Which of the following would indicate PPROM in a 32-week pregnant patient?

Vaginal fluid that makes a fern pattern on a microscope.

White vaginal discharge.

Negative fetal fibronectin test.

Vaginal fluid with a pH of 4.5.

Answer and Explanation

The Correct Answer is A

Choice A rationale

A fern pattern on a microscope slide is the definitive diagnostic sign of premature rupture of membranes (PPROM). This occurs when amniotic fluid, which contains sodium chloride, dries on the slide, forming a crystalline, fern-like pattern. This positive "ferning" test confirms the presence of amniotic fluid, indicating that the membranes have ruptured.

Choice B rationale

White vaginal discharge is a common finding during pregnancy and is not indicative of PPROM. This discharge, known as leukorrhea, is a result of increased estrogen production and blood flow to the vaginal area. It is a normal physiological change and does not signify ruptured membranes.

Choice C rationale

A negative fetal fibronectin test indicates a low probability of preterm birth within the next one to two weeks. It does not diagnose PPROM. While PPROM often leads to preterm birth, the fFN test is a predictive tool for labor, whereas ferning is a direct diagnostic test for membrane rupture.

Choice D rationale

The pH of vaginal fluid is typically acidic, ranging from 3.8 to 4.5. Amniotic fluid, however, is alkaline, with a pH of 7.0 to 7.5. Therefore, a vaginal fluid pH of 4.5 would be considered normal and would not indicate the presence of alkaline amniotic fluid, which would raise the pH to above 6.5.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A rationale

True labor contractions are characterized by their persistence and increasing intensity, unlike Braxton Hicks or false labor contractions which often subside with ambulation or a change in activity. This is due to the sustained release of oxytocin and prostaglandins, which stimulate continuous uterine muscle activity, leading to cervical change.

Choice B rationale

A key differentiator of true labor contractions is that they do not diminish with comfort measures like relaxation or taking a shower. These contractions are caused by physiological changes at the myometrial cellular level that are not easily influenced by external stimuli, and their progressive nature is essential for cervical effacement and dilation.

Choice C rationale

True labor contractions follow a predictable pattern, becoming regular in frequency, duration, and intensity over time. This is in contrast to false labor contractions, which remain irregular. The increasing regularity is a result of the synchronized rhythmic firing of myometrial cells as the labor process advances.

Choice D rationale

True labor contractions typically originate in the back and radiate to the lower abdomen, often described as a cramping or tightening sensation that encompasses the entire uterus. Discomfort localized only to the top of the uterus is more characteristic of Braxton Hicks contractions, which do not contribute to cervical change.

A. A patient with polyhydramnios. B. A patient experiencing gestational diabetes and carrying a fetus with an estimated fetal weight of 4.5 kg. C. A patient with hypotonic uterine dysfunction. D. A patient experiencing oxytocin-induction of labor.

Correct Answer is D

Explanation

Choice A rationale

Polyhydramnios, an excessive amount of amniotic fluid, is associated with an increased risk of premature rupture of membranes and umbilical cord prolapse. While it can cause uterine overdistention, leading to hypotonic dysfunction, it is not a primary risk factor for uterine rupture. The excess fluid does not directly weaken the uterine wall.

Choice B rationale

Gestational diabetes can lead to macrosomia, a fetus with a birth weight greater than 4.0 kg. While a large fetus can cause a difficult delivery and increase the risk for shoulder dystocia, the primary risk for uterine rupture is related to a scarred uterus from a previous cesarean section, not fetal size alone.

Choice C rationale

Hypotonic uterine dysfunction is characterized by weak, infrequent, or ineffective contractions during active labor. The uterine muscle is not contracting with sufficient force to cause cervical change. This condition primarily prolongs labor but does not increase the risk of uterine rupture, as the uterine wall is not under excessive strain.

Choice D rationale

Uterine rupture is a serious complication, and the risk is significantly elevated with oxytocin induction, especially in patients with a history of a previous cesarean section. Oxytocin stimulates powerful uterine contractions, and if the dose is not carefully titrated, it can overstimulate the uterus, potentially causing the old scar to tear under the intense pressure.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Which of the following would indicate PPROM in a 32-week pregnant patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching a pregnant patient about true labor contractions. The nurse evaluates that the patient understands the explanation when which statement is made?

Correct Answer is B

Explanation

The nurse is aware that uterine rupture is considered an obstetric emergency. Which of the following patients is at an increased risk for uterine rupture?

Correct Answer is D

Explanation

The nurse is caring for a patient whose labor is being augmented with oxytocin. The nurse recognizes that the oxytocin should be discontinued immediately if there is evidence of:

A 36-week pregnant patient comes to the labor and delivery unit. She states her water broke yesterday at this time. Because of her history, the nurse is concerned for which of the following?

During labor, a fetus with an average heart rate of 135 beats per minute over a 10-minute period would be considered to have a normal baseline heart rate.

A nurse should be aware that induction of labor is rated for success with a Bishop score.

In the event of shoulder dystocia, the nurse can assist by performing maneuvers to release the shoulder.

The nurse is assessing a patient who is 28 weeks pregnant and complaining of intermittent back pain and pelvic pressure. Which of the following should the nurse expect to be done? Select all that apply.