The doctor suspects that the client is in preterm labor. Which symptom is consistent with this diagnosis?

Correct Answer: D

Rationale: The correct answer is D: Abdominal cramping and lower back pain. These symptoms are typical of preterm labor due to the contractions of the uterus. Lower back pain is a common sign of labor, and abdominal cramping is indicative of uterine contractions. Severe pain in the lower quadrant (A) is more consistent with issues like appendicitis. Severe pain and hard abdomen (B) may indicate a more serious condition like placental abruption. Painless vaginal bleeding (C) is more characteristic of conditions like placenta previa. Therefore, choice D is the most appropriate in the context of suspected preterm labor.

Correct Answer: B

Rationale: The correct answer is B: Fluid volume deficit. When a pregnant client experiences a gush of fluid from the vagina at 30 weeks, it could indicate premature rupture of membranes (PROM) or preterm premature rupture of membranes (PPROM). This increases the risk of amniotic fluid leakage, leading to a decrease in the fluid surrounding the fetus. This can result in a fluid volume deficit for the fetus, potentially leading to complications such as fetal distress or preterm labor. In contrast, choices A, C, and D are less likely in this scenario. Infection (choice A) could be a risk later if the membranes are ruptured for an extended period. Hypotension (choice C) and decreased urinary output (choice D) are not directly related to the gush of fluid and are less likely in this immediate situation.

Correct Answer: B

Rationale: The correct answer is B. The nurse should get baseline blood pressure and pulse and monitor frequently during administration to assess the effectiveness and safety of the medication. This is crucial in managing severe pre-eclampsia. Choice A is incorrect because the client should be positioned on her left side to prevent vena cava compression, not supine with the head of the bed elevated. Choice C is incorrect because administering medication every 5 minutes without proper monitoring can lead to adverse effects like hypotension. Choice D is incorrect because hydralazine does not cause a positive direct Coombs test result. It is important for the nurse to provide accurate information to the client.

Correct Answer: C

Rationale: The correct answer is C: Obesity. Obesity is a significant risk factor for pre-eclampsia due to the increased strain on the cardiovascular system and potential inflammatory effects. It can lead to hypertension and vascular dysfunction, contributing to the development of pre-eclampsia. White race (A) is not a specific risk factor for pre-eclampsia. Multiparity (B) is a risk factor, but obesity has a higher association with pre-eclampsia. Infertility (D) is not a known risk factor for pre-eclampsia. In summary, obesity poses the highest risk due to its direct impact on cardiovascular health and inflammation.

Correct Answer: C

Rationale: The correct answer is C because progesterone is recommended for women with a history of preterm birth due to cervical incompetency. Progesterone helps to reduce the risk of another preterm birth by supporting the cervix and preventing it from opening too early. It is important for the nurse to discuss the action and side effects of progesterone with the patient to ensure informed decision-making. Choice A is incorrect as an abdominal ultrasound is not directly related to managing cervical incompetency. Choice B is incorrect as positioning the patient on her left side does not address the issue of cervical incompetency. Choice D is also incorrect as monitoring blood pressure is not the primary intervention for managing cervical incompetency in this case.