A client who is at 22 weeks gestation is being educated by a nurse about the amniocentesis procedure. Which of the following statements should the nurse make?

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Question 1 of 5

A client who is at 22 weeks gestation is being educated by a nurse about the amniocentesis procedure. Which of the following statements should the nurse make?

Correct Answer: C

Rationale: The correct answer is C: You should empty your bladder before the procedure. This is important because a full bladder can obstruct the visualization of the fetus during amniocentesis. By emptying the bladder, the uterus is better positioned for the procedure, making it safer and more effective. Explanation: 1. A (You will lie on your right side during the procedure) is incorrect because the position during amniocentesis is typically on the back or slightly tilted to the left. 2. B (You should not eat anything for 24 hours before the procedure) is incorrect as fasting is not required for amniocentesis. 3. D (The test is performed to determine gestational age) is incorrect as amniocentesis is used to detect genetic abnormalities, not gestational age.

Question 2 of 5

A nurse in the emergency department is caring for a client who reports abrupt, sharp, right-sided lower quadrant abdominal pain and bright red vaginal bleeding. The client states, 'I missed one menstrual cycle and cannot be pregnant because I have an intrauterine device.' The nurse should suspect which of the following?

Correct Answer: B

Rationale: The correct answer is B: Ectopic pregnancy. Given the client's symptoms of right-sided lower quadrant abdominal pain, vaginal bleeding, missed menstrual cycle, and presence of an intrauterine device, these are classic signs of an ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, commonly in the fallopian tube, leading to abdominal pain and vaginal bleeding. The other choices are incorrect because: A: Missed abortion would typically present with cramping, bleeding, and passage of tissue. C: Severe preeclampsia is characterized by high blood pressure and proteinuria, not the symptoms described. D: Hydatidiform mole would typically present with vaginal bleeding and uterine enlargement, but not the sharp abdominal pain described.

Question 3 of 5

A client at 32 weeks of gestation with placenta previa is actively bleeding. Which medication should the provider likely prescribe?

Correct Answer: A

Rationale: The correct answer is A: Betamethasone. Betamethasone is a corticosteroid used to promote fetal lung maturity in preterm labor. In this scenario, at 32 weeks of gestation with placenta previa and active bleeding, the priority is to promote fetal lung maturity in case of premature delivery due to the risk of maternal hemorrhage. Indomethacin (B) is a nonsteroidal anti-inflammatory drug and not indicated in this situation. Nifedipine (C) is a calcium channel blocker used for preterm labor to delay contractions, not for placenta previa and active bleeding. Methylergonovine (D) is used for postpartum hemorrhage and not indicated in this scenario.

Question 4 of 5

A nurse at an antepartum clinic is caring for a client who is at 4 months of gestation. The client reports continued nausea, vomiting, and scant, prune-colored discharge. The client has experienced no weight loss and has a fundal height larger than expected. Which of the following complications should the nurse suspect?

Correct Answer: C

Rationale: The correct answer is C: Hydatidiform mole. At 4 months of gestation, prune-colored discharge indicates possible passage of vesicular tissue characteristic of a molar pregnancy. This, along with continued nausea, vomiting, and larger fundal height, are signs of a hydatidiform mole. Hyperemesis gravidarum (A) typically involves severe nausea and vomiting leading to weight loss, which the client did not experience. Threatened abortion (B) presents with vaginal bleeding and cramping, not prune-colored discharge. Preterm labor (D) is characterized by regular contractions leading to cervical changes, not the symptoms described.

Question 5 of 5

A healthcare professional is assisting with the care for a client who is experiencing a ruptured ectopic pregnancy. Which of the following findings is expected with this condition?

Correct Answer: D

Rationale: The correct answer is D: Report of severe shoulder pain. In a ruptured ectopic pregnancy, the fertilized egg implants outside the uterus, usually in the fallopian tube. As the tube ruptures, there is internal bleeding which can irritate the diaphragm, causing referred pain to the shoulder. This phenomenon is known as Kehr's sign. The other choices are incorrect because with a ruptured ectopic pregnancy, there would typically be altered menses due to the pregnancy disruption, a transvaginal ultrasound would not show a fetus in the uterus, and blood progesterone levels would not be elevated.

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