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The antepartum nurse has just received shift report on four pregnant clients at 0700.
Which of the clients should the nurse assess first?

A.

G5 P2202, 32 weeks, placenta previa, today's hemoglobin 11.6 g/dL.

B.

G2 P0101, 39 weeks, type 2 diabetes mellitus (T2DM), fasting blood glucose.

C.

G1 P0000, 32 weeks, partial placental abruption, fetal heart rate (FHR) 120 bpm 15 minutes ago.

D.

G2 P1001, 28 weeks, Rh-negative (Rh-), 1 day post cerclage placement.

Answer and Explanation

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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View Related questions

Correct Answer is D

Explanation

Choice A rationale

Precipitous labor and birth are not directly associated with postpartum endometritis. The primary risk factors are related to infections during labor.

Choice B rationale

Postpartum endometritis is typically treated with a combination of antibiotics for 7-10 days, not a single dose of ampicillin or cephalosporin. A single dose would be insufficient for

treating the infection.

Choice C rationale

Postpartum endometritis is more common following cesarean birth due to increased risk of infection despite the use of sterile techniques during surgery.

Choice D rationale

Postpartum endometritis is associated with internal monitoring, amnioinfusion, prolonged labor, and prolonged rupture of membranes. These factors increase the risk of infection,

which can lead to endometritis.

Correct Answer is A

Explanation

Choice A rationale

Postpartum psychosis is a serious mental health condition that can result in delusions and hallucinations. These symptoms increase the risk of harm to the infant, so it's essential that

the mother is not left alone with the baby to ensure both their safety.

Choice B rationale

Symptoms of postpartum psychosis typically last longer than one week and require medical intervention, contrary to what is stated in this choice. Treatment usually involves

antipsychotics, mood stabilizers, and sometimes hospitalization.

Choice C rationale

Clinical response to medications can be significant in many cases, and early and aggressive treatment often leads to improvement. This statement is inaccurate and does not reflect

the current understanding of postpartum psychosis treatment.

Choice D rationale

While monitoring vital signs is essential, it is not as critical as ensuring the infant's safety given the mother’s severe mental condition. The focus should be on psychiatric

management and safety protocols rather than routine vitals alone.

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