ATI RN
Antenatal complications Questions
Question 1 of 5
Which finding would indicate concealed hemorrhage in abruptio placentae?
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.
Question 2 of 5
Which laboratory finding is indicative of DIC?
Correct Answer: A
Rationale: The correct answer is A: Decreased fibrinogen. In DIC, there is widespread activation of the coagulation cascade, leading to consumption of clotting factors like fibrinogen. This results in decreased levels of fibrinogen in the blood. Increased platelets (B) are seen in early stages, but they decrease as consumption continues. Increased hematocrit (C) is a nonspecific finding. Decreased thromboplastin time (D) is not indicative of DIC, as it would typically be prolonged due to consumption of clotting factors.
Question 3 of 5
A patient who was pregnant had a spontaneous abortion at approximately 4 weeks' gestation. At the time of the miscarriage, it was thought that all products of conception were expelled. Two weeks later, the patient presents at the clinic office complaining of “crampy†abdominal pain and a scant amount of serosanguineous vaginal drainage with a slight odor. The pregnancy test is negative. Vital signs reveal a temperature of 100°F, with blood pressure of 100/60 mm Hg, irregular pulse 88 beats/minute (bpm), and respirations, 20 breaths per minute. Based on this assessment data, what does the nurse anticipate as a clinical diagnosis?
Correct Answer: B
Rationale: The correct answer is B: Uterine infection. The patient's presentation with crampy abdominal pain, scant serosanguineous vaginal drainage, negative pregnancy test, and vital signs indicating fever, hypotension, and tachycardia are indicative of a uterine infection, most likely post-miscarriage. The timing of symptoms 2 weeks after miscarriage aligns with the typical onset of infection. The absence of products of conception being expelled completely could have led to retained tissue causing infection. Ectopic pregnancy (A) would typically present with severe abdominal pain, vaginal bleeding, and positive pregnancy test. Gestational trophoblastic disease (C) would present with irregular vaginal bleeding and elevated hCG levels. Endometriosis (D) is a chronic condition characterized by pelvic pain and abnormal menstrual bleeding, not an acute post-miscarriage complication.
Question 4 of 5
A patient who had premature rupture of the membranes (PROM) earlier in the pregnancy at 28 weeks returns to the labor unit 1 week later complaining that she is now in labor. The labor and birth nurse performs the following assessments. The vaginal exam is deferred until the physician is in attendance. The patient is placed on electronic fetal monitoring (EFM) and a baseline FHR of 130 bpm is noted. No contraction pattern is observed. The patient is then transferred to the antepartum unit for continued observation. Several hours later, the patient complains that she does not feel the baby move. Examination of the abdomen reveals a fundal height of 34 cm. Muscle tone is no different from earlier in the hospital admission. The patient is placed on the EFM and no fetal heart tones are observed. What does the nurse suspect is occurring?
Correct Answer: D
Rationale: The correct answer is D: Hidden placental abruption. In this scenario, the patient had a history of PROM at 28 weeks, which puts her at risk for placental abruption due to the weakened membranes. The sudden onset of decreased fetal movement and absence of fetal heart tones on EFM indicate a potential emergency. The fundal height of 34 cm suggests the baby is at term, ruling out placental previa or preterm labor. Active labor typically presents with contractions, which are not observed in this case. Placental abruption can be concealed, leading to a sudden decrease in fetal well-being. The nurse should suspect hidden placental abruption and notify the physician immediately for further evaluation and intervention.
Question 5 of 5
A blood-soaked peripad weighs 900 g. The nurse would document a blood loss of _____ mL.
Correct Answer: C
Rationale: The correct answer is C (900 mL). To calculate blood loss, divide the weight of the blood-soaked pad (900 g) by the specific gravity of blood (1 g/mL). This gives 900 mL. Choice A (1800 mL) is incorrect as it doubles the correct amount. Choice B (450 mL) is incorrect as it halves the correct amount. Choice D (90 mL) is incorrect as it divides the correct amount by 10. The key is to convert the weight to volume using the specific gravity of blood to determine the correct blood loss measurement.