A patient with no prenatal care is admitted to the labor and delivery unit.She is placed on an external fetal monitor, and an intravenous infusion is begun.
A tentative diagnosis of abruptio placentae is made.Which finding would support this diagnosis?

Sustained uterine hypertonicity.

Strong uterine contractions every 3-4 minutes.

Bile-colored vomitus.

Fetal heart rate acceleration with fetal activity.

Answer and Explanation

The Correct Answer is A

This means that the uterus is constantly contracted and does not relax between contractions. This can cause the placenta to separate from the uterine wall, which is called placental abruption or abruptio placentae. Placental abruption can deprive the baby of oxygen and nutrients and cause heavy bleeding in the mother.

Choice B is wrong because strong uterine contractions every 3-4 minutes are normal during labor and do not indicate placental abruption.

Choice C is wrong because bile-colored vomitus is not a sign of placental abruption, but rather a sign of hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy.

Choice D is wrong because fetal heart rate acceleration with fetal activity is a normal finding and indicates a healthy baby. Placental abruption can cause fetal distress and a decrease in fetal heart rate.

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Correct Answer is C

Explanation

The correct answer is choice C. The reason for the patient’s visit at this time.

This information will help the nurse assess the patient’s motivation, readiness, and urgency for contraception.

It will also help the nurse tailor the education and counseling to the patient’s specific needs and preferences.

Choice A is wrong because the amount of sexual experience that the patient has had is not relevant to determine the patient’s knowledge base.

It may also make the patient feel uncomfortable or judged.

Choice B is wrong because the type of contraceptive that the patient’s friends are using is not a reliable source of information.

Different methods may have different advantages and disadvantages for different people.

The nurse should provide evidence-based information and guidance on various options.

Choice D is wrong because the method of contraception that the patient believes will provide protection from sexually transmitted diseases may not be accurate or effective.

A. The patient’s cervix is dilated. B. The patient’s uterine contraction pattern is enhanced. C. The patient’s cervix is softened. D. The patient’s uterus is softened.

Correct Answer is B

Explanation

The correct answer is choice B. The patient’s uterine contraction pattern is enhanced.Prostaglandin E2 gel is used to induce labor by ripening and dilating the cervix and stimulating uterine contractions.The effectiveness of the gel can be measured by the frequency, duration and intensity of the contractions.

A stronger and more regular contraction pattern indicates that the gel is working and labor is progressing.

Choice A is wrong because cervical dilation is not the only indicator of labor induction.Cervical dilation can occur without contractions or with weak and irregular contractions, which means that labor is not established yet.

Choice C is wrong because cervical softening (or effacement) is a prerequisite for cervical dilation, but it does not necessarily mean that labor has started.Cervical softening can occur weeks before labor or even during pregnancy.

Choice D is wrong because uterine softening (or relaxation) is the opposite of what prostaglandin E2 gel is supposed to do.Uterine softening reduces the contractility and tone of the uterus, which can lead to prolonged labor or fetal distress.

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A patient with no prenatal care is admitted to the labor and delivery unit.She is placed on an external fetal monitor, and an intravenous infusion is begun. A tentative diagnosis of abruptio placentae is made.Which finding would support this diagnosis?

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Correct Answer is C

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Correct Answer is B

Explanation

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A patient with no prenatal care is admitted to the labor and delivery unit.She is placed on an external fetal monitor, and an intravenous infusion is begun.
A tentative diagnosis of abruptio placentae is made.Which finding would support this diagnosis?