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Mia is a G7P6 who is 39 weeks and 2 days.She has come to obstetrics (OB) triage complaining of contraction pain every 3 to 5 minutes, has a large amount of bloody show, and tells you her last two deliveries took about 2 hours.
What would you expect her diagnosis to be and what would be your next step?

She is experiencing labor dystocia. The provider will be called to assess the need for an immediate cesarean section, and you would begin to prepare the patient for surgery.

She is at risk for a precipitous labor. The provider will be called to the bedside immediately while you remain at Mia's side providing support and preparing her for delivery.

She is at risk for cephalopelvic disproportion. The provider will be called to assess the need for a forceps delivery, and you will call the blood bank in order to have blood on standby.

She is experiencing false labor. The provider will be called to reassess and you will monitor her closely.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Labor dystocia involves prolonged labor. Her fast delivery history suggests the opposite, indicating rapid labor progress.

Choice B rationale

Rapid labor progression, frequent contractions, and previous short labors suggest she is at risk for precipitous labor, requiring immediate preparation for delivery.

Choice C rationale

Cephalopelvic disproportion indicates size mismatch between baby and pelvis, not rapid labor. Her history of quick deliveries does not align with this condition.

Choice D rationale

False labor typically involves irregular, less intense contractions. Her regular, intense contractions and labor history suggest active labor, not false labor.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Choice A rationale

Vaginal hematomas are usually associated with severe pain due to the accumulation of blood in the tissues.

Choice B rationale

Bleeding might be visible, but hematomas often cause internal accumulation, not external bleeding.

Choice C rationale

Warmth is not typically associated with hematomas; instead, pain and swelling are more common.

Choice D rationale

Redness may occur, but pain is the most consistent symptom.

A. The patient who is 37 years of age, obese, and experiencing pregnancy-induced hypertension. B. The patient with preexisting hypertension who is currently pregnant with twins. C. The patient who is 16 years of age just diagnosed with gestational diabetes. D. The patient who is 28 years old and delivered a premature neonate 3 years prior.

Correct Answer is A

Explanation

Choice A rationale

A 37-year-old patient with obesity and pregnancy-induced hypertension presents multiple risk factors. Advanced maternal age, obesity, and hypertension collectively increase the likelihood of complications such as preeclampsia, gestational diabetes, and cesarean delivery, necessitating close monitoring and management.

Choice B rationale

A patient with preexisting hypertension and twins is indeed high-risk due to the combined strain on the cardiovascular system and potential for preterm labor or other complications associated with multiple gestations. However, the presence of pregnancy-induced hypertension and obesity in the first patient poses a slightly higher cumulative risk.

Choice C rationale

A 16-year-old patient with newly diagnosed gestational diabetes is at increased risk, particularly because of age and the potential for poorly managed diabetes leading to complications. However, this scenario presents fewer immediate cumulative risks compared to older age and existing hypertension.

Choice D rationale

A 28-year-old patient who had a premature birth three years prior must be monitored for signs of recurrent preterm labor. Yet, this history alone does not present as high a cumulative risk as older maternal age, obesity, and pregnancy-induced hypertension. .

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Naxlex Comprehensive Predictor Exams

Which symptom would the nurse expect to observe in a postpartum client with a vaginal hematoma?

Correct Answer is A

Explanation

The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits.Which patient does the nurse identify as having the highest-risk pregnancy?

Correct Answer is A

Explanation

The nurse is caring for the postpartum client.Which assessment finding should prompt the nurse to conclude that the administration of carboprost tromethamine (Hemabate) has been effective?

A gravid patient in labor suddenly has dyspnea, hypotension, frothy sputum, and loss of consciousness.The nurse knows these are signs and symptoms of which obstetrical emergency?

A client is scheduled for an external version.The nurse would expect to prepare which of the following medications to be administered prior to the procedure?

The principal risk factor predictive of preterm birth is:

Which of the following is the appropriate nursing care outcome for a client who suddenly develops anaphylactoid syndrome of pregnancy (ASP) during labor?

Included in the definition of tachysystole is:

A client is on magnesium sulfate for pre-eclampsia with severe features.The nurse must notify the attending physician regarding which of the following findings?