A client arrives to OB triage at 37 weeks gestation with a known complete placenta previa this pregnancy.
She reports feeling some inconsistent contractions over the last 4 hours and wants to know if she is in labor.
The client asks the nurse why the provider did not perform a vaginal exam.
What is the most appropriate answer by the nurse?

A vaginal exam will increase the risk of rupturing your membranes.

A vaginal exam could cause vaginal bleeding.

A vaginal exam would cause infection if you are not in labor.

A vaginal exam could initiate preterm labor.

Answer and Explanation

The Correct Answer is B

Choice A rationale

While rupturing membranes can be a concern, the primary issue with a vaginal exam in the presence of placenta previa is the risk of severe bleeding. This choice is partially correct but not the most accurate answer.

Choice B rationale

With placenta previa, the placenta covers the cervix, and a vaginal exam could easily disrupt it, leading to significant vaginal bleeding. This bleeding can be dangerous for both the mother and the baby, making this the most accurate reason to avoid a vaginal exam.

Choice C rationale

Infection risk is a concern with any invasive procedure, but it is not the primary reason to avoid a vaginal exam in the case of placenta previa. The main concern is the risk of bleeding.

Choice D rationale

Initiating preterm labor is a possible risk with any vaginal exam late in pregnancy, but it is not the primary concern in cases of placenta previa. The main issue is the potential for causing severe bleeding.

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Correct Answer is D

Explanation

Choice A rationale

Prescribing insulin is premature based on a single elevated glucose test without further diagnostic confirmation through a 3-hour Glucose Tolerance Test.

Choice B rationale

Increasing carbohydrate intake is not recommended for managing elevated glucose levels in gestational diabetes.

Choice C rationale

No changes are recommended only if the GTT results are within the expected range. Further testing is required due to the elevated result.

Choice D rationale

A 3-hour Glucose Tolerance Test is needed to confirm gestational diabetes following an elevated 1-hour test result to ensure accurate diagnosis and appropriate management.

A. Methotrexate. B. Labetalol. C. Nifedipine. D. Calcium gluconate.

Correct Answer is D

Explanation

Choice A rationale

Methotrexate is used for treating ectopic pregnancies and certain cancers, but it is not an antidote for Magnesium Sulfate toxicity.

Choice B rationale

Labetalol is a beta-blocker used for hypertension management in pregnancy, not for reversing Magnesium Sulfate toxicity.

Choice C rationale

Nifedipine is a calcium channel blocker used to manage high blood pressure and preterm labor, not for counteracting Magnesium Sulfate toxicity.

Choice D rationale

Calcium gluconate is the specific antidote for Magnesium Sulfate toxicity, effectively reversing its effects.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client at 27 weeks gestation has completed the 1-hour Glucose Tolerance Test (GTT) with a result of 160 mg/dL (expected: less than 130-140 mg/dL). What education would the nurse provide following this test result?

Correct Answer is D

Explanation

A nurse is caring for a client receiving Magnesium Sulfate therapy IV for preterm labor.Which of the following medications should the nurse anticipate administering if the client exhibits hypotension, decreased urine output, and a respiratory rate of 10/min?

Correct Answer is D

Explanation

A client at 34 weeks gestation arrives to OB triage and is concerned she may be in preterm labor.Which of the following are signs and symptoms of preterm labor? (Select all that apply.)

A 38-year-old multigravida returns to the clinic for a routine prenatal visit at 36 weeks gestation.Assessment findings include blood pressure: 149/93 mm Hg, pulse: 80 beats/min, respiratory rate: 16 breaths/min.The nurse suspects preeclampsia.What additional finding would the nurse assess for?

A nurse is caring for a client who is at 32 weeks of gestation.Hemoglobin level is 8 g/dL (normal: 12 to 16 g/dL). Platelet count is 100,000/mm³ (normal: 150,000 to 400,000/mm³). Which of the following complications is the nurse most likely dealing with?

A nurse is caring for a client who has been diagnosed with hyperemesis gravidarum.Which of the following conditions are risk factors for hyperemesis gravidarum?

A nurse in a prenatal clinic is discussing the risks of twin to twin transfusion syndrome with an 18 week pregnant client with monochorionic-monoamniotic (mono-mono) twins.Which of the following statements by the client shows an understanding of the education?

A nurse is caring for a group of clients on an antepartum unit.Which of the following clients would be the nurse's priority?

A nurse is caring for a client who is at 32 weeks of gestation.Continuous fetal monitoring and vital signs per protocol are required.Prepare for cesarean birth.A nurse reviews the assessment findings and determines the findings are consistent with which of the following complications?

A nurse is providing care at a routine visit for a 28-year-old female client who is at 36 weeks of gestation in the clinic. Exhibits Which of the following findings should the nurse report to the provider? (Select all that apply.)