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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

A temperature of 37.8°C (100°F) 18 hours postpartum is slightly elevated but not necessarily indicative of a serious issue. It may require monitoring but is not the most urgent concern.

Choice B rationale

Abdominal pain during breastfeeding 8 hours postpartum is a common experience due to uterine contractions. While it may cause discomfort, it is not typically an urgent concern.

Choice C rationale

Not having a bowel movement 24 hours postpartum is not uncommon and does not usually require immediate attention. It can be addressed with dietary changes and other interventions.

Choice D rationale

Saturating one perineal pad over 2 hours 6 hours postpartum in a G5P4 client indicates a potential risk of postpartum hemorrhage. This is a more urgent concern that requires immediate assessment and intervention to prevent complications.

Correct Answer is B

Explanation

Choice A rationale

There is no need to fast before a nonstress test. The test measures the fetal heart rate in response to fetal movements and does not require any dietary restrictions.

Choice B rationale

During a nonstress test, the client will press a button whenever they feel the baby move. This helps correlate fetal movements with heart rate changes.

Choice C rationale

The client is not required to lie flat on their back for the duration of the test. They can be in a semi-reclined position to ensure comfort and avoid supine hypotensive syndrome.

Choice D rationale

Medication to stimulate contractions is not used during a nonstress test. This is done during a contraction stress test, which is a different procedure.

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