The labor and birth nurse is reviewing the risk factors for placenta previa with a group of nursing students. The nurse determines that the students understood the discussion when they identify which patient being at the highest risk for developing a placenta previa?
- A. Female fetus, Mexican-American, primigravida
- B. Male fetus, Asian-American, previous preterm birth
- C. Male fetus, African-American, previous cesarean birth
- D. Female fetus, European-American, previous spontaneous abortion
Correct Answer: C
Rationale: The correct answer is C: Male fetus, African-American, previous cesarean birth. Placenta previa occurs when the placenta partially or completely covers the cervix. African-American women have a higher incidence of placenta previa. Previous cesarean birth is a risk factor due to possible scarring on the uterine wall, increasing the likelihood of placenta implantation issues. Male fetuses are associated with a higher risk of placenta previa, possibly due to a larger placental size. The other choices do not align with known risk factors for placenta previa, such as the ethnicity, fetal gender, and obstetric history mentioned.
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Which finding on a prenatal visit at 10 weeks might suggest a hydatidiform mole?
- A. Blood pressure of 120/80 mm Hg
- B. Complaint of frequent mild nausea
- C. Fundal height measurement of 18 cm
- D. History of bright red spotting for 1 day weeks ago
Correct Answer: C
Rationale: The correct answer is C: Fundal height measurement of 18 cm. At 10 weeks of gestation, the fundal height should typically measure around 10-12 cm. A fundal height measurement of 18 cm would suggest excessive growth, which is a characteristic finding in a hydatidiform mole due to abnormal proliferation of placental tissue.
Incorrect choices:
A: Blood pressure of 120/80 mm Hg is within normal range and not specific to hydatidiform mole.
B: Complaint of frequent mild nausea is a common symptom in early pregnancy and not specific to a mole.
D: History of bright red spotting for 1 day weeks ago is more indicative of a potential previous miscarriage, not necessarily a mole.
Which finding in the assessment of a patient following an abruption placenta could indicate a major complication?
- A. Urine output of 30 mL in 1 hour
- B. Blood pressure of 110/60 mm Hg
- C. Bleeding at IV insertion site
- D. Respiratory rate of 16 breaths per minute
Correct Answer: C
Rationale: The correct answer is C because bleeding at the IV insertion site could indicate disseminated intravascular coagulation (DIC), a major complication of placental abruption. DIC is a serious condition that results in widespread clotting and bleeding throughout the body. This finding signifies that the patient's clotting factors are being consumed rapidly, leading to uncontrolled bleeding. Options A, B, and D are not indicative of a major complication of placental abruption. A decreased urine output, low blood pressure, and normal respiratory rate may be seen in various conditions but are not specific to DIC or a major complication in this context.
What is a common sign or symptom of preeclampsia during pregnancy?
- A. abdominal cramps
- B. severe headache
- C. increased appetite
- D. elevated heart rate
Correct Answer: B
Rationale: The correct answer is B: severe headache. A common sign of preeclampsia is a severe headache due to high blood pressure, a hallmark symptom of the condition. Preeclampsia can lead to dangerous complications for both the mother and the baby. Abdominal cramps (A) are not typically associated with preeclampsia. Increased appetite (C) is not a typical symptom and may even decrease due to other factors. Elevated heart rate (D) is not a specific sign of preeclampsia; high blood pressure is the key indicator.
Which finding in the exam of a patient with a diagnosis of threatened abortion would change the diagnosis to inevitable abortion?
- A. Presence of backache
- B. Rise in hCG level
- C. Clear fluid from vagina
- D. Pelvic pressure
Correct Answer: C
Rationale: The correct answer is C: Clear fluid from vagina. In threatened abortion, the pregnancy is at risk but the fetus is still viable. In inevitable abortion, there is no chance of continuation. Clear fluid from the vagina indicates rupture of membranes, leading to inevitable abortion due to the loss of amniotic fluid. Backache, rise in hCG levels, and pelvic pressure are common symptoms in threatened abortion but do not definitively indicate progression to inevitable abortion.
A patient with preeclampsia is admitted complaining of pounding headache, visual changes, and epigastric pain. Nursing care is based on the knowledge that these signs indicate
- A. gastrointestinal upset.
- B. effects of magnesium sulfate.
- C. anxiety caused by hospitalization.
- D. worsening disease and impending convulsion.
Correct Answer: D
Rationale: The correct answer is D because the symptoms described (headache, visual changes, epigastric pain) are classic signs of worsening preeclampsia, indicating impending eclampsia with seizures. This requires urgent intervention to prevent serious complications. Option A is incorrect as gastrointestinal upset does not typically present with these specific signs. Option B is incorrect as magnesium sulfate is used to prevent seizures in preeclampsia, not cause the symptoms described. Option C is incorrect as anxiety would not cause the specific symptoms mentioned. In summary, the signs described point towards worsening disease and the likelihood of impending convulsions, necessitating immediate medical attention.