The nurse is caring for a client who might have a hydatidiform mole. The nurse should monitor the client for which of the following findings? Choice Options:

Whitish vaginal discharge.

Excessive uterine enlargement.

Fetal heart rate irregularities.

Rapidly changing human chorionic gonadotropin levels.

Answer and Explanation

The Correct Answer is D

Rationale for Choice A: Whitish vaginal discharge
While whitish vaginal discharge can occur in some cases of hydatidiform mole, it's not a specific or sensitive finding for this condition.
It can also be present in various other gynecological conditions, including normal pregnancy, infections, and hormonal imbalances.
Therefore, relying on whitish vaginal discharge alone for monitoring a potential hydatidiform mole could lead to misdiagnosis or delayed diagnosis.

Rationale for Choice B: Excessive uterine enlargement
Excessive uterine enlargement is a common sign of hydatidiform mole, but it's not always present and might not be detected early in the condition.
The uterus might not be significantly enlarged in early stages, and other factors like multiple pregnancies or uterine fibroids could also contribute to uterine enlargement.
Solely relying on uterine enlargement could miss cases of hydatidiform mole that haven't progressed to a noticeable degree.

Rationale for Choice C: Fetal heart rate irregularities
Fetal heart rate irregularities are not relevant in hydatidiform mole because there is no viable fetus present. Hydatidiform moles are characterized by abnormal growth of placental tissue without a normal fetus developing. Monitoring for fetal heart rate would be inappropriate and misleading in this context.

Rationale for Choice D: Rapidly changing hCG levels
This is the most accurate and reliable finding to monitor for in a suspected hydatidiform mole.
hCG is a hormone produced by the placenta, and it's typically elevated in pregnancy. However, in hydatidiform mole, hCG levels are often abnormally high and rise rapidly.
Serial hCG measurements can accurately detect and track the progression of a hydatidiform mole, even in its early stages. It's considered the gold standard for diagnosis and monitoring of this condition.

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Correct Answer is B

Explanation

Choice A rationale:
A blood pressure of 100/60 is within the normal range and does not pose a contraindication to oral contraceptives. While hypertension (high blood pressure) can be a contraindication, a blood pressure of 100/60 is not considered hypertensive.
However, it's essential to monitor blood pressure regularly in individuals using oral contraceptives, as some may experience a slight increase in blood pressure.

Choice B rationale:
Age is a significant factor when considering oral contraceptive use.
Adolescents under 16 years of age are generally not recommended to use oral contraceptives due to several concerns: Their reproductive systems are still developing, and hormonal contraceptives could potentially disrupt normal growth and development.
Younger adolescents may have more difficulty adhering to a strict daily medication regimen, which is crucial for the effectiveness of oral contraceptives.
They may be at a higher risk of certain side effects, such as irregular bleeding patterns and mood changes.
Acne treatment is often a primary reason for considering oral contraceptives in adolescents. However, alternative acne treatments that are more suitable for younger individuals are available.

Choice C rationale:
A hematocrit of 39 is within the normal range for females and does not contraindicate oral contraceptive use.
Hematocrit measures the proportion of red blood cells in the blood. Oral contraceptives can sometimes cause slight changes in hematocrit levels, but these changes are typically not clinically significant.

Choice D rationale:
A menstrual cycle of 14 days is considered a normal variation and does not pose a contraindication to oral contraceptives. Oral contraceptives can often regulate irregular menstrual cycles, so they may even be beneficial for individuals with shorter or longer cycles.

A. Frank breech. B. Transverse. C. Cephalic. D. Posterior.

Correct Answer is A

Explanation

Choice A:

Fetal heart tone location: In a frank breech presentation, the fetal buttocks are positioned downward and the legs are extended straight up toward the head, placing the fetal heart closer to the mother's upper abdomen. This results in fetal heart tones being heard above the umbilicus at midline.

Gestation period: At 9 weeks of gestation, the fetus is still small and has ample room to move within the uterus, making breech presentations more common. However, it's important to note that the ideal position for childbirth is cephalic, with the head down.

The nurse is caring for a client who might have a hydatidiform mole. The nurse should monitor the client for which of the following findings? Choice Options:

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing contraception options for four clients. The nurse should identify which of the following clients as having a contraindication to oral contraceptives?

Correct Answer is B

Explanation

A nurse is assisting with the care of a client who is in active labor at 9 weeks of gestation. The nurse locates the fetal heart tones above the client's umbilicus at midline. The nurse should suspect that the fetus is in which of the following positions?

Correct Answer is A

Explanation

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