A nurse is caring for a client.
During the physical examination, the nurse observes small pinpoint open vesicles and pustules on the labia majora with clear drainage noted.
A thick, mucopurulent vaginal discharge is noted on the client’s perineal pad.
After reviewing the information in the client’s medical record, which of the following provider prescriptions should the nurse anticipate?

Choice A rationale

Abdominal pain during pregnancy can be a normal part of the process as the body changes to accommodate the growing baby. However, severe abdominal pain is not normal and could be a sign of a serious condition such as preterm labor or an ectopic pregnancy.

Choice B rationale

Ballottement refers to a medical sign used in the physical examination of a pregnant woman to detect pregnancy. It involves a quick upward pushing against the uterus and feeling for return impact from the fetus. However, it is not a symptom to report during pregnancy.

Choice C rationale

A sudden gush of fluid from the vagina can be a sign of rupture of membranes, which can lead to premature birth if it occurs before 37 weeks of gestation. This is a critical symptom to report as it may indicate that labor is imminent.

Choice D rationale

Vaginal bleeding can be a sign of several serious conditions in pregnancy such as placenta previa or placental abruption. However, light spotting is common in early pregnancy.

Choice E rationale

Quickening refers to the first movement of the fetus felt by the mother, usually between 18 and 25 weeks of gestation. It is not a symptom to report during pregnancy.

Choice A rationale

While it’s important for the nurse to provide reassurance and support during the exam, this statement alone doesn’t address the client’s specific concerns or provide any useful information.

Choice B rationale

Telling the client to relax doesn’t address her concerns or provide any useful information. It’s normal to feel nervous before a pelvic exam, especially if it’s the first one.

Choice C rationale

Asking the client what part of the exam makes her most nervous allows the nurse to provide specific information and reassurance, which can help alleviate the client’s anxiety.

Choice D rationale

While a pelvic exam is often part of the process when starting oral contraceptives, it’s not always required. The need for a pelvic exam can depend on the client’s age, sexual history, and other factors.