A nurse is caring for a client who is at 37 weeks of gestation and diagnosed with placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

"This could result in profound bleeding."

"This could initiate preterm labor."

"There is an increased risk of rupture of the membranes."

"There is an increased risk of introducing infection."

Answer and Explanation

The Correct Answer is A

Explanation:

A. "This could result in profound bleeding."

This is the correct explanation. Placenta previa involves the placenta partially or completely covering the cervix. Performing an internal examination, such as a vaginal exam, can disrupt the placenta and lead to severe bleeding. This bleeding can be dangerous for both the mother and the baby, making it a critical concern to avoid internal exams in placenta previa cases.

B. "This could initiate preterm labor."

While internal examinations may trigger preterm labor in some cases, the primary concern in placenta previa is the risk of significant bleeding. Preterm labor is not typically the primary reason for avoiding internal exams in placenta previa; instead, the focus is on preventing bleeding and its associated complications.

C. "There is an increased risk of rupture of the membranes."

While an internal examination may carry a risk of membrane rupture, especially in situations with low-lying placenta or marginal previa, the primary concern in placenta previa is the potential for severe bleeding if the placenta is disturbed. Rupture of membranes is a consideration but is not the main reason for avoiding internal exams in placenta previa.

D. "There is an increased risk of introducing infection."

While infection is a concern with any invasive procedure, including internal examinations, it is not typically the primary reason for avoiding internal exams in placenta previa. The main focus is on preventing bleeding complications that can arise from disrupting the placenta.

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Correct Answer is C

Explanation

Explanation:

A. "A gain of about 1 pound per week is the best pattern for you."

This response suggests a weight gain pattern rather than a total recommended weight gain for the entire pregnancy. A gain of about 1 pound per week would typically align with the recommended weight gain for individuals with a normal pre-pregnancy BMI (Body Mass Index). However, for someone with an overweight BMI (BMI 25 to 29.9), this rate of weight gain might be higher than the recommended range. Therefore, it may not be the best pattern for the client with a BMI of 26.5.

B. "It would be best if you gained about 11 to 20 pounds."

This response provides a weight gain range that is more appropriate for individuals with an obese BMI (BMI 30 or higher) rather than those with an overweight BMI. The recommended weight gain for someone with an overweight BMI is higher than 11 to 20 pounds. Therefore, this response underestimates the recommended weight gain for the client with a BMI of 26.5.

C. "The recommendation for you is about 15 to 25 pounds."

This response aligns with the recommended weight gain range for individuals with an overweight BMI (BMI 25 to 29.9). According to the Institute of Medicine (IOM) guidelines, the recommended weight gain for someone with an overweight BMI is about 15 to 25 pounds during pregnancy. This choice accurately reflects the appropriate recommendation for the client with a BMI of 26.5.

D. "A gain of about 25 to 35 pounds is recommended for you."

This response suggests a weight gain range that is more appropriate for individuals with a normal pre-pregnancy BMI (BMI 18.5 to 24.9). The recommended weight gain for someone with an overweight BMI is lower than 25 to 35 pounds. Therefore, this response overestimates the recommended weight gain for the client with a BMI of 26.5.

A. April 27, 2021 B. April 11, 2021 C. May 11, 2021 D. May 27, 2021

Correct Answer is B

Explanation

Explanation:

To calculate the estimated date of delivery (EDD) based on the client's last menstrual period (LMP), the nurse can use Naegele's rule. Naegele's rule calculates the EDD by adding 7 days to the first day of the LMP, subtracting 3 months, and then adding 1 year.

Given the client's last menstrual period was July 4, 2020, we can apply Naegele's rule:

Add 7 days to July 4, 2020: July 11, 2020

Subtract 3 months: April 11, 2020

Add 1 year: April 11, 2021

Therefore, the appropriate response by the nurse is:

B. April 11, 2021

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A nurse is caring for a client who is at 37 weeks of gestation and diagnosed with placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client at the first prenatal visit who has a BMI of 26.5. The client asks how much weight she should gain during pregnancy. Which of the following responses should the nurse make?

Correct Answer is C

Explanation

A nurse in a prenatal clinic is caring for a client who asks what her estimated date of delivery will be if her last menstrual period was July 4, 2020. Which of the following is the appropriate response by the nurse?

Correct Answer is B

Explanation

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