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A nurse is reinforcing teaching about preterm labor with a client who is at 28 weeks of gestation.Which of the following statements by the client indicates an understanding of the teaching?

A.

“I should expect to feel pain in my upper right abdomen if I’m having preterm labor.”.

B.

“If I have contractions more often than every 10 minutes, I might be in preterm labor.”.

C.

“I can take a daily iron supplement to prevent preterm labor.”.

D.

“I might be experiencing preterm labor if walking stops my contractions.”.

Answer and Explanation

The Correct Answer is B

Choice A rationale

 

Pain in the upper right abdomen is not a typical sign of preterm labor. Preterm labor symptoms include regular contractions, lower back pain, and pelvic pressure.

 

Choice B rationale

 

Contractions occurring more frequently than every 10 minutes can indicate preterm labor. Regular contractions are a key sign of preterm labor.

 

Choice C rationale

 

While iron supplements are important during pregnancy, they do not prevent preterm labor. Preterm labor is influenced by various factors, including infections and uterine abnormalities.

 

Choice D rationale

 

Walking typically does not stop contractions associated with preterm labor. In fact, activity can sometimes exacerbate contractions.


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Correct Answer is C

Explanation

Choice A rationale

Verifying that the newborn is Rh-negative is not necessary for administering Rh(D) immune globulin. The medication is given to Rh-negative mothers to prevent Rh sensitization, regardless of the newborn’s Rh status.

Choice B rationale

A positive Coombs test indicates that the mother has already been sensitized to Rh-positive blood cells, making Rh(D) immune globulin ineffective in preventing sensitization.

Choice C rationale

Administering Rh(D) immune globulin within 72 hours after birth is crucial to prevent Rh sensitization in future pregnancies. This timing ensures that the mother’s immune system does not produce antibodies against Rh-positive blood cells.

Choice D rationale

Rh(D) immune globulin is typically administered intramuscularly, not into the abdomen. The preferred sites are the deltoid muscle or the anterolateral aspect of the thigh.

Correct Answer is D

Explanation

Choice A rationale

Applying a corticosteroid cream is not appropriate for acute perineal pain. It is more suitable for chronic inflammation or skin conditions.

Choice B rationale

Increasing fluid intake is beneficial for overall health, but it does not directly address acute perineal pain.

Choice C rationale

Catheterizing the bladder is not indicated for perineal pain unless there is a specific issue with urinary retention.

Choice D rationale

Offering an ice pack helps reduce swelling and numb the area, providing immediate relief for acute perineal pain. It is a standard intervention for postpartum perineal discomfort.

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