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

Rationale for Choice A:
It is accurate that scheduling the NST when the baby is usually active is beneficial. This is because fetal movement is expected to cause accelerations in the fetal heart rate, which is a positive sign of fetal well-being.
By scheduling the test during a time of typical fetal activity, the chances of obtaining a reactive NST (a normal result) are increased.
Therefore, this statement does not indicate a need for further teaching.

Rationale for Choice B:
Lying on the back during the NST is not recommended.
This position can cause the weight of the uterus to compress the major blood vessels (the inferior vena cava and aorta), potentially reducing blood flow to the placenta and fetus.
Reduced blood flow can, in turn, lead to a decrease in fetal heart rate and movement.
To avoid this, the recommended position for NST is a semi-Fowler's position, which involves being partially reclined with the head and upper body elevated.
This position helps to promote uterine perfusion and prevent supine hypotension.

Rationale for Choice C:
It is accurate that the baby's heart rate will be monitored during the NST.
This is the primary purpose of the test: to assess the fetal heart rate response to fetal movement. Therefore, this statement does not indicate a need for further teaching.

Rationale for Choice D:
It is accurate that the client will be able to go to the bathroom during the NST if necessary. The test is noninvasive and does not require strict immobility.
The client can move around and use the bathroom as needed, as long as the fetal heart rate monitor is not disconnected.
Therefore, this statement does not indicate a need for further teaching.

A. The recommendation for you is about 25 to 35 pounds. B. You should gain 11 to 20 pounds. C. It probably doesn't matter exactly how much weight you gain, as long as your diet is healthy. D. A gain of about 15 to 25 pounds is best for you and for your baby.

Correct Answer is A

Explanation

The correct answer is Choice A.

Choice A rationale: The recommended weight gain for a woman with a normal BMI (18.5-24.9) during pregnancy is 25-35 pounds. This range ensures adequate nutrition for both the mother and the developing baby, supporting optimal fetal growth and maternal health.

Choice B rationale: A weight gain of 11-20 pounds is recommended for women with a high BMI (≥30) during pregnancy. This range helps minimize the risk of complications such as gestational diabetes and hypertension, but it is not applicable for a woman with a normal BMI.

Choice C rationale: While a healthy diet is crucial, specific weight gain guidelines are essential to ensure the health of both mother and baby. Weight gain recommendations are based on evidence to support optimal outcomes, making it important to follow them.

Choice D rationale: A weight gain of 15-25 pounds is recommended for women with an overweight BMI (25-29.9) during pregnancy. This range helps support fetal growth while minimizing the risk of complications, but it is not applicable for a woman with a normal BMI.

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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 reinforcing teaching with a client who is at weeks of gestation and scheduled for a non-stress test (NST). Which of the following statements by the client indicates a need for further teaching?

Correct Answer is B

Explanation

A nurse is reinforcing teaching with a client who is pregnant and has a body mass index (BMI) of 22. She asks the nurse how much weight she should gain over the course of her pregnancy. Which of the following statements is an appropriate response by the nurse?

Correct Answer is A

Explanation

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