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 A
Explanation
Choice A rationale
Hypoglycemia is a low blood glucose level that can occur in newborns who have macrosomia and whose mothers have diabetes mellitus. This is because the fetus produces excess insulin in response to the high maternal glucose levels, and after birth, the insulin level remains high while the glucose level drops. Hypoglycemia can cause seizures, lethargy, poor feeding, and brain damage in the newborn.
Choice B rationale
Hypomagnesemia is a low magnesium level that can occur in newborns who have intrauterine growth restriction (IUGR) and whose mothers have preeclampsia. This is because the placental insufficiency and the maternal hypertension impair the magnesium transfer to the fetus. Hypomagnesemia can cause tremors, irritability, hypotonia, and cardiac arrhythmias in the newborn.
Choice C rationale
Hyperbilirubinemia is a high bilirubin level that can occur in newborns who have hemolytic disease of the newborn (HDN) and whose mothers have Rh incompatibility or ABO incompatibility. This is because the maternal antibodies destroy the fetal red blood cells, which release bilirubin. Hyperbilirubinemia can cause jaundice, kernicterus, and brain damage in the newborn.
Choice D rationale
Hypocalcemia is a low calcium level that can occur in newborns who are preterm, small for gestational age (SGA), or have perinatal asphyxia. This is because the immature parathyroid gland, the low body fat, or the hypoxia impair the calcium regulation in the newborn. Hypocalcemia can cause jitteriness, tetany, seizures, and cardiac arrhythmias in the newborn.
Correct Answer is B
Explanation
Choice A rationale
Vaginal discharge is not a finding that indicates preeclampsia. Vaginal discharge is a normal occurrence during pregnancy, as the cervix and vaginal walls soften and produce more mucus. Vaginal discharge can also indicate infections, such as yeast or bacterial vaginosis, which are not related to preeclampsia.
Choice B rationale
Elevated blood pressure is a finding that indicates preeclampsia. Preeclampsia is a condition that causes high blood pressure and proteinuria in pregnant women after 20 weeks of gestation. Preeclampsia can lead to serious complications, such as eclampsia, HELLP syndrome, and placental abruption, which can endanger the mother and the fetus. The nurse should monitor the client's blood pressure and report any readings above 140/90 mm Hg.
Choice C rationale
Joint pain is not a finding that indicates preeclampsia. Joint pain is a common complaint during pregnancy, as the hormones and weight gain cause changes in the joints and ligaments. Joint pain can also indicate other conditions, such as arthritis, gout, or lupus, which are not related to preeclampsia.
Choice D rationale
Increased urine output is not a finding that indicates preeclampsia. Increased urine output is a normal occurrence during pregnancy, as the growing uterus puts pressure on the bladder and the kidneys filter more blood. Increased urine output can also indicate diabetes, urinary tract infection, or diuretic use, which are not related to preeclampsia.
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