A pregnant, homeless woman who has received no prenatal care presents to the clinic in her third trimester because she is having vaginal bleeding, but reports that she is not in pain. Ultrasound reveals a placenta previa. Which action should the nurse implement?

Contact social services for a temporary shelter.

Obtain a hemoglobin and hematocrit level.

Have the client transported to the hospital.

Schedule weekly perinatal appointments.

Answer and Explanation

The Correct Answer is C

A. Contact social services for a temporary shelter. While contacting social services is important for the overall care of a homeless pregnant woman, it is not the immediate priority in the presence of placenta previa and vaginal bleeding.

B. Obtain a hemoglobin and hematocrit level. Assessing hemoglobin and hematocrit levels is important to evaluate the extent of blood loss and anemia, but the priority is to ensure the woman’s and fetus’s immediate safety due to placenta previa.

C. Have the client transported to the hospital. This is the correct action. Placenta previa can cause significant bleeding and requires immediate medical attention, including potential delivery. Transporting the client to the hospital ensures she receives the necessary urgent care.

D. Schedule weekly perinatal appointments. Weekly perinatal appointments are important for ongoing care, but in the context of active bleeding and placenta previa, immediate hospital care is necessary first.

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Correct Answer is A

Explanation

A. Fetal growth and gestational age. Ultrasound during pregnancy is commonly used to assess fetal growth, development, and gestational age. It allows healthcare providers to monitor the health and progress of the pregnancy, as well as detect any potential issues or abnormalities.

B. Lecithin-sphingomyelin ratio. This ratio is typically assessed in amniotic fluid samples to predict fetal lung maturity, but it's not the primary reason for a routine ultrasound during pregnancy.

C. Chromosomal abnormalities. While some prenatal screening tests, such as nuchal translucency ultrasound or cell-free DNA testing, can help assess the risk of chromosomal abnormalities, a routine ultrasound is not primarily conducted for this purpose.

D. Sex and size of the infant. While ultrasound can reveal the sex of the baby and provide estimates of fetal size, these are secondary to the primary goal of assessing fetal growth and gestational age.

A. Deep, continuous pain in the calf muscles. B. Painful symptoms alleviated by warmth. C. Cool, pale skin below the knees. D. Decreased pain when legs are elevated.

Correct Answer is D

Explanation

A. Deep, continuous pain in the calf muscles. This symptom is more indicative of deep vein thrombosis (DVT) rather than venous insufficiency.

B. Painful symptoms alleviated by warmth. This symptom is not typically associated with venous insufficiency; it may be seen in conditions like arthritis.

C. Cool, pale skin below the knees. This finding is more suggestive of arterial insufficiency rather than venous insufficiency.

D. Decreased pain when legs are elevated. Venous insufficiency is characterized by impaired blood flow in the veins, leading to symptoms such as leg aching, tiredness, swelling, and skin changes like leathery appearance. Elevating the legs can help alleviate symptoms of venous insufficiency by reducing venous pressure and improving blood flow back to the heart. Therefore, a subjective finding indicating decreased pain when the legs are elevated suggests venous insufficiency.

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A pregnant, homeless woman who has received no prenatal care presents to the clinic in her third trimester because she is having vaginal bleeding, but reports that she is not in pain. Ultrasound reveals a placenta previa. Which action should the nurse implement?

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Naxlex Comprehensive Predictor Exams

Gestational Ultrasound. In preparing the client for the procedure, the nurse should explain that the primary reason for conducting the ultrasound is to obtain which information?

Correct Answer is A

Explanation

While assessing the legs of an adult client, the nurse observes leathery-looking skin. The client reports aching, tired legs that swell if standing for long periods of time. To screen for venous insufficiency, the nurse should ask the client if they have experienced which subjective finding?

Correct Answer is D

Explanation

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