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The nurse is assessing a client with ruptured membranes. What finding suggests chorioamnionitis?
- A. Clear amniotic fluid.
- B. Foul-smelling vaginal discharge.
- C. Fetal heart rate of 140 beats/minute.
- D. Absence of maternal fever.
Correct Answer: B
Rationale: Foul-smelling discharge is a key indicator of chorioamnionitis, an infection of the amniotic fluid.
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The nurse is assessing a client with suspected ectopic pregnancy. What is the most common symptom?
- A. Bright red vaginal bleeding.
- B. Severe lower abdominal pain.
- C. Increased fetal movement.
- D. Painless vaginal spotting.
Correct Answer: B
Rationale: Severe lower abdominal pain, often on one side, is a hallmark symptom of ectopic pregnancy.
The nurse is teaching a prenatal class about breast changes during pregnancy. Which change is expected?
- A. Decrease in nipple pigmentation.
- B. Reduction in breast size.
- C. Darkening of the areola.
- D. Development of inverted nipples.
Correct Answer: C
Rationale: Darkening of the areola is a common change due to hormonal influences during pregnancy.
When reviewing the arterial blood gas values for a client, a nurse notes a pH of 7.32, PaCO2 of 48 mm Hg, and HCO3 of 23 mEq/L. What does this indicate about the acid-base balance?
- A. Respiratory acidosis
- B. Respiratory alkalosis
- C. Metabolic acidosis
- D. Metabolic alkalosis
Correct Answer: A
Rationale: The given values suggest respiratory acidosis. In respiratory acidosis, the pH is low (<7.35), PaCO2 is high (>45 mm Hg), and the HCO3 is normal or slightly elevated. In this scenario, the low pH (7.32) and high PaCO2 (48 mm Hg) indicate respiratory acidosis, where there is an excess of carbon dioxide in the blood, leading to acidification of the body fluids.
A client at 39 weeks' gestation is in labor and reports intense back pain. What is the likely cause?
- A. Occiput posterior fetal position.
- B. Placental abruption.
- C. Breech presentation.
- D. Uterine rupture.
Correct Answer: A
Rationale: Intense back pain during labor is commonly associated with the occiput posterior fetal position.
The nurse is teaching a client about signs of preterm labor. Which symptom should be reported immediately?
- A. Increased fetal movements.
- B. Lower back pain and cramping.
- C. Mild swelling of the feet.
- D. Occasional Braxton Hicks contractions.
Correct Answer: B
Rationale: Lower back pain and cramping may indicate preterm labor and should be reported promptly.