A nurse is caring for a client.
For each assessment finding, click to specify if the finding is consistent with placenta previa or abruptio placenta. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.
Pain score
Vaginal bleeding characteristics
Hematocrit
Abdominal assessment
Hemoglobin
Blood pressure
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A,B"},"D":{"answers":"B"},"E":{"answers":"A,B"},"F":{"answers":"A,B"}}
Assessment findings |
Placenta previa |
Abruptio placenta |
Pain score |
|
✅ |
Vaginal bleeding characteristics |
|
✅ |
Hematocrit |
✅ |
✅ |
Abdominal assessment |
|
✅ |
Hemoglobin |
✅ |
✅ |
Blood pressure |
✅ |
✅ |
Rationale:
Pain: The client has abdominal pain, rated 7/10, which is sharp and associated with uterine hypertonicity and tenderness in the left upper quadrant. Placenta previa typically presents with painless bleeding and minimal to no abdominal pain, while abruptio placenta involves severe pain due to placental separation.
Vaginal bleeding: Dark red vaginal bleeding was reported. Placenta previa results in painless bright red bleeding, while abruptio placenta presents with dark red bleeding often accompanied by clots and associated pain.
Hemoglobin: Hemoglobin is 8.1 g/dL, which is low (normal range: 12 to 16 g/dL), indicating blood loss or hemorrhage. Both conditions can lead to low hematocrit and hemoglobin, but abruptio placenta may cause more significant blood loss, leading to a greater decrease in these values.
Hematocrit: The hematocrit is 24%, which is also low (normal range: 36% to 47%), further suggesting blood loss. Both conditions can lead to low hematocrit and hemoglobin, but abruptio placenta may cause more significant blood loss, leading to a greater decrease in these values.
Abdominal assessment: Placenta previa tends to show a soft abdomen with no tenderness, while abruptio placenta causes rigid, board-like abdominal muscles with tenderness, often localized.
Blood Pressure: Blood pressure is 95/62 mm Hg, which is on the lower side but not critically low. Placenta previa typically has normal or slightly low blood pressure, while abruptio placenta can cause hypotension due to significant blood loss and shock.
Fetal Heart Rate: FHR is 116/min, with minimal variability noted, which may indicate fetal distress which can be seen in both conditions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
A. COPD: Clients with chronic obstructive pulmonary disease (COPD) are at increased risk for pneumonia due to compromised lung function, chronic inflammation, and decreased mucociliary clearance, making it easier for pathogens to infect the lungs.
B. Hypertension: While hypertension is a significant cardiovascular risk factor, it does not directly increase the risk of pneumonia. Therefore, it is not a relevant factor in this case.
C. Dermatitis: Dermatitis is a skin condition and does not affect lung function or immunity in a way that would increase the risk of pneumonia.
D. Smoking history: Smoking damages the respiratory epithelium and impairs the immune defenses of the lungs, making smokers more susceptible to respiratory infections such as pneumonia.
E. Type 2 diabetes mellitus: Diabetes compromises immune function and increases the risk of infections, including pneumonia, due to hyperglycemia impairing neutrophil function and other immune responses.
F. Hypothyroidism: While hypothyroidism may cause some general symptoms such as fatigue, it does not directly compromise respiratory function or immunity in a way that increases the risk of pneumonia.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Explanation
The client has dark red vaginal bleeding and low hemoglobin (8.1 g/dL) and hematocrit (24%), which indicate significant blood loss.
The low blood pressure (95/62 mm Hg) and tachycardia (104 bpm) are signs of the body's response to blood loss, which can lead to hypovolemic shock.
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