A nurse is reinforcing teaching with a client who is pregnant about expected changes related to pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

It’s normal to have a white vaginal discharge.

I should recognize fetal movement by 12 weeks.

My nipples and areola will become pale as my breasts enlarge.

The fundus is responsible for the swelling in my ankles.

Answer and Explanation

The Correct Answer is A

Choice A rationale:
It’s normal to have a white vaginal discharge during pregnancy. This is due to increased estrogen levels, which stimulate the production of cervical mucus. The mucus is typically white or clear, and has a mild odor. It helps to maintain a healthy vaginal environment and protect against infection.
Increased vaginal discharge is one of the earliest signs of pregnancy, and it typically continues throughout the pregnancy. While it may be bothersome at times, it is not a cause for concern unless it has a strong odor, is yellow or green in color, or is accompanied by itching or burning.
It is important for pregnant women to keep the vaginal area clean and dry to prevent infection. This can be done by wearing cotton underwear, avoiding tight-fitting clothing, and showering or bathing regularly.

Choice B rationale:
Most women do not recognize fetal movement until 16 to 22 weeks of pregnancy. This is because the fetus is still very small and its movements are not strong enough to be felt.
Some women may feel fluttering or "butterflies" in their abdomen as early as 12 weeks, but this is not always a reliable indication of fetal movement. It is more likely to be caused by gas or intestinal activity.

Choice C rationale:
The nipples and areola typically become darker, not paler, during pregnancy. This is due to increased levels of melanin, a pigment that is also responsible for skin color.
The darkening of the nipples and areola may be more pronounced in women with darker skin.

Choice D rationale:
The fundus is the top of the uterus. It does not cause swelling in the ankles.
Swelling in the ankles is a common symptom of pregnancy, especially in the third trimester. It is caused by a combination of factors, including increased blood volume, fluid retention, and pressure from the growing uterus on the veins in the legs.

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Correct Answer is D

Explanation

The correct answer is Choice D.

Choice A rationale: The client's age, being 20 years old, is not a contraindication to the use of a diaphragm. Diaphragms can be used by individuals of reproductive age, provided there are no other contraindications.

Choice B rationale: Having a vaginal birth 6 months ago is not a contraindication to using a diaphragm. The diaphragm's fit may need adjustment, but it can still be used safely postpartum.

Choice C rationale: Smoking cigarettes is a risk factor for several health conditions but is not a specific contraindication for the use of a diaphragm. However, smoking cessation should be encouraged for overall health benefits.

Choice D rationale: Having more than one sex partner increases the risk of sexually transmitted infections (STIs). Diaphragms do not protect against STIs, making it important to use condoms in conjunction with the diaphragm for clients with multiple sex partners.

A. Prolapsed cord. B. Premature rupture of membranes. C. Abruptio placentae. D. Placenta previa

Correct Answer is C

Explanation

The correct answer is choice C, Abruptio placentae.

Choice A rationale:

A prolapsed cord is an obstetric emergency where the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby. It’s a rare condition but can occur during labor if the baby is not yet engaged, and the water breaks. The main concern is that the cord can become compressed, cutting off the baby’s oxygen supply. However, it does not typically present with continuous abdominal pain and vaginal bleeding without labor.

Choice B rationale:

Premature rupture of membranes (PROM) refers to a patient whose membranes have ruptured before the onset of labor. While PROM can lead to complications, it is not typically associated with continuous abdominal pain and vaginal bleeding. PROM is more often characterized by the sudden release of fluid from the vagina.

Choice C rationale:

Abruptio placentae, also known as placental abruption, is the premature separation of the placenta from the uterus. It is a serious condition that can occur in the third trimester and is associated with continuous abdominal pain and vaginal bleeding, which are the symptoms described in the question. This condition poses significant risks to both the mother and the fetus, including fetal distress, preterm birth, and maternal hemorrhage.

Choice D rationale:

Placenta previa is a condition where the placenta covers the cervix either completely or partially. It can cause painless, bright red vaginal bleeding but is not typically associated with abdominal pain. The bleeding with placenta previa is usually not continuous but rather occurs in episodes.

In this scenario, the continuous abdominal pain and vaginal bleeding are classic signs of abruptio placentae, making Choice C the most likely diagnosis.

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A nurse is reinforcing teaching with a client who is pregnant about expected changes related to pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who requests a prescription for a diaphragm. Which of the following findings should the nurse identify as a contraindication to the client’s use of a diaphragm?

Correct Answer is D

Explanation

A nurse in the antepartum unit is assisting with the care of a client who is at 36 weeks of gestation and reports continuous abdominal pain and vaginal bleeding. The nurse should identify that the client is likely experiencing which of the following complications?

Correct Answer is C

Explanation

A nurse is caring for a client who is pregnant and has suspected placenta previa. Which of the following should the nurse monitor the client for?

A nurse is assisting with the admission of a client who is at 10 weeks of gestation and reports abdominal pain and moderate vaginal bleeding. Incomplete abortion is the initial diagnosis. Which of the following actions should the nurse contribute to the client’s plan of care?

A nurse is collecting data from a client who is at 35 weeks of gestation. Which of the following findings should the nurse report to the provider?

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A nurse is reinforcing teaching with a client who smokes one pack of cigarettes per day. The nurse should instruct the client that her newborn is at increased risk for which of the following clinical manifestations?

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A nurse is assisting with the admission of a client who is at 8 weeks of gestation and has heavy vaginal bleeding. Which of the following actions should the nurse take?