twins, are considered a risk factor for developing preeclampsia. Therefore, pregnant women carrying twins require close monitoring for signs and symptoms of preeclampsia.

C. Chorioamnionitis:

Chorioamnionitis is an infection of the fetal membranes (chorion and amnion) and amniotic fluid. It typically occurs due to bacterial infection ascending from the vagina into the uterus, often during prolonged labor or rupture of membranes. While chorioamnionitis is a concern in pregnancy, it's not necessarily more common in twin pregnancies compared to singleton pregnancies.

D. Post-term labor:

Post-term labor refers to labor that begins after 42 weeks of gestation. Prolonged pregnancy beyond the due date can increase the risks of complications for both the mother and the baby, including fetal distress, macrosomia (large birth weight), and meconium aspiration. Post-term labor can occur in both singleton and multiple pregnancies, but it's not specifically more associated with twin pregnancies.

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Correct Answer is A

Explanation

A. "I'm sorry you lost your baby."

This response demonstrates empathy and validation of the client's emotions. It acknowledges the client's loss and offers support during a difficult time. By expressing sympathy, the nurse shows understanding and compassion towards the client's grief.

B. "A baby still wasn't formed in your uterus."

This response may come across as dismissive or invalidating of the client's emotions. It does not acknowledge the client's loss or address their emotional needs. It focuses more on the biological aspect of the situation rather than the client's feelings.

C. "Will a pill help your pain?"

This response only addresses physical pain management and does not acknowledge the emotional distress the client is experiencing. While pain relief is important, it is equally important to address the client's emotional needs and provide support during a difficult time.

D. "Why are you crying?"

This response may come across as insensitive or intrusive. It puts the client on the spot and may make them feel uncomfortable or defensive about their emotions. It does not provide empathy or support and fails to acknowledge the client's loss or offer condolences.

A. mammogram B. hormone receptor status C. fine-needle aspiration D. genetic testing for BRCA

Correct Answer is A

Explanation

A. Mammogram

A mammogram is typically the next step in the diagnostic process when a breast lump is detected during a clinical breast examination. Mammography allows for further evaluation of the lump and surrounding breast tissue to determine its characteristics, such as size, shape, and density. It is an important tool for detecting breast abnormalities, including masses and calcifications, which can help in diagnosing breast cancer.

B. Hormone receptor status

While hormone receptor status testing may be part of the diagnostic workup for breast cancer, it is usually not the immediate next step after discovering a breast lump during a clinical examination. Hormone receptor status testing is typically performed after a confirmed diagnosis of breast cancer to guide treatment decisions, such as the use of hormone therapy.

C. Fine-needle aspiration

Fine-needle aspiration (FNA) may be used in conjunction with other diagnostic tests, such as mammography or ultrasound, to further evaluate a breast lump. However, it is not typically the first step in the diagnostic process, especially if a lump is found during a clinical breast examination. FNA involves using a thin needle to extract cells or fluid from the lump for examination under a microscope to determine if it is benign or malignant.

D. Genetic testing for BRCA

Genetic testing for BRCA mutations is typically not the immediate next step after finding a breast lump during a clinical examination. Genetic testing for BRCA mutations is usually recommended for individuals with a strong family history of breast or ovarian cancer or those who meet specific criteria based on personal or family history. It is not typically the initial diagnostic step in evaluating a breast lump.

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A woman pregnant with twins comes to the clinic for an evaluation. While assessing the client, the nurse would be especially alert for signs and symptoms for which potential problem?

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