Difficulty: Medium
Average Score: 71%
Simulated
Passage / Scenario
Nurse's Notes (0700hrs): Fetal heart tones (FHT): 145/min, Uterine contractions every 2 minutes, lasting 80 seconds, moderate intensity. Vital Signs (0700hrs): Client reports low back pain and frequent urination since last night. Urination is painful and only a small amount is passed each time. Abdomen is soft and nontender. Vaginal examination: 2 cm dilated, 100% effaced, 0 station. Bloody mucus noted on sterile glove. Medical History: G2P1, 34 weeks pregnant, No known allergies, Previous pregnancy was full-term with no complications. Diagnostic Results (0700hrs): Place client on electronic fetal monitor, Administer IV fluids, Monitor vital signs every hour, Notify provider of any changes in client status. A 28-year-old female client is admitted to the labor and delivery unit at 0700hrs. She is 34 weeks pregnant and reports having low back pain and frequent urination since last night. She mentions that urination is painful and she can only pass a small amount each time.Given the client's symptoms and the progression of her condition, the nurse suspects that the client may be experiencing complications related to preterm labor and a possible urinary tract infection (UTI). For each characteristic in the table, select whether it is more likely to be associated with preterm labor, a urinary tract infection (UTI), or both. Each column must have at least one response option selected. Candidates can select as many options as apply for each column.
Correct answer
A: UTI, B: Both, C: UTI, D: Preterm Labor, E: Preterm Labor, F: Both
Rationale
Frequent urination is more likely associated with a UTI due to irritation of the urinary tract. Low back pain can be associated with both preterm labor (due to uterine contractions) and UTI (due to kidney involvement). A temperature of 38.3°C (101°F) is more likely associated with a UTI, as fever is a common symptom of infection. A strong urge to push is indicative of preterm labor as it suggests advanced labor progression. Contractions every 1.5 minutes are a clear sign of preterm labor. A pain level of 8 can be associated with both conditions due to severe contractions in labor or significant infection-related discomfort in UTI.