A nurse in a provider's office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption?
Cigarette smoking
Hypertension
Blunt force trauma
Cocaine use
The Correct Answer is B
Choice A rationale
This is incorrect because cigarette smoking is not the most common risk factor for abruption. Cigarette smoking can increase the risk of abruption by causing vasoconstriction and reducing placental blood flow, but it is less prevalent and less severe than hypertension.
Choice B rationale
This is correct because hypertension is the most common risk factor for abruption. Hypertension can cause damage to the uterine vessels and lead to bleeding and separation of the placenta from the uterine wall. Hypertension affects about 40% of clients who experience abruption and can be chronic or pregnancy-induced.
Choice C rationale
This is incorrect because blunt force trauma is not the most common risk factor for abruption. Blunt force trauma can cause abruption by applying direct pressure or shear force to the placenta, but it is less common and less predictable than hypertension. Blunt force trauma can result from motor vehicle accidents, falls, or physical abuse.
Choice D rationale
This is incorrect because cocaine use is not the most common risk factor for abruption. Cocaine use can increase the risk of abruption by causing vasoconstriction and uterine contractions, but it is less common and less consistent than hypertension. Cocaine use can also cause other complications, such as fetal growth restriction, preterm labor, or stillbirth.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Assessing deep tendon reflexes every hour is an appropriate order for a client who has severe preeclampsia. This can help detect increased neuromuscular irritability, which is a sign of worsening preeclampsia or impending eclampsia. The nurse should report any hyperreflexia, clonus, or decreased sensation to the provider.
Choice B rationale
Continuous fetal monitoring is an appropriate order for a client who has severe preeclampsia. This can help assess the fetal well-being and detect any signs of fetal distress, such as bradycardia, tachycardia, or decreased variability. The nurse should report any abnormal fetal heart rate patterns to the provider.
Choice C rationale
Ambulating twice daily is not an appropriate order for a client who has severe preeclampsia. This may increase the risk of bleeding, seizures, or placental abruption. The client should be on bed rest or restricted activity to reduce the blood pressure and prevent complications.
Choice D rationale
Obtaining a daily weight is an appropriate order for a client who has severe preeclampsia. This can help monitor the fluid status and the severity of edema, which are common manifestations of preeclampsia. The nurse should report any excessive weight gain or loss to the provider.
Correct Answer is D
Explanation
Choice A rationale
Estrogen is not the hormone essential for maintaining pregnancy. Estrogen is a hormone that stimulates the growth and development of the female reproductive organs, the breasts, and the placenta. Estrogen also increases the blood flow and the uterine contractility during pregnancy. However, estrogen alone is not sufficient to sustain the pregnancy, as it needs to be balanced by progesterone.
Choice B rationale
Oxytocin is not the hormone essential for maintaining pregnancy. Oxytocin is a hormone that stimulates the contraction of the uterine and the mammary glands. Oxytocin plays a role in the initiation and the progression of labor, as well as in the milk ejection during breastfeeding. However, oxytocin is not involved in the maintenance of the pregnancy, as it can cause premature labor if released too early.
Choice C rationale
Human chorionic gonadotropin (hCG) is not the hormone essential for maintaining pregnancy. hCG is a hormone that is produced by the placenta and the embryo. hCG supports the corpus luteum, which is the structure that produces progesterone in the early pregnancy. hCG also prevents the immune system from rejecting the fetus, and stimulates the production of other hormones, such as estrogen and progesterone. However, hCG is not the main hormone that maintains the pregnancy, as its levels decline after the first trimester, when the placenta takes over the production of progesterone.
Choice D rationale
Progesterone is the hormone essential for maintaining pregnancy. Progesterone is a hormone that prepares the endometrium, which is the lining of the uterus, for the implantation of the fertilized egg. Progesterone also maintains the pregnancy by preventing the uterine contractions and the immune response against the fetus. Progesterone is produced by the corpus luteum in the early pregnancy, and by the placenta in the later pregnancy.
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