The nurse is caring for a patient admitted with vaginal bleeding and cramping who delivered a stillborn infant at 22 weeks' gestation. What data in the patient's health history are associated with this complication of pregnancy?

Correct Answer: B

Rationale: The correct answer is B: hypertension times 4 years. Hypertension is a risk factor for complications during pregnancy, such as preterm birth and stillbirth. The patient's history of chronic hypertension increases the likelihood of developing conditions like preeclampsia, which can lead to fetal complications like stillbirth. The other choices (A, C, and D) are not directly associated with the complication of pregnancy described in the scenario. A motor vehicle accident, appendectomy, and nausea do not have a direct causal relationship with the patient's current condition of vaginal bleeding and cramping after delivering a stillborn infant at 22 weeks' gestation.

Correct Answer: B

Rationale: The correct answer is B: Delivery of the fetus. Preeclampsia is a serious condition that can only be cured by delivering the baby and placenta. This is because the placenta is the source of the problem in preeclampsia. Other options like magnesium sulfate, antihypertensive medications, and aspirin can help manage symptoms but do not cure the underlying condition. Magnesium sulfate is used to prevent seizures in severe cases, antihypertensive medications control high blood pressure, and aspirin may be used for prevention but not as a cure. Delivery is the definitive treatment to resolve preeclampsia and prevent further complications for both the mother and the baby.

Correct Answer: B

Rationale: The correct answer is B: Total placenta previa. In total placenta previa, the placenta completely covers the opening of the cervix, posing a risk of severe bleeding during vaginal delivery. Cesarean birth is necessary to prevent maternal hemorrhage and ensure a safe delivery. Partial abruptio placentae (A) may require cesarean birth if there is significant bleeding or fetal distress, but it's not an absolute indication for cesarean section. Ectopic pregnancy (C) and eclampsia (D) do not always necessitate cesarean birth unless there are other obstetric indications.

Correct Answer: B

Rationale: The correct answer is B: Hard boardlike abdomen. This finding indicates concealed hemorrhage in abruptio placentae because it suggests intra-abdominal bleeding causing rigidity and firmness. This is due to blood pooling in the abdomen, leading to a tense, boardlike feeling upon palpation. The other choices are incorrect because: A) Bradycardia is not a specific indicator of concealed hemorrhage in this context; C) Decrease in fundal height is more characteristic of a missed miscarriage or intrauterine fetal demise; D) Decrease in abdominal pain is not typically associated with concealed hemorrhage, which often presents with severe abdominal pain.

Correct Answer: D

Rationale: A dilation and curettage (D&C) is indicated for an incomplete abortion at 10 weeks because it involves dilating the cervix and removing remaining products of conception from the uterus to prevent infection or excessive bleeding. Incomplete abortion at 16 weeks (Choice B) would be too advanced for a D&C and may require a different procedure. A complete abortion at 8 weeks (Choice A) does not require a D&C as all products of conception have already been expelled. Threatened abortion at 6 weeks (Choice C) indicates a possible miscarriage, but a D&C is not necessary unless the miscarriage is confirmed and incomplete.