Wednesday, January 15, 2014

NCLEX Question for Bleeding during Pregnancy

Mrs. F., pregnant for the first time, calls the clinic to say she is bleeding. To obtain important information, the nurse should next ask,
 
a.  “When did you last feel the baby move.”
b. “How long have you been pregnant.”?
c.  “When was your pregnancy test done?”
d.  “Are you having any uterine cramping?”

Correct Answer: b. When a pregnant woman is bleeding vaginally, the nurse should first ask her how many weeks or months pregnant she is; management of bleeding differs in an early pregnancy contrasted with bleeding in late pregnancy. Additional information would include if tissue amniotic fluid was discharged and what other symptoms, such as cramps or pain, are present.
 
Feeling fetal movement is a good indicator of fetal well-being in late pregnancy.  If this client were in the third trimester, this would be additional information obtained.
 
The actual timing of a pregnancy test does not relate to the length of pregnancy; testing can be done at any time.
 
Careful assessment is required to determine whether the cause of the bleeding is a threatened abortion; this would include other symptoms, such as cramps or abdominal pain, that maybe present.  The nurse must first determine the length of gestation.

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