You are receiving report from the night shift nurse on a laboring client.
She is 39 weeks gestation, cervical exam is 9cm/100%/0, she has an epidural in place for pain management.
ROM occurred 25 hours ago with a moderate amount of clear fluid.
EFM assessment includes baseline 175bpm, minimal variability, no accelerations, no decelerations.
Vital signs: Blood pressure: 118/84 mmHg.
Respiratory Rate: 16/min.
O2 saturation: 99% on R

Intraamniotic infection.

Pyelonephritis.

Cholestasis of pregnancy.

Placental abruption.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Intraamniotic infection (chorioamnionitis) is suspected due to the combination of prolonged rupture of membranes (25 hours), maternal fever (39.2°C), and fetal tachycardia (baseline of 175 bpm). These are key indicators of infection within the amniotic sac.

Choice B rationale

Pyelonephritis, an infection of the kidneys, is unlikely without the presence of symptoms such as flank pain, dysuria, and significant changes in urinalysis. The primary signs point towards intraamniotic infection.

Choice C rationale

Cholestasis of pregnancy primarily presents with intense itching, especially on the hands and feet, and does not typically involve fever or abnormal fetal heart rates. Thus, it is less likely in this scenario.

Choice D rationale

Placental abruption involves the separation of the placenta from the uterine wall before delivery, often presenting with abdominal pain, vaginal bleeding, and uterine contractions. The absence of these symptoms makes this diagnosis less likely.

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Correct Answer is A

Explanation

Choice A rationale

Placenta accreta spectrum involves abnormal adherence of the placenta to the uterine wall, leading to complications during delivery and often necessitating a cesarean and possibly a hysterectomy.

Choice B rationale

Placenta previa refers to the placenta covering the cervix, which can cause bleeding but is managed differently.

Choice C rationale

Placenta abruption is the premature separation of the placenta from the uterus, leading to pain and bleeding, managed differently from accreta spectrum.

Choice D rationale

Posterior placental location refers to the position of the placenta in the uterus and does not typically require a cesarean and hysterectomy unless complicated by other factors.

A. Asthma. B. Hyperthyroidism. C. Previous cesarean delivery. D. Hypertension.

Correct Answer is D

Explanation

Choice A rationale

Asthma is a respiratory condition and is not directly linked to an increased risk of placental abruption. While chronic conditions can affect pregnancy, asthma is not a direct risk factor for abruption.

Choice B rationale

Hyperthyroidism is a thyroid condition that can cause complications during pregnancy, but it is not a known risk factor for placental abruption. It affects the mother's metabolism and can impact fetal development, but does not typically cause placental detachment.

Choice C rationale

Previous cesarean delivery is associated with risks such as uterine rupture in future pregnancies, but not specifically with placental abruption. The scar tissue from a cesarean may affect the placenta's position, but does not increase the risk of abruption directly.

Choice D rationale

Hypertension, or high blood pressure, is a significant risk factor for placental abruption. It can damage the blood vessels in the placenta, leading to separation from the uterine wall and resulting in abruption, which can be dangerous for both mother and baby.

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse in a provider's office is caring for a client who is at 37 weeks of gestation and at risk for placental abruption.The nurse should recognize that which of the following is a risk factor for abruption?

Correct Answer is D

Explanation

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 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 30-year-old female client who is gravida 4, para 3, at 32 weeks of gestation in the antepartum clinic. Exhibits A nurse reviews the assessment findings and determines the findings are consistent with which of the following complications?

A nurse is providing education about TORCH infections to a pregnant client and her partner.The nurse identifies that the client is at risk for which infection?

A nurse is educating a client at the end of her second trimester about car safety.Which statement by the client indicates a correct understanding of the nurse's education?

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?