A nurse is caring for a client who is in preterm labor with a current L/S ratio of 1:1. Which of the following actions should the nurse take?

Administer betamethasone 12 mg IM.

Prepare the client for immediate delivery.

Administer hydralazine 25 mg IV.

Infuse a bolus of IV fluid.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Administering betamethasone 12 mg IM helps accelerate fetal lung maturity by stimulating the production of surfactant. This is crucial for a preterm baby, as immature lungs are one of the biggest risks in preterm labor. Administering betamethasone can significantly improve neonatal outcomes by reducing respiratory distress syndrome and other complications related to prematurity.

Choice B rationale

Preparing the client for immediate delivery is not the first action as the primary goal in managing preterm labor with an L/S ratio of 1: is to delay labor and enhance fetal lung maturity. Betamethasone administration is prioritized to maximize fetal lung development before considering delivery.

Choice C rationale

Administering hydralazine 25 mg IV is used to manage hypertension and is unrelated to enhancing fetal lung maturity in preterm labor. It is not indicated in this situation as the primary concern is not managing blood pressure.

Choice D rationale

Infusing a bolus of IV fluid might be used to manage preterm labor but does not directly address the need to improve fetal lung maturity. The main priority is administering steroids like betamethasone to expedite fetal lung development.

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Correct Answer is D

Explanation

Choice A rationale

Heartburn is common due to the relaxation of the lower esophageal sphincter caused by progesterone, but quickening (the first movement of the fetus felt by the mother) typically occurs earlier in pregnancy, around 18-20 weeks.

Choice B rationale

Nausea and vomiting are more common in the first trimester due to hormonal changes, particularly increased levels of hCG. These symptoms often decrease as pregnancy progresses.

Choice C rationale

A stuffy nose and bleeding gums can occur due to increased blood volume and hormonal changes affecting mucous membranes, but these are more noticeable in the earlier stages of pregnancy.

Choice D rationale

Constipation and hemorrhoids are common in the third trimester. The growing uterus can put pressure on the rectum and intestines, slowing down bowel movements and increasing the risk of hemorrhoids.

A. Obtain the client's personal and family medical history. B. Obtain information about prior pregnancies. C. Check the client's urine with a reagent strip. D. Schedule the client for prenatal laboratory testing. E. Discuss chorionic villus sampling with the client.

Correct Answer is A

Explanation

Choice A rationale

Obtaining the client's personal and family medical history is essential during the initial prenatal visit. This history helps identify any genetic disorders or chronic conditions that might affect the pregnancy. It also provides insight into the client's overall health and any potential risk factors.

Choice B rationale

Information about prior pregnancies is important but not the first priority. Prior pregnancy information can provide insights into previous complications, but a comprehensive medical history should come first.

Choice C rationale

Checking the client's urine with a reagent strip is not the primary action during an initial visit. Urine tests are useful for detecting infections and certain conditions, but they come after a thorough history has been obtained.

Choice D rationale

Scheduling the client for prenatal laboratory testing is necessary, but it follows the initial assessment and history-taking. Laboratory tests help confirm the pregnancy and assess overall health but are not the first step.

Choice E rationale

Discussing chorionic villus sampling (CVS) is premature at this stage. CVS is a prenatal test conducted around 10-13 weeks for detecting chromosomal abnormalities, but it's not relevant during the initial visit without understanding the client's medical history.

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