A woman who is gravida 3 para 2 enters the intrapartum unit. The most important initial nursing assessments are:
If she has had prenatal care.
Membrane status and her EDD/EDC.
Time of last food intake and fasting blood sugar.
Pain level and birth plan.
The Correct Answer is B
A. Prenatal care history is important but not as urgent as membrane status and estimated delivery date.
B. Membrane status and estimated delivery date are critical for assessing the stage of labor and planning care.
C. Fasting blood sugar is relevant in diabetic patients but not an immediate priority.
D. Pain level and birth plan are important but secondary to assessing labor progress.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
Performing a vaginal examination is contraindicated in cases of unexplained vaginal bleeding, especially if placenta previa is suspected. It could disrupt the placenta, leading to severe hemorrhage.
Since the client is Rh-negative and there is a risk of fetal-maternal hemorrhage, administering RhoGAM is necessary to prevent Rh sensitization, which could affect future pregnancies.
While prenatal counseling is generally beneficial, it is non-essential in the acute management of vaginal bleeding and doesn't directly address the immediate clinical issue.
Correct Answer is {"dropdown-group-1":"B"}
Explanation
Given the client's symptoms of severe lower abdominal pain on the left side, the nurse should be concerned about a potential ectopic pregnancy, where the fertilized egg implants outside the uterus, commonly in the fallopian tube. This is a medical emergency, as it can lead to life-threatening complications if the tube ruptures.
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