A nurse in a prenatal clinic is caring for a client who is suspected of having a hydatidiform mole. Which of the following findings should the nurse expect to observe in this client?
Irregular fetal heart rate
Rapid decline in human chorionic gonadotropin (hCG) levels
Profuse, clear vaginal discharge
Excessive uterine enlargement
The Correct Answer is D
Choice A reason: Irregular fetal heart rate is not an expected finding in a client with a hydatidiform mole, as it can indicate fetal arrhythmia, distress, or demise. A client with a hydatidiform mole may have no fetal heart tones, as the pregnancy is nonviable and consists of abnormal trophoblastic tissue.
Choice B reason: Rapid decline in human chorionic gonadotropin (hCG) levels is not an expected finding in a client with a hydatidiform mole, as it can indicate a normal or abnormal termination of pregnancy. A client with a hydatidiform mole may have markedly elevated hCG levels, as the trophoblastic tissue secretes excessive amounts of the hormone.
Choice C reason: Profuse, clear vaginal discharge is not an expected finding in a client with a hydatidiform mole, as it can indicate a normal or abnormal cervical mucus production. A client with a hydatidiform mole may have vaginal bleeding, which is often dark brown or bright red, and may contain grape-like vesicles.
Choice D reason: Excessive uterine enlargement is an expected finding in a client with a hydatidiform mole, as it reflects the rapid growth of the trophoblastic tissue and the accumulation of fluid-filled vesicles. A client with a hydatidiform mole may have a uterus that is larger than expected for the gestational age, and may experience uterine cramping or pain.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Misoprostol is not the first line medication for postpartum hemorrhage, as it is a prostaglandin E1 analog that causes uterine contractions and cervical ripening. Misoprostol is used for the prevention and treatment of postpartum hemorrhage, but it is less effective and more side effects than oxytocin, which is the first line medication.
Choice B reason: Pitocin is the first line medication for postpartum hemorrhage, as it is a synthetic form of oxytocin, which is a hormone that stimulates uterine contractions and retraction. Pitocin is used for the induction and augmentation of labor, and the prevention and treatment of postpartum hemorrhage, as it reduces blood loss and enhances hemostasis.
Choice C reason: Hemabate is not the first line medication for postpartum hemorrhage, as it is a prostaglandin F2 alpha analog that causes uterine contractions and vasoconstriction. Hemabate is used for the treatment of postpartum hemorrhage, but it is contraindicated in clients with asthma, hypertension, or cardiac disease, as it can cause bronchospasm, hypertension, or cardiac arrhythmias.
Choice D reason: Methergine is not the first line medication for postpartum hemorrhage, as it is an ergot alkaloid that causes sustained uterine contractions and vasoconstriction. Methergine is used for the treatment of postpartum hemorrhage, but it is contraindicated in clients with hypertension, preeclampsia, or cardiac disease, as it can cause severe hypertension, cerebrovascular accidents, or myocardial infarction.
Correct Answer is C
Explanation
Choice A reason: This statement is incorrect, as it describes the direct Coombs test, not the indirect Coombs test. The direct Coombs test is performed on the newborn's blood, and it detects the presence of maternal antibodies that have attached to the newborn's red blood cells. The direct Coombs test can help diagnose hemolytic disease of the newborn, which is a condition where the maternal antibodies destroy the newborn's red blood cells, causing anemia and jaundice.
Choice B reason: This statement is incorrect, as it is not the purpose of the indirect Coombs test, but rather a possible complication of hemolytic disease of the newborn. Kernicterus is a severe form of jaundice that occurs when the bilirubin level in the blood is very high, and it can cause brain damage, deafness, or death. Kernicterus can be prevented by treating the jaundice with phototherapy or exchange transfusion.
Choice C reason: This statement is correct, as it describes the indirect Coombs test, which is performed on the mother's blood, and it detects the presence of Rh-positive antibodies that have formed in response to the exposure to the Rh-positive blood of the newborn. The indirect Coombs test can help identify the risk of hemolytic disease of the newborn, and guide the administration of Rh immunoglobulin, which is a medication that prevents the formation of Rh-positive antibodies.
Choice D reason: This statement is incorrect, as it is not possible for the newborn to have Rh-negative antibodies, since the newborn has Rh-positive blood. Rh-negative antibodies are produced by Rh-negative individuals who have been exposed to Rh-positive blood, such as Rh-negative mothers who have Rh-positive newborns. Rh-negative antibodies can cross the placenta and attack the Rh-positive red blood cells of the newborn, causing hemolytic disease of the newborn.
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