The antepartum nurse has just received shift report on four pregnant clients at 0700.
Which of the clients should the nurse assess first?
G5 P2202, 32 weeks, placenta previa, today's hemoglobin 11.6 g/dL.
G2 P0101, 39 weeks, type 2 diabetes mellitus (T2DM), fasting blood glucose.
G1 P0000, 32 weeks, partial placental abruption, fetal heart rate (FHR) 120 bpm 15 minutes ago.
G2 P1001, 28 weeks, Rh-negative (Rh-), 1 day post cerclage placement.
The Correct Answer is C
Choice A rationale
The hemoglobin level of 11.6 g/dL is within the normal range for a pregnant woman. While placenta previa requires monitoring, it is not immediately life-threatening.
Choice B rationale
Type 2 diabetes mellitus requires regular monitoring and management, but a single fasting blood glucose level does not indicate an immediate emergency unless it is extremely high or low.
Choice C rationale
Partial placental abruption can lead to significant complications for both the mother and fetus, including hemorrhage and fetal distress, making it the priority for immediate assessment.
Choice D rationale
An Rh-negative status and a recent cerclage placement are important for ongoing monitoring but do not present an immediate life-threatening condition that demands the first assessment.
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Correct Answer is B
Explanation
Choice A rationale
Induction timing is secondary to assessing readiness. The Bishop score determines cervical favorability for induction success.
Choice B rationale
The Bishop score assesses cervical readiness for labor induction, which is vital in planning an effective induction.
Choice C rationale
Refusal to induce without considering clinical data is inappropriate. The Bishop score evaluation determines readiness.
Choice D rationale
Prostaglandin preparation follows Bishop score assessment to ensure induction safety and efficacy.
Correct Answer is C
Explanation
Choice A rationale
Dexamethasone does not directly stop labor contractions; instead, it is used to enhance fetal lung maturity.
Choice B rationale
Dexamethasone is not for infection prevention; antibiotics are used for that purpose in cases of premature rupture of membranes.
Choice C rationale
Dexamethasone is administered to enhance fetal lung maturity, reducing the risk of respiratory distress syndrome in preterm infants.
Choice D rationale
Dexamethasone is not used for pain relief in preterm labor; other medications are prescribed for pain management.