A nurse is caring for a client who is at 40 weeks of gestation and is in early labor. The client has a platelet count of 75,000/mm3 and is requesting pain relief. Which of the following treatment modalities should the nurse anticipate?

Correct Answer: C

Rationale: The correct answer is C: Attention-focusing. At 40 weeks gestation with a platelet count of 75,000/mm3, epidural analgesia is contraindicated due to the risk of epidural hematoma. Naloxone hydrochloride is an opioid antagonist used for opioid overdose, not for labor pain relief. Pudendal nerve block is used for local anesthesia during the second stage of labor, not for early labor pain relief. Attention-focusing techniques can help the client manage pain without pharmacological interventions, ensuring safety for both the client and the baby.

Correct Answer: D

Rationale: The correct answer is D: Pregestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and protein in the urine during pregnancy. Pregestational diabetes is a known risk factor for developing preeclampsia due to the underlying vascular and inflammatory changes associated with diabetes. In contrast, choices A, B, and C are not typically considered risk factors for preeclampsia. A singleton pregnancy (choice A) is a normal occurrence and not a risk factor for preeclampsia. A BMI of 20 (choice B) falls within the healthy weight range and is not a known risk factor for preeclampsia. Maternal age of 32 years (choice C) is also not considered a significant risk factor for preeclampsia in the absence of other factors.

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.

Correct Answer: D

Rationale: The correct answer is D because all of the choices are risk factors for preterm labor. A: Urinary tract infection can lead to inflammation and contractions. B: Multifetal pregnancy puts more stress on the uterus, increasing the risk. C: Oligohydramnios is associated with a higher risk of preterm labor due to decreased amniotic fluid levels. In summary, all the choices contribute to the increased likelihood of preterm labor.

Correct Answer: B

Rationale: The correct answer is B: "I'm sad for you." This response shows empathy and acknowledges the client's feelings without making assumptions or providing false reassurance. It validates the client's emotions and offers support. Incorrect choices: A: This statement assumes the client's feelings and may not be comforting. C: This statement is insensitive and can cause unnecessary guilt or blame. D: While well-intentioned, this statement may not align with the client's beliefs and can be dismissive of their grief.

Correct Answer: D

Rationale: The data "G3 T1 P0 A1 L1" indicates the client has had 3 pregnancies (G3), 1 term delivery (T1), 0 preterm deliveries (P0), 1 living child (A1), and 1 living child currently (L1). Therefore, the correct interpretation is that the client has one living child (A1) from one term delivery (T1). Choice D ("ALL OF THE ABOVE - has one living child") is correct as it summarizes the information accurately. Choices A, B, and C are incorrect because they do not encompass all the aspects of the data provided in the client's health record.

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.

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.

Correct Answer: C

Rationale: The correct answer is C: Iron. During pregnancy, the body's demand for iron increases to support the growing fetus and placenta. Iron is essential for the production of hemoglobin, which carries oxygen to the baby. Inadequate iron intake can lead to maternal anemia and complications. Calcium is important for bone health, but the focus in the 8th week of gestation should be on iron. Vitamin E is an antioxidant that is important for overall health but not specifically targeted for increased intake in the 8th week of pregnancy. Vitamin D is crucial for calcium absorption and bone health, but iron takes precedence during this stage of pregnancy.