A nurse in an antepartum unit is triaging clients.
Which of the following clients should the nurse see first?
A client who is at 38 weeks of gestation and reports a cough and fever.
A client who is at 14 weeks of gestation and reports nausea and vomiting.
A client who is at 28 weeks of gestation and reports painless vaginal bleeding.
A client who has missed a period and reports vaginal spotting.
The Correct Answer is C
Choice A rationale
A cough and fever in a client at 38 weeks of gestation could indicate an infection, which should be addressed promptly. However, it is not as immediately life-threatening as painless vaginal bleeding at 28 weeks of gestation, which could indicate a serious complication such as placental abruption.
Choice B rationale
Nausea and vomiting at 14 weeks of gestation are common symptoms of early pregnancy and, while uncomfortable, are not usually a sign of a serious problem. This client should be seen, but not before a client with a potentially life-threatening condition like painless vaginal bleeding.
Choice C rationale
Painless vaginal bleeding at 28 weeks of gestation is a serious symptom that could indicate placental abruption, a condition where the placenta detaches from the uterus, which can be life-threatening for both the mother and the baby. This client should be seen first.
Choice D rationale
Vaginal spotting in a client who has missed a period could indicate early pregnancy or a number of other conditions. While this client should be seen to confirm the cause of the spotting, it is not as immediately urgent as painless vaginal bleeding at 28 weeks of gestation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Aspirin is not typically recommended for cramps following a D&C. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are usually suggested for pain relief. Aspirin can increase the risk of bleeding, which is not desirable after a surgical procedure like a D&C2.
Choice B rationale
Products of conception will not be present in vaginal bleeding after a D&C. The purpose of a D&C is to remove tissue from the uterus, including any remaining products of conception following a miscarriage.
Choice C rationale
While a balanced diet is always important, there’s no specific recommendation for an increased intake of zinc-rich foods following a D&C. Good nutrition can support healing, but there’s no need to focus specifically on zinc.
Choice D rationale
Vaginal intercourse can be resumed after 2 weeks following a D&C. This allows time for the cervix to close and any post-procedure bleeding to stop. It’s also important to prevent infection.
Correct Answer is D
Explanation
Choice A rationale
Vitamin E is an important nutrient during pregnancy as it acts as an antioxidant, helping to protect cells from damage. However, its requirements do not decline during pregnancy due to an increase in body fat.
Choice B rationale
While iron is an important nutrient during pregnancy, it’s not necessary to double your intake. Iron needs do increase during pregnancy because it’s needed to make more blood to supply oxygen to the baby. However, this should be managed under the guidance of a healthcare provider.
Choice C rationale
While it’s true that calcium intake should be increased during breastfeeding, this is not specifically related to nutrition during pregnancy. During pregnancy, adequate calcium intake is important for the development of the baby’s bones and teeth.
Choice D rationale
Prenatal vitamins are designed to meet the increased nutritional needs of pregnancy, and they include a variety of vitamins and minerals. One of these is vitamin D, which helps the body absorb calcium and is important for the baby’s bone growth. Therefore, taking prenatal vitamins can indeed help to meet the need for increased vitamin D during pregnancy.
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