During an initial examination in the labor room, the nurse notes a large amount of yellow-green or gray frothy and bubbly discharge around the vaginal walls with a foul smell.
The nurse suspects the woman has which type of sexually transmitted infection?

Gonorrhea.

Trichomoniasis.

Chlamydia.

Syphilis.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Gonorrhea typically presents with a purulent, often thick, yellow discharge. While it can have a foul odor, the description of frothy and bubbly is less characteristic of gonorrhea. Diagnosis usually involves a cervical culture or nucleic acid amplification testing (NAAT).

Choice B rationale

Trichomoniasis, caused by the protozoan *Trichomonas vaginalis*, is characteristically associated with a large amount of yellow-green or gray, frothy, and bubbly vaginal discharge with a distinct, often foul or fishy odor. Microscopic examination of the discharge reveals the motile trichomonads for definitive diagnosis.

Choice C rationale

Chlamydia often presents with a thin or mucopurulent discharge, which may be yellowish, but it is not typically described as frothy or bubbly. Many women with chlamydia are asymptomatic. Diagnosis is usually made through NAAT of cervical or urine samples.

Choice D rationale

Syphilis in its primary stage presents with a painless chancre. Secondary syphilis can involve a generalized rash and flu-like symptoms. Vaginal discharge is not a primary characteristic of either the primary or secondary stages of syphilis. Diagnosis involves serological testing.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

Rationales for Each Condition

Hyperemesis Gravidarum

Weight loss: Excessive vomiting leads to poor nutritional intake and dehydration, causing unintended weight loss. The normal weight gain expected in the first trimester of pregnancy is around 0.5–2 kg. A weight loss of 0.9 kg in two weeks is concerning.
Hypotension: Dehydration due to persistent vomiting causes reduced intravascular volume, leading to low blood pressure. Normal blood pressure ranges from 90/60 mm Hg to 120/80 mm Hg. The client's 96/52 mm Hg value indicates potential volume depletion.
Tachycardia: Fluid loss and electrolyte imbalances increase heart rate as a compensatory mechanism to maintain perfusion. The normal heart rate ranges from 60–100 bpm, and the client's 116 bpm suggests dehydration-related tachycardia.

Cystitis

Dysuria: Inflammation of the bladder due to infection causes pain or burning during urination, a classic symptom of cystitis. The absence of other urinary symptoms, such as urgency or hematuria, helps differentiate cystitis from other conditions.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Upon reviewing the client’s medical record, the nurse determines that the client is at risk for developing choriocarcinoma and thyrotoxicosis.

Rationale for correct answers

Choriocarcinoma is a malignant form of gestational trophoblastic disease (GTD) that arises from a molar pregnancy, as evidenced by grape-like vesicles seen on ultrasound and excessively elevated beta-hCG (normal in pregnancy: up to 100,000 mIU/mL by late first trimester). This condition can lead to metastases if not diagnosed and treated promptly.

Thyrotoxicosis occurs due to excess beta-hCG, which stimulates thyroid hormone production. This is supported by the slightly elevated free T4 levels, a common feature of molar pregnancy-related hyperthyroidism.

Rationale for incorrect Response 1 options

Preterm labor: The client is at 20 weeks with no contractions noted, and cervical changes are not reported.
Placenta previa: Characterized by painless bright red bleeding later in pregnancy; this client has dark brown discharge consistent with molar pregnancy.
Cardiac arrhythmia: No evidence of electrolyte abnormalities or arrhythmogenic conditions such as hyperkalemia.

Rationale for incorrect Response 2 options

Preeclampsia: Normal blood pressure (≥140/90 mm Hg would be concerning); no proteinuria.
Urinary tract infection: No leukocytes, nitrites, or dysuria reported.
Hypoglycemia: Normal serum glucose levels; vomiting history does not indicate hypoglycemia.

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During an initial examination in the labor room, the nurse notes a large amount of yellow-green or gray frothy and bubbly discharge around the vaginal walls with a foul smell.The nurse suspects the woman has which type of sexually transmitted infection?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a 26-year-old female client who is at 14 weeks of gestation in the antepartum clinic. Exhibits For each assessment finding, click to specify if the finding is consistent with hyperemesis gravidarum or cystitis. Each finding may support more than one pregnancy complication.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

A nurse is caring for a 30-year-old female client who is at 20 weeks of gestation in the labor and delivery unit. Exhibits Upon reviewing the client’s medical record, the nurse determines that the client is at risk for developing dropdown and dropdown.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

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During an initial examination in the labor room, the nurse notes a large amount of yellow-green or gray frothy and bubbly discharge around the vaginal walls with a foul smell.
The nurse suspects the woman has which type of sexually transmitted infection?