A multigravida patient comes into the clinic for one of her second-trimester prenatal visits. The nurse reviews her laboratories that were drawn prior to the visit. Which laboratories results should concern the nurse most?

Correct Answer: B

Rationale: The correct answer is B: Hemoglobin 9.5 g/dL. This result indicates the patient is anemic, which is concerning during pregnancy as it can lead to complications like preterm birth or low birth weight. Anemia can also affect the mother's health. Platelet count of 200,000/μL is within the normal range, not a cause for concern. White blood cell count of 11,000/μL may indicate infection but is not as critical as anemia in pregnancy. Rubella titer ratio of 1:10 suggests immunity to rubella, which is not an immediate concern during the prenatal visit.

Correct Answer: C

Rationale: The correct answer is C, positive pregnancy test. This is a probable sign of pregnancy because it directly indicates the presence of the pregnancy hormone hCG in the woman's body. Amenorrhea (choice A) and uterine enlargement (choice B) are actually presumptive signs of pregnancy, as they can be caused by factors other than pregnancy. Breast tenderness (choice D) is a possible sign of pregnancy but is not as specific or conclusive as a positive pregnancy test.

Correct Answer: C

Rationale: The correct answer is C: pelvic dystocia. Pelvic dystocia occurs when the fetal head is unable to navigate through the pelvis due to its size, shape, or orientation. This can lead to prolonged labor and potential complications during delivery. Uterine dystocia (A) refers to abnormalities in uterine contractions, fetal dystocia (B) pertains to issues with the fetus itself, and contraction dystocia (D) involves problems with the strength or coordination of uterine contractions. Pelvic dystocia specifically addresses the anatomical mismatch between the fetal head and maternal pelvis, making it the correct choice in this scenario.

Correct Answer: C

Rationale: Uterine tachysystole is excessive uterine contractions, reducing placental perfusion and causing fetal hypoxia. This can lead to potential complications such as fetal distress and hypoxia. Category I fetal heart rate tracing is typically associated with normal fetal heart rate. Placenta previa is unrelated to uterine tachysystole. Prolapsed cord is a potential complication of uterine hyperstimulation, not tachysystole.

Correct Answer: A

Rationale: The correct answer is A: Assess deep tendon reflexes for hyperreflexia. This is crucial in preeclampsia to monitor for signs of worsening condition like eclampsia. Hyperreflexia is a common symptom in severe preeclampsia indicating CNS irritability. Providing IV fluid boluses (B) can worsen fluid overload. Educating that preeclampsia is only a concern for pregnancy (C) is incorrect as it can progress during labor. Discouraging pain medication (D) is inappropriate as it can mask symptoms like headaches, a common sign of worsening preeclampsia.