A client who is 32 weeks pregnant calls the clinic complaining of an increase in vaginal discharge, pelvic pressure, and low back and abdominal pain. Based on this information, what action will the nurse take?

Tell the client to take a warm shower, rest, and call back tomorrow.

Schedule an appointment for the client at the clinic tomorrow.

Instruct the client to drink cranberry juice and call if she experiences a fever.

Instruct the client to go to labor triage at the hospital for evaluation.

Answer and Explanation

The Correct Answer is D

A. Tell the client to take a warm shower, rest, and call back tomorrow. While rest and hydration can sometimes help with mild discomfort, this client’s symptoms—pelvic pressure, low back pain, abdominal pain, and increased vaginal discharge—are concerning for preterm labor and require immediate evaluation. Delaying care could increase the risk of preterm birth.

B. Schedule an appointment for the client at the clinic tomorrow. Waiting until the next day is not appropriate, as preterm labor is an urgent condition that needs immediate assessment to prevent premature birth. Prompt intervention may allow for tocolytic therapy or steroid administration to improve fetal lung maturity if preterm birth is imminent.

C. Instruct the client to drink cranberry juice and call if she experiences a fever. Cranberry juice is sometimes used to prevent urinary tract infections (UTIs), but this client’s symptoms are more indicative of preterm labor rather than an infection. Fever is not a defining symptom of preterm labor, and delaying care could result in complications.

D. Instruct the client to go to labor triage at the hospital for evaluation. This is the best response because the symptoms suggest possible preterm labor. Evaluation in the hospital can include cervical checks, fetal monitoring, and tests such as fetal fibronectin (fFN) to assess the risk of preterm birth. Immediate intervention can help delay labor and improve neonatal outcomes.

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Correct Answer is B

Explanation

While many women are able to get pregnant again after an ectopic pregnancy, it is not guaranteed. The ability to conceive again depends on various factors, such as:

The extent of damage to the fallopian tube.
Whether one or both tubes are still functional.
The treatment used (e.g., methotrexate vs. surgery).
Any underlying fertility issues.

It is important to be honest but reassuring, explaining that many women do go on to have healthy pregnancies, but future fertility can be affected and should be discussed with a healthcare provider. Saying she "absolutely will" get pregnant again is inaccurate and potentially misleading.

A. Maternal temperature of 101.4 F B. Maternal blood pressure of 138/89 C. Change in fetal baseline heart rate from 125 to 90 D. Change in the maternal pulse from 80 to 93

Correct Answer is C

Explanation

A. Maternal temperature of 101.4°F. A fever may indicate infection (chorioamnionitis), but it is not an immediate reason to stop oxytocin. The nurse should monitor for additional signs of infection and notify the provider, but the priority is fetal well-being.

B. Maternal blood pressure of 138/89. This blood pressure is not critically high and does not indicate a hypertensive crisis. Oxytocin can cause fluid retention and slight blood pressure changes, but this reading alone does not require stopping the infusion.

C. Change in fetal baseline heart rate from 125 to 90. A decrease in fetal heart rate (bradycardia) is a sign of fetal distress and requires immediate intervention. Oxytocin can cause uterine hyperstimulation, leading to decreased placental perfusion and fetal hypoxia. The priority is to stop oxytocin, reposition the mother, provide oxygen, and notify the provider.

D. Change in the maternal pulse from 80 to 93. A mild increase in heart rate is not uncommon during labor and may be due to pain, anxiety, or IV fluids. It does not indicate an emergency or the need to stop oxytocin.

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A client who is 32 weeks pregnant calls the clinic complaining of an increase in vaginal discharge, pelvic pressure, and low back and abdominal pain. Based on this information, what action will the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A woman is admitted due to a suspected ectopic pregnancy. While explaining treatment the patient asks if she will be able to get pregnant again. You answer that she absolutely will get pregnant again. Is this the correct thing to say?

Correct Answer is B

Explanation

A nurse is monitoring the labor of a patient who is receiving IV oxytocin (Pitocin) at 6 ml/hr. Which of the following clinical signs would lead the nurse to stop the infusion?

Correct Answer is C

Explanation

The nurse is preparing to administer methotrexate to the patient. This drug is most often used for which obstetric complication?

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