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 D

Explanation

Explanation:

A. It destroys Rh antibodies in newborns who are Rh positive.

This statement is incorrect. Rh immunoglobulin does not destroy Rh antibodies in newborns. It is given to Rh-negative mothers to prevent the formation of Rh antibodies in response to exposure to Rh-positive fetal blood cells.

B. It destroys Rh antibodies in mothers who are Rh negative.

This statement is inaccurate. Rh immunoglobulin does not destroy Rh antibodies in mothers. Instead, it acts by binding and neutralizing Rh-positive fetal blood cells that enter the maternal circulation, preventing the mother's immune system from producing Rh antibodies against these cells.

C. It prevents the formation of Rh antibodies in newborns who are Rh positive.

This statement is not entirely correct. Rh immunoglobulin is administered to Rh-negative mothers to prevent them from developing Rh antibodies in response to exposure to Rh-positive fetal blood cells during pregnancy or childbirth. It does not directly prevent the formation of Rh antibodies in newborns.

D. It prevents the formation of Rh antibodies in mothers who are Rh negative.

This statement is accurate. Rh immunoglobulin works by preventing the Rh-negative mother's immune system from producing Rh antibodies against Rh-positive fetal blood cells. By doing so, it reduces the risk of Rh isoimmunization and its potential complications in subsequent pregnancies.

A. Report of headache B. Polyuria C. Tachycardia D. Absence of clonus

Correct Answer is A

Explanation

Explanation:

A. Report of headache

Severe preeclampsia is characterized by hypertension (high blood pressure) along with other signs and symptoms of preeclampsia, such as proteinuria (protein in the urine) and end-organ dysfunction. Headache is a common symptom associated with severe preeclampsia and is often described as persistent and severe.

B. Polyuria

Polyuria, or excessive urination, is not typically associated with severe preeclampsia. In fact, decreased urine output (oliguria) can be a concern in severe cases due to reduced kidney function and fluid retention.

C. Tachycardia

Tachycardia, or a rapid heart rate, is not a typical finding in severe preeclampsia. In fact, hypertension and vascular constriction associated with preeclampsia can lead to normal or even lower heart rates in some cases.

D. Absence of clonus

Clonus refers to rhythmic, involuntary muscle contractions and relaxations. In the context of preeclampsia, the presence of clonus (especially hyperreflexia and positive clonus) is a concerning sign associated with central nervous system irritability and potential seizures. Absence of clonus would not be an expected finding in severe preeclampsia, as neurological manifestations such as hyperreflexia and clonus can occur in more severe cases.

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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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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?