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A client in labor reports sudden pain and bright red vaginal bleeding. What should the nurse suspect?
- A. Placenta previa.
- B. Abruptio placentae.
- C. Preterm labor.
- D. Rupture of membranes.
Correct Answer: B
Rationale: Bright red bleeding and sudden pain suggest abruptio placentae, requiring urgent intervention.
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A client in labor is receiving epidural anesthesia. What is the priority nursing intervention?
- A. Monitor maternal heart rate.
- B. Assess for bladder distention.
- C. Check maternal blood pressure frequently.
- D. Encourage frequent position changes.
Correct Answer: C
Rationale: Frequent monitoring of maternal blood pressure is essential to detect and manage hypotension caused by epidural anesthesia.
A nurse caring for a client who is at 20 weeks of gestation and has trichomoniasis. Which of the following findings should the nurse expect?
- A. Thick, White Vaginal Discharge
- B. Urinary Frequency
- C. Vulva Lesions
- D. Malodorous Discharge
Correct Answer: D
Rationale: Trichomoniasis is a sexually transmitted infection caused by the parasite Trichomonas vaginalis. In pregnant individuals, trichomoniasis can result in adverse pregnancy outcomes such as preterm birth and low birth weight. A common symptom of trichomoniasis is a frothy, yellow-green, malodorous vaginal discharge. Therefore, in this client scenario, the nurse should expect to find a malodorous discharge as a result of trichomoniasis. The other options presented are not typically associated with trichomoniasis.
The nurse assesses a patient for medical eligibility for contraceptive use. What is the meaning of an MEC score of 2?
- A. There is no restriction for the use of the contraceptive method.
- B. There is an unacceptable health risk if the contraceptive method is used.
- C. There is a risk that outweighs the advantages of the contraceptive method.
- D. There is an advantage of using a contraceptive method that outweighs any risk.
Correct Answer: B
Rationale: An MEC score of 2 indicates that there is an unacceptable health risk if the contraceptive method is used. This means that the potential health risks associated with using this particular contraceptive method outweigh the benefits. Therefore, the nurse should advise against using this method for contraception due to the elevated health risks involved. It is essential for healthcare providers to meticulously assess the medical eligibility of a patient before recommending any contraceptive method to ensure the safety and well-being of the individual.
What is the primary purpose of administering vitamin K to a newborn?
- A. Prevent anemia
- B. Enhance immune function
- C. Prevent bleeding disorders
- D. Promote growth and development
Correct Answer: C
Rationale: Newborns are born with low levels of vitamin K, essential for blood clotting.
The nurse is monitoring a client receiving oxytocin for labor induction. What finding requires the nurse to take immediate action?
- A. Contractions lasting 90 seconds.
- B. Contractions every 2–3 minutes.
- C. Fetal heart rate of 180 beats/minute.
- D. Client reports mild nausea.
Correct Answer: C
Rationale: A fetal heart rate of 180 bpm indicates tachycardia, which may suggest fetal distress requiring immediate intervention.