A nurse is caring for a client who is being admitted to the labor and delivery unit.
Client reports mild abdominal pain and light vaginal bleeding.
Reports last menstrual period was 11 weeks ago.

Ectopic pregnancy.

Molar pregnancy.

Answer and Explanation

Correct Answer : A,B

Choice A rationale

Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. Symptoms can include unilateral abdominal pain, light to heavy vaginal bleeding, and a positive pregnancy test. An ectopic pregnancy is a serious condition requiring prompt medical attention.

Choice B rationale

Molar pregnancy, also known as gestational trophoblastic disease, is characterized by abnormal growth of trophoblasts, the cells that normally develop into the placenta. It can present with symptoms such as vaginal bleeding (ranging from spotting to heavy bleeding), pelvic pain or pressure, and a uterus that may be larger than expected for the gestational age. The absence of a fetal heartbeat and elevated hCG levels are also characteristic.

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Correct Answer is A

Explanation

Choice A rationale

G represents gravida, the total number of pregnancies, including the current one (2). T represents term births, the number of pregnancies delivered at 37 weeks gestation or later (1). P represents preterm births, the number of pregnancies delivered between 20 and 36 weeks gestation (0). A represents abortions, the number of pregnancies ending before 20 weeks gestation (0). L represents living children (1).

Choice B rationale

This option incorrectly states L as 2. The client has one living child from the previous pregnancy.

Choice C rationale

This option incorrectly states P as 1. The client's previous pregnancy was delivered at 38 weeks, which is considered a term birth, not preterm.

Choice D rationale

This option incorrectly states G as 3. The client is currently pregnant with twins, making this her second pregnancy in total.

A. Document the findings and continue to monitor the client. B. Notify the client's provider. C. Encourage the client to empty her bladder. D. Increase the frequency of fundal massage.

Correct Answer is A

Explanation

Choice A rationale

In the immediate postpartum period, it is normal to observe lochia rubra, which is a dark red discharge, and the passage of small blood clots. A firm, midline fundus at the umbilicus indicates that the uterus is contracting effectively to control bleeding. Given these expected findings within the first hour postpartum, continued monitoring is the appropriate initial action.

Choice B rationale

Notifying the provider is usually indicated when there are deviations from the expected postpartum findings, such as excessive bleeding, a boggy uterus, or signs of infection. The current assessment does not indicate such complications.

Choice C rationale

Encouraging the client to empty her bladder is important in the postpartum period as a full bladder can interfere with uterine contraction and lead to increased bleeding. However, with a firm, midline fundus and expected lochia, this is not the priority action over continued monitoring.

Choice D rationale

Increasing the frequency of fundal massage is indicated when the uterus is boggy or not contracting effectively, leading to increased bleeding. The client's fundus is already firm, so increasing massage is not the immediate priority.

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A nurse is caring for a client who is being admitted to the labor and delivery unit.Client reports mild abdominal pain and light vaginal bleeding.Reports last menstrual period was 11 weeks ago.

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is caring for a client who is 1 hour postpartum and observes a large amount of lochia rubra and several small clots on the client's perineal pad.The fundus is midline and firm at the umbilicus.Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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A nurse is caring for a client who is being admitted to the labor and delivery unit.
Client reports mild abdominal pain and light vaginal bleeding.
Reports last menstrual period was 11 weeks ago.