A nurse is evaluating a client who is at 28 weeks of gestation and has pre-term labor.

Which of the following findings indicates that the client’s condition is improving?

Decreased frequency and intensity of contractions

Increased cervical dilation and effacement

Increased amount and color of vaginal discharge

Decreased fetal heart rate variability

Answer and Explanation

The Correct Answer is A

Decreased frequency and intensity of contractions indicates that the client’s condition is improving. Preterm labor occurs when regular contractions result in the opening of your cervix before 37 weeks of pregnancy.

If preterm labor can’t be stopped, your baby will be born early and may have health problems.

Choice B is wrong because increased cervical dilation and effacement means that the cervix is thinning and opening more, which are signs of labor progression.

Choice C is wrong because increased amount and color of vaginal discharge may indicate infection, bleeding, or rupture of membranes, which are complications of preterm labor.

Choice D is wrong because decreased fetal heart rate variability means that the baby’s heart rate is not changing much, which may indicate fetal distress or hypoxia. A normal fetal heart rate variability is between 6 and 25 beats per minute.

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Correct Answer is A

Explanation

Assess fetal heart rate and activity.

The nurse should identify that a client who reports a sudden gush of fluid from her vagina is at risk forpremature rupture of membranes (PROM), which can lead toinfection,cord prolapse, andfetal distress.Therefore, the priority action is to assess the fetal heart rate and activity to monitor for signs of hypoxia or distress.

Choice B is wrong because performing a nitrazine test on the fluid is not the first action.A nitrazine test can confirm the presence of amniotic fluid by detecting its alkaline pH, but it is not as urgent as assessing the fetal well-being.

Choice C is wrong because administering oxytocin (Pitocin) IV infusion is contraindicated in this situation.Oxytocin is used to induce or augment labor, but it can causeuterine hyperstimulation,fetal distress, andplacental abruptionif given to a client who has PROM.

Choice D is wrong because placing the client in Trendelenburg position is not recommended for a client who has PROM.Trendelenburg position can increase the risk ofcord prolapseandaspirationin this situation.

A. Decreased fetal movement B. Increased vaginal discharge C. Pelvic pressure D. All of the above

Correct Answer is D

Explanation

All of the above.The nurse should include all of these signs and symptoms in the teaching as they may indicate pre-term labor.Pre-term labor occurs when regular contractions begin to open the cervix before 37 weeks of pregnancy.

Choice A is wrong because decreased fetal movement is not a normal sign of pre-term labor, but it may indicate fetal distress or other complications.

Choice B is wrong because increased vaginal discharge is not a normal sign of pre-term labor, but it may indicate infection or rupture of membranes.

Choice C is wrong because pelvic pressure is not a normal sign of pre-term labor, but it may indicate cervical dilation or descent of the fetus.

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A nurse is evaluating a client who is at 28 weeks of gestation and has pre-term labor. Which of the following findings indicates that the client’s condition is improving?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is at 33 weeks of gestation and has pre-term labor. The client reports a sudden gush of fluid from her vagina. Which of the following actions should the nurse take first?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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A nurse is evaluating a client who is at 28 weeks of gestation and has pre-term labor.

Which of the following findings indicates that the client’s condition is improving?