Practice Quiz

CPM Certified Professional Midwife

Category - Prenatal

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A client at 38 weeks’ gestation is admitted to the unit after complaining of painful, moderate vaginal bleeding of dark, clotted blood. A series of diagnostic and laboratory tests verify that the client is experiencing abruptio placenta. The fetal heart rate is 180 beats per minute. Which of the following actions is the priority action of the midwife?
  1. Order bed rest for the remainder of the pregnancy.
  2. Prepare the client for cesarean delivery.
  3. Prepare the client for platelet transfusion.
  4. Instruct the client to avoid sexual intercourse throughout the pregnancy.
Explanation
Answer: B - The priority action of the midwife is to prepare the client for cesarean delivery, order the necessary diagnostic tests and crossmatch about 4 units of packed red blood cells. The main goal when caring for a client with abruptio placenta at term is to deliver the infant, either through vaginal or cesarean birth. Options A and D are more appropriate for clients who are not at term.
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