A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what would be an expected diagnostic procedure?

Amniocentesis for fetal lung maturity

Contraction stress test (CST)

Internal fetal monitoring

Ultrasound for placental location

None of the above

Answer and Explanation

The Correct Answer is D

Choice A reason: Amniocentesis for fetal lung maturity is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a procedure that involves inserting a needle into the amniotic sac to obtain a sample of amniotic fluid, which can be used to assess the fetal lung development. It is usually done in late pregnancy or preterm labor, not in the second trimester.

Choice B reason: Contraction stress test (CST) is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that involves stimulating uterine contractions, either by nipple stimulation or oxytocin infusion, to evaluate the fetal heart rate response. It is used to assess fetal well-being and placental function, not to diagnose the cause of bleeding.

Choice C reason: Internal fetal monitoring is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a method of measuring the fetal heart rate and uterine contractions using electrodes or catheters that are inserted through the cervix and attached to the fetal scalp or the amniotic sac. It is usually done during labor, not in the second trimester.

Choice D reason: Ultrasound for placental location is an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that uses sound waves to create an image of the uterus, the placenta, and the fetus. It can help to determine the position and attachment of the placenta, which can be the cause of bleeding if it is low-lying or covering the cervix (placenta previa).

Choice E reason: None of the above is not a correct answer. There is one expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding, which is ultrasound for placental location.

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Correct Answer is D

Explanation

Choice A reason: This is incorrect because oral antiviral therapy is not effective for PID, which is caused by bacterial infection. Antiviral therapy is used for viral infections, such as herpes or HIV.

Choice B reason: This is incorrect because antibiotics only until symptoms subside is not sufficient for PID, which can cause serious complications, such as infertility, ectopic pregnancy, or chronic pelvic pain. Antibiotics should be continued for the full course of treatment, usually 14 days, to ensure complete eradication of the infection.

Choice C reason: This is incorrect because frequent pelvic examination to monitor the progress of healing is not recommended for PID, which can cause inflammation and irritation of the pelvic organs. Pelvic examination should be avoided or minimized to prevent further trauma or spread of the infection.

Choice D reason: This is correct because bed rest in a semi-Fowler position is beneficial for PID, which can cause fluid accumulation and pressure in the pelvic cavity. Bed rest helps to reduce inflammation and pain, while semi-Fowler position helps to drain the fluid and prevent abscess formation.

A. Eat five small meals daily. B. Lie down after each meal. C. Reduce the amount of fiber she consumes. D. Substitute other calcium sources for milk in her diet.

Correct Answer is A

Explanation

Choice A reason: Eating five small meals daily can help reduce heartburn in pregnancy by preventing overeating and reducing the pressure on the stomach from the growing uterus. It can also help maintain a steady blood glucose level and prevent nausea and vomiting.

Choice B reason: Lying down after each meal can worsen heartburn in pregnancy by allowing the stomach acid to reflux into the esophagus. It can also cause breathing difficulties and increase the risk of aspiration. The woman should avoid lying down for at least two hours after eating and elevate her head and chest when sleeping.

Choice C reason: Reducing the amount of fiber she consumes can cause constipation and hemorrhoids in pregnancy, which can increase the discomfort and pain. Fiber is important for maintaining a healthy digestive system and preventing gestational diabetes and preeclampsia. The woman should consume at least 25 grams of fiber per day from fruits, vegetables, whole grains, beans, and nuts.

Choice D reason: Substituting other calcium sources for milk in her diet can deprive the woman and the baby of essential nutrients, such as protein, vitamin D, and riboflavin. Milk is not a common cause of heartburn in pregnancy, unless the woman is lactose intolerant or allergic to dairy products. The woman should consume at least three servings of dairy products per day or take calcium supplements as prescribed.

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A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what would be an expected diagnostic procedure?

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