The nurse is performing a physical assessment of a pregnant woman ...

[pane00]

The nurse is performing a physical assessment of a pregnant woman at 18 weeks' gestation and documents the following: vaginal bleeding, a uterus that is larger than expected for the weeks of pregnancy, anemia, excessive nausea and vomiting, and signs
 
  of pregnancy-induced hypertension. What complication might the nurse suspect based on these symptoms? A) Ectopic pregnancy
  B) Hydatidiform mole
  C) Hyperemesis gravidarum
  D) Preeclampsia

Question 2

The licensed nurse is getting a report from an unlicensed assistive person in relation to the morning vital signs. Which statement would indicate that the rectal temperature needs to be taken via a different route?
 
  A) The client was on oxygen when I took the reading.
  B) I was unable to read the temperature because there was a small amount of stool on the thermometer.
  C) Because the client was confused, I took the temperature rectally.
  D) The client has had diarrhea three times this morning.

[johnharpe]

Answer to Question 1

B
Feedback:
The signs and symptoms of hydatidiform mole include vaginal bleeding, a uterus that is larger than expected for the weeks of pregnancy, anemia, excessive nausea and vomiting, and signs of pregnancy-induced hypertension occurring before 24 weeks of pregnancy. The word ectopic means outside; therefore, an ectopic pregnancy is one that implants outside the uterus. Hyperemesis gravidarum, or pernicious vomiting, is more severe than normal morning sickness. The woman who previously was experiencing normal progression of pregnancy, but who develops PIH with edema, proteinuria, or both (usually after the 20th week of gestation) has preeclampsia.

Answer to Question 2

D
Feedback:
Rectal temperature measurement is contraindicated in conditions such as diarrhea and rectal disease, and following rectal surgery. Rectal temperature can be taken when caring for unconscious or confused clients, infants and young children, and after mouth surgery or for the client receiving oxygen, unless specifically contraindicated or if tympanic thermometers are available. When taking the rectal temperature, a small amount of stool will not affect the temperature reading.

[pane00]

Thank you

[johnharpe]

Happy to help you