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 A

Explanation

Leukocoria (white pupils) is a symptom of retinopathy of prematurity (ROP), an eye disease that can happen in premature babies.ROP happens when abnormal blood vessels grow on the retina, the light-sensitive layer of tissue in the back of the eye.

Choice B is wrong because strabismus (crossed eyes) is not a symptom of ROP, but a possible complication that can occur later in life.

Choice C is wrong because nystagmus (involuntary eye movements) is not a symptom of ROP, but another possible complication that can occur later in life.

Choice D is wrong because it includes choices B and C, which are incorrect.

Normal ranges for gestational age and birth weight are 38 to 42 weeks and 5.5 to 10 pounds, respectively.Babies born before 31 weeks or weighing less than 3 pounds are at risk for ROP.

A. Accelerations B. Early decelerations C. Variable decelerations D. Absent variability

Correct Answer is D

Explanation

According to the search results, magnesium sulfate can have a negative effect on the fetal heart rate (FHR) by lowering the baseline, decreasing the variability, and reducing the reactivity or acceleration pattern.Absent variability means that there is no fluctuation in the FHR and it indicates fetal hypoxia or acidosis.

This is a potential adverse effect of magnesium sulfate on the fetus and requires immediate intervention.

Choice A.Accelerations is wrong because accelerations are transient increases in the FHR that indicate fetal well-being.They are not affected by magnesium sulfate.

Choice B.Early decelerations is wrong because early decelerations are decreases in the FHR that occur with uterine contractions and are caused by fetal head compression.They are benign and do not indicate fetal distress.They are not associated with magnesium sulfate.

Choice C.Variable decelerations is wrong because variable decelerations are abrupt decreases in the FHR that vary in shape, duration, and timing and are caused by umbilical cord compression.

They may or may not indicate fetal compromise.

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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 assessing a pre-term newborn who has retinopathy of prematurity (ROP). Which of the following manifestations should the nurse expect to observe?

Correct Answer is A

Explanation

A nurse is evaluating the fetal heart rate tracing of a client who is in pre-term labor and receiving magnesium sulfate. The nurse should identify that which of the following patterns indicates a potential adverse effect of the medication on the fetus?

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?