Which of the following findings would the nurse interpret as ...

[LaDunn]

Which of the following findings would the nurse interpret as suggesting a diagnosis of gestational trophoblastic disease?
 
  A) Elevated hCG levels, enlarged abdomen, quickening
  B) Vaginal bleeding, absence of FHR, decreased hPL levels
  C) Visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen
  D) Gestational hypertension, hyperemesis gravidarum, absence of FHR

Question 2

The nurse is evaluating care provided to a patient giving birth to her first child. Which outcome regarding labor indicates that care has been effective?
 
  A) Client achieved 4 cm of dilation after 7 hours of labor.
  B) Client achieved full dilatation after 8 hours of labor.
  C) Client delivered infant within 2 hours after full dilatation with epidural.
  D) Client delivered infant within 30 minutes after full dilatation without epidural.

[Harbringer]

Answer to Question 1

D
Feedback:
Gestational trophoblastic disease may be manifested by early development of preeclampsia (gestational hypertension), severe morning sickness due to high hCG levels, and absence of fetal heart rate or activity. There is no fetus, so quickening and evidence of a fetal skeleton would not be seen. The abdominal enlargement is greater than expected for pregnancy dates, but hCG, not hPL, levels are increased.

Answer to Question 2

A
Feedback:
For a nulliparous patient, achievement of 4 cm of dilation after 7 hours of labor is expected and indicates that care has been effective. Full dilatation after 8 hours is appropriate for a multiparous patient. Delivering the infant within 2 hours after full dilatation with an epidural is appropriate for a multiparous patient. Delivering the infant within 30 minutes after full dilatation without an epidural is appropriate for a multiparous patient without an epidural.

[LaDunn]

Excellent

[amcvicar]

TYSM