A nurse is caring for a client who is 9 weeks pregnant at her first prenatal visit.Vital signs Medical History 0900: Medical history Gravida 3 Para weeks of gestation Allergies: Penicillin Height 5 feet 4 inches, 163 cm Weight 178 lb, 80.7 kg BMI 30.6 Client reports two previous children were born vaginally and at term.Client reports, “I have had a vaginal spotting and mild abdominal cramping the last couple days”. Diagnostic tests Client reports dysuria and urinary frequency.Client reports mild nausea in the morning for the last 2-3 weeks.Abdominal enlargement is noted.Chadwick’s sign is present.(Select All that Apply.) Blood pressure Gastrointestinal complaints Lower abdominal cramping Hcg result Vaginal spotting Heart rate.Time What priority information should the nurse report to the provider?
Blood pressure.
Gastrointestinal complaints.
Lower abdominal cramping.
Hcg result.
Vaginal spotting.
Heart rate.
Dysuria.
Correct Answer : A,C,E,G
Choice A rationale
Blood pressure is a critical parameter to monitor during pregnancy. Elevated blood pressure, as seen in this case (149/91 mmHg), can indicate the onset of hypertensive disorders such as preeclampsia, which can have severe consequences for both the mother and the fetus. Preeclampsia is characterized by high blood pressure and signs of damage to another organ system, often the kidneys. It is essential to report elevated blood pressure to the provider for further evaluation and management.
Choice B rationale
Gastrointestinal complaints, such as nausea and vomiting, are common during pregnancy due to hormonal changes. However, they are typically not a priority unless they are severe or accompanied by other concerning symptoms. In this case, the gastrointestinal complaints are mild and have been present for 2-3 weeks, which is consistent with normal early pregnancy symptoms.
Choice C rationale
Lower abdominal cramping can be a sign of various conditions, including normal uterine growth, gastrointestinal issues, or more serious concerns such as ectopic pregnancy or miscarriage. Given the patient’s report of vaginal spotting and mild abdominal cramping, it is crucial to report this to the provider to rule out any potential complications.
Choice D rationale
The hCG result is important for confirming pregnancy and monitoring its progression. However, in this context, it is not the most immediate priority compared to other symptoms. Elevated or abnormal hCG levels can indicate potential issues, but the presence of other symptoms such as spotting and cramping takes precedence.
Choice E rationale
Vaginal spotting during early pregnancy can be a sign of implantation bleeding, but it can also indicate more serious conditions such as threatened miscarriage or ectopic pregnancy. Given the patient’s report of spotting and cramping, it is essential to report this to the provider for further evaluation and management.
Choice F rationale
Heart rate is an important vital sign to monitor, but in this case, the patient’s heart rate is within the normal range for pregnancy. Therefore, it is not a priority to report unless there are other concerning symptoms or significant changes in heart rate.
Choice G rationale
Dysuria, or painful urination, can indicate a urinary tract infection (UTI), which is common during pregnancy and can lead to complications if left untreated. UTIs can cause discomfort and may lead to more serious infections such as pyelonephritis. It is important to report dysuria to the provider for appropriate testing and treatment.
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View Related questions
Correct Answer is B
Explanation
Choice A rationale
Fetal movements, known as quickening, are typically felt by the mother between 16 and 25 weeks of pregnancy, not specifically at week 245.
Choice B rationale
The baby’s heartbeat can be detected by 10-12 weeks of pregnancy using a Doppler ultrasound device. This is an important milestone in fetal development and prenatal care
.
Choice C rationale
Lanugo, the fine hair covering the fetus, usually appears around 20 weeks of pregnancy and starts to disappear closer to the end of the third trimester, not specifically by week 355.
Choice D rationale
The sex of the baby is determined at conception, but it can be detected via ultrasound around 18-20 weeks of pregnancy, not by week 85.
Correct Answer is D
Explanation
Choice A rationale
Striae gravidarum, or stretch marks, are a common occurrence during pregnancy due to the rapid stretching of the skin. They are not a medical emergency and do not require immediate attention from a healthcare provider.
Choice B rationale
During pregnancy, the nipples and areola typically become darker, not paler, as the breasts enlarge. This change is due to hormonal influences and increased blood flow to the area.
Choice C rationale
Fetal movement, also known as quickening, is usually felt by the mother between 18 to 25 weeks of gestation, not as early as 10 weeks. At 10 weeks, the fetus is still too small for its movements to be felt by the mother.
Choice D rationale
Some nausea and vomiting, known as morning sickness, is normal during pregnancy. However, if a pregnant woman is unable to keep food or water down, it is important to contact a healthcare provider to ensure she and the baby are receiving adequate nutrition and hydration.