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A nurse in a provider’s office is collecting data from a client who is at 34 weeks of gestation and reports having a sudden gush of vaginal fluid.Which of the following manifestations is the priority?

A.

Amniotic fluid with meconium noted.

B.

Maternal temperature 38.3°C (101°F).

C.

Foul smelling vaginal discharge.

D.

Fetal heart tones 98/min.

Answer and Explanation

The Correct Answer is D

Choice A rationale

 

Amniotic fluid with meconium noted can indicate fetal distress, but it is not the most immediate priority compared to fetal heart tones.

 

Choice B rationale

 

A maternal temperature of 38.3°C (101°F) can indicate infection, but it is not the most immediate priority compared to fetal heart tones.

 

Choice C rationale

 

Foul-smelling vaginal discharge can indicate infection, but it is not the most immediate priority compared to fetal heart tones.

 

Choice D rationale

 

Fetal heart tones of 98/min indicate fetal bradycardia, which is a sign of fetal distress and requires immediate intervention to ensure the well-being of the fetus.


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Correct Answer is D

Explanation

Choice A rationale

Tingling in the fingers, also known as carpal tunnel syndrome, is more commonly associated with the later stages of pregnancy when fluid retention is more pronounced. It is not typically a common discomfort during the first trimester.

Choice B rationale

Round ligament pain is more common in the second trimester when the uterus is growing rapidly and the ligaments supporting it stretch. This type of pain usually manifests as sharp, shooting pain in the lower abdomen or groin.

Choice C rationale

Perineal discomfort and pressure are more common in the later stages of pregnancy, particularly in the third trimester, as the baby descends into the pelvis and prepares for birth. It is not typically a discomfort experienced during the first trimester.

Choice D rationale

Increased urgency and frequency of urination are common discomforts during the first trimester of pregnancy. This occurs due to hormonal changes and the growing uterus pressing on the bladder, which reduces its capacity.

Correct Answer is B

Explanation

Choice A rationale

Lying in a left side-lying position for 30 minutes after meals can help reduce heartburn symptoms by preventing stomach acid from flowing back into the esophagus. However, it is not the most effective recommendation for managing heartburn during pregnancy.

Choice B rationale

Taking sips of milk between meals can help neutralize stomach acid and provide relief from heartburn. Milk can act as a buffer, reducing the acidity in the stomach and alleviating discomfort.

Choice C rationale

Eating three large meals per day can exacerbate heartburn symptoms by increasing the amount of stomach acid produced. Smaller, more frequent meals are recommended to help manage heartburn during pregnancy.

Choice D rationale

Drinking a cup of black coffee before breakfast can worsen heartburn symptoms due to its acidic nature and caffeine content. It is not recommended for individuals experiencing frequent heartburn, especially during pregnancy.

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