Scenario:
A nurse is caring for a 27-year-old female client in the clinic who is presumptively pregnant.

Exhibits

The nurse reviews the client's laboratory results. The nurse understands that the client is most likely experiencing which condition? Select all that apply.

Chlamydia

Pre-eclampsia

Gonorrhea

Pyelonephritis

Answer and Explanation

Correct Answer : A,C,D

Choice B rationale: Pre-eclampsia is characterized by high blood pressure and protein in the urine after 20 weeks of pregnancy. The client's urine protein is negative, and she is only presumptively pregnant at this stage, making pre-eclampsia unlikely.

Choice C rationale: The detection of Gonorrhea in the client's urine sample indicates an active infection. Gonorrhea is a sexually transmitted infection that can cause symptoms such as vaginal discharge, burning with urination, and increased urinary frequency, which the client is experiencing.

Choice D rationale: Pyelonephritis, a severe urinary tract infection, is indicated by the presence of many bacteria and positive nitrites in the urine, along with symptoms like fever and flank pain. The client’s urine test results and symptoms suggest pyelonephritis.

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Correct Answer is B

Explanation

Choice A rationale

Screening for group B streptococcus B-hemolytic (GBS) is typically performed between 35-37 weeks gestation, not during the initial visit. This screen aims to reduce neonatal GBS infections.

Choice B rationale

A complete physical assessment is necessary during the initial prenatal visit to establish a baseline health status and identify any potential health issues or risk factors in pregnancy.

Choice C rationale

Measuring fundal height is usually done after 20 weeks gestation to assess fetal growth and development, not during the initial prenatal visit, where the focus is on baseline assessments.

Choice D rationale

Performing a urinalysis is part of the initial prenatal visit to screen for urinary tract infections, glucose, protein, and other substances, ensuring maternal and fetal health.

A. Client at 6 weeks gestation reporting frequent urination. B. Client at 25 weeks gestation reporting menstrual-like cramps. C. Client at 30 weeks gestation reporting leg cramps while reclining. D. Client at 36 weeks gestation reporting a reddened, pruritic lower abdominal rash.

Correct Answer is B

Explanation

Choice A rationale

Frequent urination is common in early pregnancy due to hormonal changes and increased blood flow to the pelvic area. It is not typically a sign of an urgent complication requiring immediate attention.

Choice B rationale

Menstrual-like cramps at 25 weeks gestation could indicate preterm labor, which is a potential emergency. Prompt evaluation is necessary to ensure the health and safety of both the mother and the fetus.

Choice C rationale

Leg cramps while reclining are common in later stages of pregnancy due to changes in circulation and increased pressure on the veins. They are usually not a sign of an urgent complication.

Choice D rationale

A reddened, pruritic lower abdominal rash could indicate a skin condition or allergic reaction, but it is generally not an urgent complication during pregnancy unless accompanied by other severe symptoms.

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Scenario: A nurse is caring for a 27-year-old female client in the clinic who is presumptively pregnant. Exhibits The nurse reviews the client's laboratory results. The nurse understands that the client is most likely experiencing which condition? Select all that apply.

Nursing Test Bank

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

Scenario: A nurse is caring for a 27-year-old female client in the clinic who is presumptively pregnant. Exhibits Which two (2) client findings in the history and physical require further investigation?

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Scenario:
A nurse is caring for a 27-year-old female client in the clinic who is presumptively pregnant.

Exhibits

The nurse reviews the client's laboratory results. The nurse understands that the client is most likely experiencing which condition? Select all that apply.