Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, what would be an expected diagnostic procedure?
A. Amniocentesis for fetal lung maturity
Amniocentesis for fetal lung maturity is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a procedure that involves inserting a needle into the amniotic sac to obtain a sample of amniotic fluid, which can be used to assess the fetal lung development. It is usually done in late pregnancy or preterm labor, not in the second trimester.
B. Contraction stress test (CST)
Contraction stress test (CST) is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that involves stimulating uterine contractions, either by nipple stimulation or oxytocin infusion, to evaluate the fetal heart rate response. It is used to assess fetal well-being and placental function, not to diagnose the cause of bleeding.
C. Internal fetal monitoring
Internal fetal monitoring is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a method of measuring the fetal heart rate and uterine contractions using electrodes or catheters that are inserted through the cervix and attached to the fetal scalp or the amniotic sac. It is usually done during labor, not in the second trimester.
D. Ultrasound for placental location
Ultrasound for placental location is an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that uses sound waves to create an image of the uterus, the placenta, and the fetus. It can help to determine the position and attachment of the placenta, which can be the cause of bleeding if it is low-lying or covering the cervix (placenta previa).
E. None of the above
None of the above is not a correct answer. There is one expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding, which is ultrasound for placental location.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Maternal Newborn Midterm Proctored Exam 1. Take the full exam now
Full Explanation
Choice A reason: Amniocentesis for fetal lung maturity is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a procedure that involves inserting a needle into the amniotic sac to obtain a sample of amniotic fluid, which can be used to assess the fetal lung development. It is usually done in late pregnancy or preterm labor, not in the second trimester.
Choice B reason: Contraction stress test (CST) is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that involves stimulating uterine contractions, either by nipple stimulation or oxytocin infusion, to evaluate the fetal heart rate response. It is used to assess fetal well-being and placental function, not to diagnose the cause of bleeding.
Choice C reason: Internal fetal monitoring is not an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a method of measuring the fetal heart rate and uterine contractions using electrodes or catheters that are inserted through the cervix and attached to the fetal scalp or the amniotic sac. It is usually done during labor, not in the second trimester.
Choice D reason: Ultrasound for placental location is an expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding. It is a test that uses sound waves to create an image of the uterus, the placenta, and the fetus. It can help to determine the position and attachment of the placenta, which can be the cause of bleeding if it is low-lying or covering the cervix (placenta previa).
Choice E reason: None of the above is not a correct answer. There is one expected diagnostic procedure for a pregnant woman with bright red, painless vaginal bleeding, which is ultrasound for placental location.
Similar Questions
A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman: (Select the one most appropriate answer.
A. Eat five small meals daily.
Eating five small meals daily can help reduce heartburn in pregnancy by preventing overeating and reducing the pressure on the stomach from the growing uterus. It can also help maintain a steady blood glucose level and prevent nausea and vomiting.
B. Lie down after each meal.
Lying down after each meal can worsen heartburn in pregnancy by allowing the stomach acid to reflux into the esophagus. It can also cause breathing difficulties and increase the risk of aspiration. The woman should avoid lying down for at least two hours after eating and elevate her head and chest when sleeping.
C. Reduce the amount of fiber she consumes.
Reducing the amount of fiber she consumes can cause constipation and hemorrhoids in pregnancy, which can increase the discomfort and pain. Fiber is important for maintaining a healthy digestive system and preventing gestational diabetes and preeclampsia. The woman should consume at least 25 grams of fiber per day from fruits, vegetables, whole grains, beans, and nuts.
D. Substitute other calcium sources for milk in her diet.
Substituting other calcium sources for milk in her diet can deprive the woman and the baby of essential nutrients, such as protein, vitamin D, and riboflavin. Milk is not a common cause of heartburn in pregnancy, unless the woman is lactose intolerant or allergic to dairy products. The woman should consume at least three servings of dairy products per day or take calcium supplements as prescribed.
Full Explanation
Choice A reason: Eating five small meals daily can help reduce heartburn in pregnancy by preventing overeating and reducing the pressure on the stomach from the growing uterus. It can also help maintain a steady blood glucose level and prevent nausea and vomiting.
Choice B reason: Lying down after each meal can worsen heartburn in pregnancy by allowing the stomach acid to reflux into the esophagus. It can also cause breathing difficulties and increase the risk of aspiration. The woman should avoid lying down for at least two hours after eating and elevate her head and chest when sleeping.
Choice C reason: Reducing the amount of fiber she consumes can cause constipation and hemorrhoids in pregnancy, which can increase the discomfort and pain. Fiber is important for maintaining a healthy digestive system and preventing gestational diabetes and preeclampsia. The woman should consume at least 25 grams of fiber per day from fruits, vegetables, whole grains, beans, and nuts.
Choice D reason: Substituting other calcium sources for milk in her diet can deprive the woman and the baby of essential nutrients, such as protein, vitamin D, and riboflavin. Milk is not a common cause of heartburn in pregnancy, unless the woman is lactose intolerant or allergic to dairy products. The woman should consume at least three servings of dairy products per day or take calcium supplements as prescribed.
A patient with pregnancy-induced hypertension is admitted complaining of pounding headache, visual changes, and epigastric pain.
Nursing care is based on the knowledge that these signs are an indication of:
A. Anxiety due to hospitalization.
Anxiety due to hospitalization is not a likely cause of the signs reported by the patient. Anxiety can cause some symptoms, such as headache, palpitations, or sweating, but it does not cause visual changes or epigastric pain. Anxiety is also not a common complication of pregnancy-induced hypertension, which is a condition characterized by high blood pressure and protein in the urine.
B. Effects of magnesium sulfate.
Effects of magnesium sulfate are not a likely cause of the signs reported by the patient. Magnesium sulfate is a medication used to prevent seizures and lower blood pressure in patients with pregnancy-induced hypertension. It can cause some side effects, such as flushing, nausea, or drowsiness, but it does not cause headache, visual changes, or epigastric pain. In fact, magnesium sulfate can help relieve these symptoms by reducing the cerebral edema and vasospasm caused by pregnancy-induced hypertension.
C. Worsening disease and impending convulsion.
Worsening disease and impending convulsion are the most likely cause of the signs reported by the patient. These signs indicate that the patient is developing severe preeclampsia or eclampsia, which are life-threatening complications of pregnancy-induced hypertension. Preeclampsia is characterized by high blood pressure, protein in the urine, and signs of organ damage, such as headache, visual changes, epigastric pain, or decreased urine output. Eclampsia is the occurrence of seizures in a patient with preeclampsia. These conditions can lead to stroke, bleeding, placental abruption, or fetal distress, and require immediate medical attention.
D. Gastrointestinal upset.
Gastrointestinal upset is not a likely cause of the signs reported by the patient. Gastrointestinal upset can cause some symptoms, such as nausea, vomiting, or abdominal pain, but it does not cause headache, visual changes, or epigastric pain. Gastrointestinal upset is also not a common complication of pregnancy-induced hypertension, which is a condition that affects the blood vessels and organs, not the digestive system.
E. Gastrointestinal upset.
Full Explanation
Choice A reason: Anxiety due to hospitalization is not a likely cause of the signs reported by the patient. Anxiety can cause some symptoms, such as headache, palpitations, or sweating, but it does not cause visual changes or epigastric pain. Anxiety is also not a common complication of pregnancy-induced hypertension, which is a condition characterized by high blood pressure and protein in the urine.
Choice B reason: Effects of magnesium sulfate are not a likely cause of the signs reported by the patient. Magnesium sulfate is a medication used to prevent seizures and lower blood pressure in patients with pregnancy-induced hypertension. It can cause some side effects, such as flushing, nausea, or drowsiness, but it does not cause headache, visual changes, or epigastric pain. In fact, magnesium sulfate can help relieve these symptoms by reducing the cerebral edema and vasospasm caused by pregnancy-induced hypertension.
Choice C reason: Worsening disease and impending convulsion are the most likely cause of the signs reported by the patient. These signs indicate that the patient is developing severe preeclampsia or eclampsia, which are life-threatening complications of pregnancy-induced hypertension. Preeclampsia is characterized by high blood pressure, protein in the urine, and signs of organ damage, such as headache, visual changes, epigastric pain, or decreased urine output. Eclampsia is the occurrence of seizures in a patient with preeclampsia. These conditions can lead to stroke, bleeding, placental abruption, or fetal distress, and require immediate medical attention.
Choice D reason: Gastrointestinal upset is not a likely cause of the signs reported by the patient. Gastrointestinal upset can cause some symptoms, such as nausea, vomiting, or abdominal pain, but it does not cause headache, visual changes, or epigastric pain. Gastrointestinal upset is also not a common complication of pregnancy-induced hypertension, which is a condition that affects the blood vessels and organs, not the digestive system.
A placenta previa in which the placental edge just reaches the internal os is more commonly known as:
A. total.
A total placenta previa is when the placenta completely covers the internal os, blocking the baby's exit from the uterus.
B. marginal.
Placenta previa is a condition where the placenta implants in the lower uterine segment and may cover or be near the cervical internal os. When the placental edge just reaches the internal os but does not cover it, it is called a marginal previa.
C. complete.
A complete placenta previa is when the placenta partially covers the internal os, reducing the space for the baby to pass through.
D. partial.
"Partial placenta previa" refers to a situation where the placenta partially covers the internal cervical os — meaning some, but not all, of the opening is obstructed by placental tissue.
Full Explanation
Choice A reason: A total placenta previa is when the placenta completely covers the internal os, blocking the baby's exit from the uterus.
Choice B reason: Placenta previa is a condition where the placenta implants in the lower uterine segment and may cover or be near the cervical internal os. When the placental edge just reaches the internal os but does not cover it, it is called a marginal previa.
Choice C reason: A complete placenta previa is when the placenta partially covers the internal os, reducing the space for the baby to pass through.
Choice D reason: "Partial placenta previa" refers to a situation where the placenta partially covers the internal cervical os — meaning some, but not all, of the opening is obstructed by placental tissue.