A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?

Administer Rho(D) immune globulin.

Monitor fetal heart rate

Assess maternal vital signs

Obtain an order for an ultrasound exam.

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Monitor fetal heart rate.

This is because cramping and vaginal bleeding after amniocentesis are signs of possible complications such as miscarriage, preterm labor, or injury to the fetus.

Monitoring fetal heart rate can help assess the well-being of the fetus and detect any signs of distress.

Choice A is wrong because administering Rho(D) immunoglobulin is only necessary if the mother has Rh-negative blood and the baby has Rh-positive blood, which can cause Rh sensitization.

This is not given routinely to all women who have amniocentesis.

Choice C is wrong because assessing maternal vital signs is not the first priority when there is a risk of fetal compromise.

Maternal vital signs can be affected by many factors and are not specific indicators of fetal health.

Choice D is wrong because obtaining an order for an ultrasound exam is not the first action to take.

An ultrasound exam can help confirm the diagnosis of complications such as placental abruption or fetal demise, but it requires time and equipment that might delay immediate intervention.

Monitoring fetal heart rate can be done quickly and easily at the bedside.

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Correct Answer is A

Explanation

An equivocal CST indicates late decelerations of the FHR with less than 50% of contractions.

This means that the fetus may have some degree of hypoxia or distress, but not enough to warrant immediate delivery.

An equivocal CST may also result from hyperstimulation of the uterus, which can cause excessive contractions and reduce blood flow to the placenta.

Choice B is wrong because late decelerations of the FHR with at least 50% of contractions is a positive CST, which indicates a high risk of fetal death due to hypoxia and is a contraindication to labor.

Choice C is wrong because no late decelerations of the FHR during contractions is a negative CST, which indicates a good fetal wellbeing and tolerance of labor.

Choice D is wrong because variable decelerations of the FHR with or without contractions are not related to uterine activity and may indicate cord compression or other fetal problems.

Variable decelerations are not used to interpret CST results.

A. A 25-year-old client who has migraine headaches with aura. B. A 32-year-old client who has endometriosis. C. A 28-year-old client who has polycystic ovary syndrome D. A 22-year-old client who has irregular menstrual cycles.

Correct Answer is A

Explanation

This is because migraine headaches with aura are a contraindication for receiving oral contraceptives, as they increase the risk of stroke and other cardiovascular complications.

Some possible explanations for the other choices are:

Choice B: A 32-year-old client who has endometriosis.

This is not a contraindication for receiving oral contraceptives, as they can actually help reduce the symptoms of endometriosis by suppressing ovulation and reducing menstrual bleeding.

Choice C: A 28-year-old client who has polycystic ovary syndrome (PCOS).

This is not a contraindication for receiving oral contraceptives, as they can help regulate the menstrual cycle and lower the levels of androgens (male hormones) that cause acne, hirsutism (excess hair growth), and other problems in women with PCOS.

Choice D: A 22-year-old client who has irregular menstrual cycles.

This is not a contraindication for receiving oral contraceptives, as they can help normalize the menstrual cycle and prevent unintended pregnancy.

Normal ranges for oral contraceptive doses are:

Estrogen: 10 to 35 mcg of ethinyl estradiol or estradiol valerate

Progestin: varies depending on the type and brand of oral contraceptive

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A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later. Which of the following actions should the nurse take first?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the results of a Contraction Stress Test (CST) with a pregnant client. What does an equivocal CST indicate?

Correct Answer is A

Explanation

A nurse is reviewing contraception options for four clients. The nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives?

Correct Answer is A

Explanation

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A nurse is reviewing the results of an Alpha-fetoprotein Test (AFP) with a pregnant client. What does a low level of AFP (<0.5 MoM) potentially indicate?

A client is scheduled for a transvaginal ultrasound in two weeks. The client asks the nurse what they should do to prepare for the test. What is the best response by the nurse?

A nurse is caring for a client who had chorionic villus sampling (CVS) performed at 12 weeks’ gestation and asks when she can expect results from this test. The nurse should inform her that results are typically available within which timeframe?

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A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?