The nurse is giving discharge instructions to the client following evacuation of the molar pregnancy. Which of the following information should the nurse ascertain that the client understands?

Have her blood checked every month for the next 360 days.

Receive Rhogam with the next pregnancy

Seek genetic counselling with her partner before the next pregnancy

Becoming pregnant within the year

Answer and Explanation

The Correct Answer is A

A. Have her blood checked every month for the next 360 days is correct. After a molar pregnancy (also known as a hydatidiform mole), the client must have serial monitoring of hCG levels (usually monthly for 6 to 12 months) to ensure that all molar tissue has been removed and that gestational trophoblastic disease (such as choriocarcinoma) does not develop. A rising or persistently elevated hCG level can indicate malignancy.

B. Receive Rhogam with the next pregnancy may be necessary if the client is Rh-negative, but it is not specific or essential to the follow-up care for a molar pregnancy itself.

C. Seek genetic counselling with her partner before the next pregnancy is not routinely required after a molar pregnancy unless there’s a history of recurrent molar pregnancies or other genetic concerns.

D. Becoming pregnant within the year is discouraged. Pregnancy should be avoided for at least 6 to 12 months after molar pregnancy to allow for monitoring of hCG levels without interference from a new pregnancy, which could complicate interpretation of results.

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Correct Answer is ["A","D"]

Explanation

A. Dark red vaginal bleeding is often seen in placental abruption. The blood from an abruption is typically dark red (indicating that it is older blood) and may be mixed with amniotic fluid, making it more challenging to assess. However, the bleeding can sometimes be concealed, especially in complete abruption or retroplacental hemorrhage, where blood accumulates behind the placenta.

B. Absence of pain is incorrect. In fact, placental abruption is typically associated with abdominal pain, which can be severe and often comes on suddenly. Pain occurs due to the detachment of the placenta from the uterine wall and subsequent irritation or bleeding into the uterine cavity.

C. Insidious onset is incorrect. Placental abruption usually has a sudden or acute onset of symptoms, such as vaginal bleeding and abdominal pain. An insidious onset would be more suggestive of other conditions, such as placenta previa.

D. Absent fetal heart tones is a critical finding. Placental abruption can cause fetal distress or fetal death, especially if the abruption is severe. Absent fetal heart tones are a sign of fetal compromise or death resulting from the disruption of placental blood flow.

A. Apply an ice pack to the site. B. Offer warm blankets. C. Offer a warm sitz bath. D. Encourage the woman to void

Correct Answer is A

Explanation

A. Ice helps to reduce swelling, numb the area, and relieve pain during the first 24 hours after an episiotomy. Applying ice immediately after birth can help minimize discomfort and inflammation.

B. Offer warm blankets may provide comfort but will not specifically target pain relief or swelling at the site of the episiotomy.

C. Offer a warm sitz bath is beneficial for postpartum healing and pain relief but should not be used immediately after the procedure. Warm sitz baths are typically recommended after the first 24 hours to promote relaxation and improve blood circulation.

D. Encourage the woman to void is important for overall comfort and bladder function but will not directly address the pain from the episiotomy.

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The nurse is giving discharge instructions to the client following evacuation of the molar pregnancy. Which of the following information should the nurse ascertain that the client understands?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse suspects that a pregnant client may be experiencing a placental abruption based on assessment of which finding? Select all that apply.

Correct Answer is ["A","D"]

Explanation

A client who has just given birth to a healthy newborn required an episiotomy. Which action would the nurse implement immediately after birth to decrease the client's pain from the procedure?

Correct Answer is A

Explanation

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