A client with frank vaginal bleeding is admitted at 30 weeks' gestation. What problem would the nurse most likely suspect?

In the context of a client presenting with frank vaginal bleeding at 30 weeks' gestation, the most likely underlying issue indicated by this symptom is placenta previa. This condition is characterized by the placenta partially or completely covering the cervix, which can lead to significant bleeding as the uterus expands and the cervix begins to soften and thin preparing for labor.

At 30 weeks, a pregnant woman experiencing significant vaginal bleeding, especially if the bleed is bright red and the pregnancy is near the third trimester, strongly points towards placenta previa. This is particularly relevant because it typically occurs later in pregnancy and is more common as a potential cause of bleeding in the later stages of gestation compared to the other conditions listed.

While other conditions like placental abruption and uterine rupture can also cause significant bleeding, they are often accompanied by other more acute symptoms such as severe pain and fetal distress. Ectopic pregnancy, while it can result in bleeding, generally occurs earlier in pregnancy before 30 weeks. Thus, based on the timing and nature of the bleeding, the nurse would most appropriately suspect placenta previa as the underlying problem in this scenario.