A nurse in a prenatal clinic is caring for a client who is at 1 week of pregnancy and has noticed bleeding without contractions.
She is in no distress and states that she can feel the baby moving. Which of the following might be the cause?

Premature maturity.

Incompetency.

Location of the placenta.

Frequency and duration of contractions.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Premature maturity is not a plausible cause of bleeding without contractions at 1 week of pregnancy. Premature maturity, or preterm labor, refers to labor that begins before 37 weeks of gestation. It is characterized by contractions and cervical changes, often accompanied by other symptoms such as lower back pain, pelvic pressure, or a change in vaginal discharge. At 1 week of pregnancy, the fetus is still in the very early stages of development, and premature labor is not possible.

Choice C rationale:

The location of the placenta can sometimes cause bleeding in pregnancy, but it is typically associated with later stages of gestation, such as the second or third trimester. Placental conditions like placenta previa, where the placenta lies low in the uterus and partially or completely covers the cervix, can lead to bleeding, but this is unlikely to occur at 1 week of pregnancy. Moreover, placenta previa is usually accompanied by pain or cramping, which is not present in the client's case.

Choice D rationale:

The frequency and duration of contractions are relevant in assessing labor progression, but they are not a primary cause of bleeding without contractions. Contractions are the rhythmic tightening and relaxing of the uterine muscles that help to dilate the cervix and move the baby through the birth canal. Bleeding without contractions at 1 week of pregnancy suggests a different underlying issue.

Choice B rationale:

Incompetency, also known as cervical insufficiency or cervical incompetence, is the most likely cause of bleeding without contractions at 1 week of pregnancy. It occurs when the cervix is weak and begins to open prematurely, even without the presence of contractions. This can lead to bleeding and potential miscarriage or preterm birth. The fact that the client can feel the baby moving does not rule out cervical insufficiency, as fetal movement can sometimes be felt as early as 13-16 weeks of pregnancy.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Rationale for Choice A: Whitish vaginal discharge
While whitish vaginal discharge can occur in some cases of hydatidiform mole, it's not a specific or sensitive finding for this condition.
It can also be present in various other gynecological conditions, including normal pregnancy, infections, and hormonal imbalances.
Therefore, relying on whitish vaginal discharge alone for monitoring a potential hydatidiform mole could lead to misdiagnosis or delayed diagnosis.

Rationale for Choice B: Excessive uterine enlargement
Excessive uterine enlargement is a common sign of hydatidiform mole, but it's not always present and might not be detected early in the condition.
The uterus might not be significantly enlarged in early stages, and other factors like multiple pregnancies or uterine fibroids could also contribute to uterine enlargement.
Solely relying on uterine enlargement could miss cases of hydatidiform mole that haven't progressed to a noticeable degree.

Rationale for Choice C: Fetal heart rate irregularities
Fetal heart rate irregularities are not relevant in hydatidiform mole because there is no viable fetus present. Hydatidiform moles are characterized by abnormal growth of placental tissue without a normal fetus developing. Monitoring for fetal heart rate would be inappropriate and misleading in this context.

Rationale for Choice D: Rapidly changing hCG levels
This is the most accurate and reliable finding to monitor for in a suspected hydatidiform mole.
hCG is a hormone produced by the placenta, and it's typically elevated in pregnancy. However, in hydatidiform mole, hCG levels are often abnormally high and rise rapidly.
Serial hCG measurements can accurately detect and track the progression of a hydatidiform mole, even in its early stages. It's considered the gold standard for diagnosis and monitoring of this condition.

A. The ultrasound determines there is more than one fetus. B. The ultrasound is for determining fetal age. C. The ultrasound is for identifying the location and mass. D. The ultrasound is for imaging.

Correct Answer is C

Explanation

Choice A:

While an ultrasound can indeed determine if there are multiple fetuses, this is not the primary reason for performing it prior to amniocentesis. The number of fetuses is typically established earlier in pregnancy through routine ultrasounds.

Focusing solely on multiple fetuses might lead the client to believe that ultrasounds are only conducted in such cases, which is not accurate.

Choice B:

Determining fetal age is a crucial aspect of prenatal care, but it's not the main reason for an ultrasound before amniocentesis. Fetal age is typically assessed through earlier ultrasounds, often in the first trimester.

Highlighting fetal age might misinform the client about the specific purpose of the ultrasound in this context.

Choice C:

This is the most appropriate response because it accurately identifies the primary purpose of the ultrasound.

Amniocentesis involves inserting a needle into the amniotic sac to collect a sample of amniotic fluid. To ensure the safety of the procedure and minimize risks to the fetus, it's essential to accurately visualize the location of the amniotic sac and placenta, as well as assess the position of the fetus.

Ultrasound provides real-time imaging that allows the healthcare provider to visualize these structures with precision, guiding the needle insertion and reducing the risk of complications.

Choice D:

While stating that the ultrasound is for imaging is technically correct, it's too general and doesn't provide the specific reason for its use in this context.

A more informative response would clarify the specific imaging goals for amniocentesis, as outlined in Choice C.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse in a prenatal clinic is caring for a client who is at 1 week of pregnancy and has noticed bleeding without contractions. She is in no distress and states that she can feel the baby moving. Which of the following might be the cause?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who might have a hydatidiform mole. The nurse should monitor the client for which of the following findings? Choice Options:

Correct Answer is D

Explanation

A nurse in a prenatal office is caring for a client who is at gestation and is scheduled for an amniocentesis. The client asks why ultrasounds are performed prior to the procedure. Which of the following responses by the nurse is appropriate?

Correct Answer is C

Explanation

A nurse is assisting with the admission of a client who is at 10 weeks of gestation and reports abdominal pain and moderate vaginal bleeding. Incomplete abortion is the initial diagnosis. Which of the following actions should the nurse contribute to the client’s plan of care?

A nurse in the antepartum unit is assisting with the care of a client who is at 36 weeks of gestation and reports continuous abdominal pain and vaginal bleeding. The nurse should identify that the client is likely experiencing which of the following complications?

A nurse is reviewing contraception options for four clients. The nurse should identify which of the following clients as having a contraindication to oral contraceptives?

A nurse is caring for a client who has just learned that she is pregnant. The nurse should reinforce with the client to call her provider if she experiences which of the following manifestations?

A nurse is assisting with the care of a client who is at 37 weeks of gestation and has placenta previa. Which of the following risks is the primary reason the nurse should avoid performing a pelvic examination?

A nurse is assisting with the admission of a client who is at 8 weeks of gestation and has heavy vaginal bleeding. Which of the following actions should the nurse take?

A nurse is caring for a client who has consented to an amniocentesis for genetic cell analysis. The client asks why she can’t have the test before 14 weeks of gestation. Which of the following responses should the nurse make?

A nurse is admitting a client who is at 36 weeks gestation and has pain, bright red vaginal bleeding. The nurse recognizes this finding as an indication of which of the following conditions? Choice Options:

A nurse in a prenatal clinic is caring for a client who is at 1 week of pregnancy and has noticed bleeding without contractions.
She is in no distress and states that she can feel the baby moving. Which of the following might be the cause?