An ultrasound is performed on a client at term who is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on this finding, what would be the next action?

Strict intake and output monitoring

Prepare for delivery of the fetus by cesarean section (C/S)

Weekly monitoring of coagulation factors

Complete bed rest for the remainder of the pregnancy

Answer and Explanation

The Correct Answer is B

A. Strict intake and output monitoring is important for managing any patient with significant blood loss or who is at risk for complications, but it does not directly address the immediate needs of a client with abruptio placentae. The priority is stabilizing the mother and delivering the fetus safely.

B. Prepare for delivery of the fetus by cesarean section (C/S) is correct. Abruptio placentae (placental abruption) is a life-threatening condition where the placenta prematurely detaches from the uterine wall, leading to bleeding and potential fetal distress. Immediate delivery is often required, especially if there is significant bleeding or fetal compromise. A cesarean section is usually the preferred method of delivery in these cases to reduce the risk of maternal and fetal complications.

C. Weekly monitoring of coagulation factors is important for managing coagulopathies that might develop in the presence of placental abruption, but it is not the immediate action required. Immediate delivery is the priority.

D. Complete bed rest for the remainder of the pregnancy may be recommended for certain cases of placental abruption with mild symptoms, but in the presence of moderate vaginal bleeding and significant findings on ultrasound, immediate delivery (typically by C-section) is more urgent.

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Correct Answer is A

Explanation

A. "This is meconium stool and is normal for a newborn." is the correct and most appropriate response. Meconium is the newborn’s first stool, typically passed within the first 24 to 48 hours of life. It is black, tarry, and sticky in appearance and consists of materials the baby ingested while in the womb, such as amniotic fluid, mucus, and cells. It is completely normal and expected.

B. "You probably took iron during your pregnancy and that is what causes this type of stool." is incorrect. While iron supplements can darken adult stools, meconium is unrelated to maternal iron intake and is a normal physiological occurrence in all newborns.

C. “This is unusual, and I need to report this to your pediatrician." is incorrect and would be alarming to the parent unnecessarily. This is a normal finding, not something requiring physician notification.

D. "I'll take a sample and check it for possible bleeding" is also inappropriate unless there are other signs of concern (e.g., blood in stool later on). Meconium is not indicative of bleeding and does not warrant testing under normal circumstances.

A. convection B. conduction C. radiation D. evaporation

Correct Answer is B

Explanation

A. Convection is the loss of heat due to air or fluid movement around the body. While keeping the newborn warm in a draft-free area can help with this, the blanket on the scale primarily addresses heat loss through contact with the cold surface.
B. Conduction occurs when heat is transferred from the baby’s body to a cooler surface that it comes into direct contact with, like the cold scale. By placing a warmed blanket on the scale, the nurse minimizes heat loss due to conduction, ensuring the baby stays warm.
C. Radiation involves heat transfer to cooler objects nearby, but a warmed blanket on the scale does not directly address heat loss through radiation.
D. Evaporation occurs when moisture on the skin evaporates, taking heat away. A warmed blanket would not primarily address evaporation; it’s meant to prevent conduction heat loss.

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An ultrasound is performed on a client at term who is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on this finding, what would be the next action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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