A nurse is caring for a client.

Exhibits

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

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Verbal de-escalation by acknowledging the client’s emotions (“You seem to be very upset”) helps to diffuse tension and can prevent further agitation.

B. Initiating seclusion should be a last resort after other de-escalation techniques fail.

C. Engaging the panic alarm is necessary only if the client becomes physically violent.

D. Using a face shield is not warranted unless there is a risk of bodily fluid exposure.

A. Fax the client's name and identifiable information to the rehabilitation facility. B. Email the client's health information to the facility in an unencrypted file. C. Discuss the client's response to the transfer with another staff nurse. D. Provide a verbal report of the client's condition to the paramedic performing the transfer.

Correct Answer is D

Explanation

A. Fax the client's name and identifiable information to the rehabilitation facility: Faxing may be insecure and breach confidentiality.

B. Email the client's health information in an unencrypted file: Unencrypted emails are not secure.

C. Discuss the client's response to the transfer with another staff nurse: This is unnecessary and may breach confidentiality.

D. Provide a verbal report of the client's condition to the paramedic performing the transfer: A direct, verbal report ensures that only essential information is shared securely.

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Body Systems	Findings
Respiratory	Respiratory rate 26/min
Cardiovascular	Heart rate 112/min Capillary refill 4 seconds
Gastrointestinal	Hyperactive bowel sounds
Integumentary	Diaper area reddened with erythema noted Extremities cool Reports no tears
Neurologic	Lethargic

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a newly licensed nurse about caring for clients in the emergency department. Which of the following actions should the nurse include when teaching about interacting with a client who is aggravated, pacing, and speaking loudly?

Correct Answer is A

Explanation

A nurse is preparing a client for transfer to a long-term rehabilitation facility following a below-knee amputation of the right leg. Which of the following actions should the nurse take to protect the client's confidentiality?

Correct Answer is D

Explanation

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A nurse is inserting an indwelling urinary catheter for a male client. Which of the following actions should the nurse take?

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