A nurse is teaching a newly licensed nurse about advance directives. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

Choice A reason: Placental abruption presents with sudden, severe abdominal pain, vaginal bleeding, rigid uterus, contractions, and hypotension (88/50 mm Hg), indicating placental separation and fetal distress. Recognizing this prompts urgent cesarean delivery, critical for maternal and fetal survival, preventing hemorrhage or hypoxia in late-term pregnancies with abruptio placentae.

Choice B reason: Amniotic fluid embolus causes sudden respiratory distress and cardiovascular collapse, not primarily rigid uterus or bleeding, unlike abruption. Misidentifying risks delaying cesarean for abruption, increasing maternal and fetal mortality. Abruption’s distinct presentation requires urgent intervention, critical for accurate diagnosis in late-term obstetric emergencies.

Choice C reason: Placenta previa causes painless bleeding, not severe pain, rigid uterus, or hypotension, unlike abruption’s painful, rigid presentation. Assuming previa risks incorrect management, delaying critical surgery for abruption, essential for preventing hemorrhage and ensuring maternal-fetal safety in late-term pregnancies with bleeding complications.

Choice D reason: Uterine rupture causes severe pain and bleeding but typically with fetal parts palpable or loss of uterine tone, not persistent contractions or rigidity, unlike abruption. Misdiagnosing risks delaying abruption management, critical for preventing maternal shock or fetal demise in late-term obstetric emergencies requiring urgent intervention.

Choice A reason: Evacuating clients first ensures safety in a fire, following the RACE protocol (Rescue, Alarm, Contain, Extinguish). Removing people from smoke prevents injury or asphyxiation, critical for prioritizing life safety, ensuring rapid response, and minimizing harm in healthcare settings during fire emergencies like a trash receptacle fire.

Choice B reason: Activating the alarm is second in RACE protocol, after evacuation. Prioritizing alarm over evacuation risks delaying client safety, potentially exposing them to smoke or flames, critical to avoid in ensuring immediate protection and adherence to fire safety standards in healthcare fire response scenarios.

Choice C reason: Closing doors/windows contains fire but is third in RACE, after evacuation and alarm. Prioritizing containment risks trapping clients in danger, increasing injury risk, critical to prevent in ensuring life safety and following protocol for effective fire management in healthcare unit emergencies.

Choice D reason: Using an extinguisher is last in RACE, after evacuation, alarm, and containment. Prioritizing extinguishing risks nurse and client safety, delaying evacuation, potentially causing harm, critical to avoid in ensuring life safety and proper fire response in healthcare settings with a trash receptacle fire.