A 23-year-old primigravida who appears to be in her third trimester of pregnancy comes to the labor and delivery unit reporting acute abdominal pain. She has had no prenatal care. Which assessment should the nurse do first?
Obtain a full history.
Examine the cervix for dilation
Examine the cervix for dilation.
Palpate for uterine contraction frequency
The Correct Answer is C
This is because the first priority for a pregnant woman with acute abdominal pain is to assess the fetal well-being and rule out any obstetric complications such as placental abruption, uterine rupture, or preterm labor. Fetal heart tones can indicate the presence and viability of the fetus and alert the nurse to any signs of fetal distress or hypoxia.
Choice A: Obtain a full history is wrong because it is not the most urgent action.
A full history can provide valuable information about the possible causes of abdominal pain, but it should not delay the assessment of fetal status and maternal vital signs.
Choice B: Examine the cervix for dilation is wrong because it can be harmful in some cases. A digital cervical examination should be avoided until placenta previa is ruled out by ultrasound, as it can cause bleeding and worsen the condition.
Moreover, cervical dilation alone does not indicate the cause or severity of abdominal pain.
Choice D: Palpate for uterine contraction frequency is wrong because it is not the most reliable method to assess labor. Uterine contractions can be measured by external tocodynamometry or internal intrauterine pressure catheter, which can provide more accurate and objective data than manual palpation.
Furthermore, uterine contractions do not necessarily indicate labor, as they can also be caused by other conditions such as dehydration, infection, or irritable uterus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is choice B. Insulin amount needs will continue to increase throughout the second and third trimesters.This is because gestational diabetes is a form of diabetes that develops during pregnancy, usually during the 2nd or 3rd trimester.It is caused by hormonal changes that interfere with the action of insulin, leading to high blood sugar levels.As the pregnancy progresses, the placenta produces more hormones that increase insulin resistance, so the mother needs more insulin to keep her blood sugar within normal range.
Choice A is wrong because insulin amount needs will not remain stable during the third trimester.They will increase as the placenta grows and produces more hormones that cause insulin resistance.
Choice C is wrong because insulin amount needs will not decrease during the third trimester.They will increase as the placenta grows and produces more hormones that cause insulin resistance.
Choice D is wrong because insulin amount needs will not remain stable for the rest of the second and during the third trimesters.They will increase as the pregnancy progresses and the placenta produces more hormones that increase insulin resistance.
Normal ranges for blood sugar during pregnancy are: fasting < 95 mg/dL, 1 hour after meal < 140 mg/dL, 2 hours after meal < 120 mg/dL.
Correct Answer is B
Explanation
The correct answer is choice B. Syphilis.A negative rapid plasma reagin (RPR) test indicates that a patient is probably not infected with syphilis, a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum.The RPR test works by detecting the nonspecific antibodies that your body produces while fighting the infection.
Choice A is wrong because herpes simplex II is a viral infection that causes genital herpes, and it is not detected by the RPR test.
Choice C is wrong because gonorrhea is a bacterial infection caused by Neisseria gonorrhoeae, and it is also not detected by the RPR test.
Choice D is wrong because condylomata are genital warts caused by human papillomavirus (HPV), and they are not detected by the RPR test either.
The RPR test is a screening test, and it can give false-positive results due to other conditions or infections.Therefore, a positive RPR test should always be confirmed by a more specific treponemal test, such as TPPA or FTA-ABS.The RPR test can also be used to monitor the treatment response of syphilis, as the antibody levels should decrease after effective antibiotic therapy.
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