As related to the care of the patient with miscarriage, nurses should be aware that:

it is a natural pregnancy loss before labor begins.

it often can be attributed to careless maternal behavior such as poor nutrition or excessive exercise.

if it occurs before the 12th week of pregnancy, it may manifest only as moderate discomfort and blood loss.

it occurs in fewer than 5% of all clinically recognized pregnancies.

Answer and Explanation

The Correct Answer is A

Choice A reason: A miscarriage is defined as a spontaneous abortion of a fetus before the 20th week of gestation. It is a natural pregnancy loss that occurs before labor begins and is usually caused by chromosomal abnormalities, infections, or maternal health problems.

Choice B reason: A miscarriage is not often attributed to careless maternal behavior such as poor nutrition or excessive exercise. These factors may affect the quality of life of the mother and the fetus, but they are not the main causes of miscarriage. Most miscarriages are not preventable and are not the fault of the mother.

Choice C reason: A miscarriage that occurs before the 12th week of pregnancy may manifest only as moderate discomfort and blood loss, but this is not always the case. Some women may experience severe cramping, bleeding, and tissue passing from the vagina. Others may have no symptoms at all and only discover the miscarriage during a routine ultrasound.

Choice D reason: A miscarriage occurs in more than 5% of all clinically recognized pregnancies. The actual rate of miscarriage is estimated to be 10% to 20%, but many women may not realize they are pregnant or may not report the loss to their health care provider.

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Correct Answer is B

Explanation

The correct answer is: B. 3-1-1-0-3.

Choice A reason:

This option suggests the woman has been pregnant four times, which is incorrect. She has had three pregnancies: one set of twins (counted as one pregnancy) and two singletons.

Choice B reason:

This is the correct option. The woman has had three pregnancies (Gravida = 3), one full-term delivery (Term = 1), one preterm delivery (the twins, Preterm = 1), no abortions (Abortions = 0), and three living children (Living = 3).

Choice C reason:

This option incorrectly suggests two preterm deliveries and one abortion, neither of which is indicated in the woman's history.

Choice D reason:

This option incorrectly suggests two preterm deliveries (the twins are counted as one preterm delivery) and does not accurately reflect the woman's history.

GTPAL stands for Gravida (total number of pregnancies), Term births (deliveries after 37 weeks), Preterm births (deliveries between 20-36 weeks), Abortions (losses before 20 weeks), and Living children. Normal ranges: Term (≥37 weeks), Preterm (20-36 weeks)

A. ask the woman to reschedule the appointment for the examination. B. ask the woman to describe the symptoms that indicate to her that she has a vaginal infection. C. reassure the woman that using vaginal cream is not a problem for the examination. D. inform the woman that vaginal creams may interfere with the Papanicolaou (Pap) test for which she is scheduled.

Correct Answer is D

Explanation

Choice A reason: Asking the woman to reschedule the appointment for the examination is not the best response, as it may delay the detection and treatment of any potential problems. The nurse should inform the woman about the possible effect of the vaginal cream on the Pap test and offer her the option to reschedule or proceed with the examination.

Choice B reason: Asking the woman to describe the symptoms that indicate to her that she has a vaginal infection is a good way to assess the woman's condition and provide education, but it is not the initial response. The nurse should first inform the woman about the possible effect of the vaginal cream on the Pap test and then ask her about her symptoms.

Choice C reason: Reassuring the woman that using vaginal cream is not a problem for the examination is not true, as vaginal creams can alter the pH of the vaginal environment and affect the accuracy of the Pap test. The nurse should inform the woman about the possible effect of the vaginal cream on the Pap test and explain the importance of avoiding vaginal creams, douches, or intercourse for 48 hours before the test.

Choice D reason: Informing the woman that vaginal creams may interfere with the Pap test for which she is scheduled is the best response, as it educates the woman about the purpose and procedure of the Pap test and allows her to make an informed decision about whether to reschedule or proceed with the examination. The nurse should also explain the risks and benefits of both options and respect the woman's choice.

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As related to the care of the patient with miscarriage, nurses should be aware that:

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Naxlex Comprehensive Predictor Exams

A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicated that she has delivered premature twins, one full-term baby, and has had no abortions. Which GTPAL should the nurse document in this client's record?

Correct Answer is B

Explanation

A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection and has been using an over-the-counter cream for the past 2 days to treat it. The nurse's initial response should be to:

Correct Answer is D

Explanation

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