A client at 28 weeks of gestation presents with bleeding from the vagina.

Which assessment finding should the nurse prioritize?

Regular uterine contractions occurring every 15 minutes

Low back pain and pelvic pressure

Change in vaginal discharge

Rupture of membranes

Answer and Explanation

The Correct Answer is A

Regular uterine contractions occurring every 15 minutes.

This finding suggests that the client may have placental abruption, which is a serious complication that requires immediate medical attention. Placental abruption is the premature separation of the placenta from the uterine wall, which can cause heavy bleeding, pain, and fetal distress.

Choice B is wrong because low back pain and pelvic pressure are common symptoms of preterm labor, which is not as urgent as placental abruption.

Choice C is wrong because a change in vaginal discharge is not a specific sign of any complication and may be normal in pregnancy.

Choice D is wrong because rupture of membranes is not a priority finding in this case, unless it is associated with infection or cord prolapse.

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Correct Answer is D

Explanation

“I will call my doctor if I have more than four contractions in an hour.” This statement indicates that the client understands the signs of preterm labor and when to seek medical attention.Preterm labor is defined as having regular contractions and cervical changes before 37 weeks of gestation.More than four contractions in an hour may indicate that preterm labor is occurring and requires prompt evaluation.

Choice A is wrong because drinking at least eight glasses of water every day is not a specific instruction for preventing preterm labor.However, dehydration can trigger contractions and should be avoided.

Choice B is wrong because lying on the back with a pillow under the knees can reduce blood flow to the uterus and the baby.This position can also increase the risk of blood clots in the legs.A better position is lying on the left side, which improves circulation and reduces pressure on the cervix.

Choice C is wrong because avoiding sexual intercourse until reaching term is not necessary for most women with a history of preterm labor.Sexual activity does not cause preterm labor or premature rupture of membranes (PROM).However, some women may be advised to abstain from sex if they have certain conditions, such as placenta previa or a short cervix.

A. Asthma B. Diabetes mellitus C. Hypertension D. Cardiac disease

Correct Answer is D

Explanation

Nifedipine is a calcium channel blocker that is used to relax uterine contractions and postpone preterm labor.However, it can also lower blood pressure and cause side effects such as headache, dizziness, flushing, and palpitations.Therefore, it should be avoided in clients who have cardiac disease or other conditions that affect the heart function.

Choice A is wrong because asthma is not a contraindication for nifedipine.Nifedipine does not affect the airways or cause bronchospasm.

Choice B is wrong because diabetes mellitus is not a contraindication for nifedipine.Nifedipine does not affect blood glucose levels or insulin secretion.

Choice C is wrong because hypertension is not a contraindication for nifedipine.In fact, nifedipine can be used to treat high blood pressure as well as preterm labor.However, blood pressure should be monitored closely during nifedipine therapy to avoid hypotension.

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A client at 28 weeks of gestation presents with bleeding from the vagina. Which assessment finding should the nurse prioritize?

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge instructions to a client who had pre-term labor at 32 weeks of gestation and was prescribed bed rest at home. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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A client at 28 weeks of gestation presents with bleeding from the vagina.

Which assessment finding should the nurse prioritize?