A nurse is caring for a patient who had an amniocentesis performed at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which action should be taken first?

Notify the healthcare provider immediately.

Administer pain medication to the patient.

Encourage the patient to rest and elevate her legs.

Offer emotional support and reassurance to the patient.

Answer and Explanation

The Correct Answer is A

This is because cramping and vaginal bleeding 24 hours after amniocentesis are signs of possible complications, such as injury to the baby or mother, leaking of amniotic fluid, infection, Rh sensitization, preterm labor, or miscarriage.

These complications are rare, but they can be serious and require immediate medical attention.

Choice B is wrong because administering pain medication to the patient does not address the underlying cause of the cramping and bleeding, and may delay seeking help.

Choice C is wrong because encouraging the patient to rest and elevate her legs may not prevent further complications, and may also delay seeking help.

Choice D is wrong because offering emotional support and reassurance to the patient is not enough to ensure the safety of the baby and the mother, and may give a false sense of security.

Normal ranges for amniocentesis are:

No chromosomal defects detected in the fetus and no abnormal proteins present in amniotic fluid

No signs of infection or other illness in the baby

Fetal lungs mature enough for birth if delivery is planned sooner than 39 weeks

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Correct Answer is B

Explanation

Serum creatinine and urea are waste products of protein metabolism that are normally filtered by the kidneys and excreted in urine.

In pregnancy, the glomerular filtration rate (GFR) increases by about 50%, which means more creatinine and urea are cleared from the blood.Therefore, serum creatinine and urea levels decrease in pregnancy compared to nonpregnant women.

A. Increased serum creatinine and urea levels are wrong because they indicate impaired kidney function or dehydration, which are not normal in pregnancy.

C. Unchanged serum creatinine and urea levels are wrong because they do not reflect the increased GFR in pregnancy.

D. Increased glomerular filtration rate is correct but it is not a finding regarding serum creatinine and urea levels, which are the focus of the question.

Normal ranges for serum creatinine and urea vary depending on the laboratory and the units used, but based on a nonpregnant reference interval of 45-90 μmol/l (0.51-1.02 mg/dl) for creatinine and 2.5-6.4 mmol/l (7-18 mg/dl) for urea, a serum creatinine of >77 μmol/l (0.87 mg/dl) and a blood urea of >8.5 mmol/l (24 mg/dl) should be considered outside the normal range for pregnancy.

A. hCG B. Progesterone C. Estrogen D. Prolactin

Correct Answer is D

Explanation

Prolactin is a hormone that is responsible for inhibiting ovulation and stimulating milk production during pregnancy.

It is produced by the anterior pituitary gland and increases throughout pregnancy.

Choice A is wrong because hCG (human chorionic gonadotropin) is a hormone that is produced by the placenta and maintains the corpus luteum, which secretes progesterone and estrogen.

hCG does not inhibit ovulation or stimulate milk production.

Choice B is wrong because progesterone is a hormone that is produced by the corpus luteum and the placenta and supports the endometrium, prevents uterine contractions, and prepares the breasts for lactation.

Progesterone does not inhibit ovulation or stimulate milk production.

Choice C is wrong because estrogen is a hormone that is produced by the corpus luteum and the placenta and stimulates uterine growth, blood flow, and breast duct development.

Estrogen does not inhibit ovulation or stimulate milk production.

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A nurse is caring for a patient who had an amniocentesis performed at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later. Which action should be taken first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory results of a pregnant client. Which finding is expected regarding serum creatinine and urea levels?

Correct Answer is B

Explanation

A nurse is educating a pregnant client about the endocrine changes during pregnancy. Which hormone is responsible for inhibiting ovulation and stimulating milk production?

Correct Answer is D

Explanation

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A nurse is caring for a patient who had an amniocentesis performed at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which action should be taken first?