A 37 weeks' gestation patient with a scheduled nonstress test (NST) has the following vital signs recorded over two days: 2/10 1535: BP 162/100, HR 78, SpO2 100%; 2/10 1600: BP 168/100, HR 76, SpO2 100%; 2/11 1200: BP 166/100, HR 84, SpO2 99%; 2/11 1818: BP 152/86, HR 78, SpO2 99%. The nurse anticipates needing to administer Magnesium Sulfate to prevent which of the following complications?

Preterm labor.

Gestational diabetes.

Seizures.

Fetal growth restriction.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Preterm labor is defined as labor that occurs between 20 and 37 weeks of gestation. The patient is already at 37 weeks' gestation, so preterm labor is not a complication to prevent.

Choice B rationale

Gestational diabetes is glucose intolerance that develops during pregnancy. While elevated blood pressure can sometimes be associated with gestational diabetes, magnesium sulfate is not a primary treatment or preventative measure for this condition. Management typically involves dietary changes, exercise, and sometimes insulin.

Choice C rationale

Magnesium sulfate is commonly administered in the setting of preeclampsia with severe features or eclampsia to prevent seizures. The patient's consistently elevated blood pressure readings (above 160/110 mmHg on multiple occasions) indicate severe hypertension, a key diagnostic criterion for preeclampsia with severe features, placing her at high risk for seizures (eclampsia). Magnesium sulfate acts as a central nervous system depressant, reducing neuronal excitability and thus the risk of seizures.

Choice D rationale

Fetal growth restriction (FGR) is a condition where the fetus does not grow at the expected rate in utero. While severe preeclampsia can contribute to FGR due to placental insufficiency, magnesium sulfate is not directly used to prevent fetal growth restriction. The primary focus of magnesium sulfate in this scenario is maternal seizure prophylaxis.

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Correct Answer is B

Explanation

Choice A rationale

Betamethasone does not directly increase the fetal heart rate. Factors influencing fetal heart rate include fetal oxygenation, maternal hydration, and medications affecting the maternal or fetal autonomic nervous system. Normal fetal heart rate ranges from 110 to 160 beats per minute.

Choice B rationale

Betamethasone is a corticosteroid administered to pregnant women at risk of preterm delivery to accelerate fetal lung maturity. It stimulates the production of surfactant, a lipoprotein that reduces surface tension in the alveoli, preventing collapse upon expiration and improving the neonate's ability to breathe independently.

Choice C rationale

Betamethasone does not halt cervical dilation. Cervical dilation is primarily influenced by uterine contractions and the presenting fetal part. Medications like tocolytics, such as terbutaline or magnesium sulfate, are used to inhibit uterine contractions in preterm labor.

Choice D rationale

Betamethasone is not used to stop preterm labor contractions. Its primary purpose is to enhance fetal lung maturation. Tocolytic medications are the class of drugs used to attempt to delay or stop preterm labor contractions, allowing time for corticosteroids to be administered.

A. Combination oral contraceptives. B. Depo-Provera. C. Barrier methods such as female condoms. D. Contraceptive implant.

Correct Answer is C

Explanation

Choice A rationale

Combination oral contraceptives are contraindicated for smokers over 35 due to an increased risk of cardiovascular events such as thromboembolism and myocardial infarction. While the client is younger, her smoking habit is still a significant risk factor, and oral contraceptives do not protect against sexually transmitted infections given her multiple partners.

Choice B rationale

Depo-Provera, an injectable progestin, can cause irregular bleeding and potential weight gain, which might not be ideal given the client's existing irregular menstrual cycles and menorrhagia. Furthermore, it does not offer protection against sexually transmitted infections.

Choice C rationale

Barrier methods such as female condoms, when used consistently and correctly, provide protection against both pregnancy and sexually transmitted infections, which is crucial given the client's multiple partners. While they require proper education and may have a higher failure rate than hormonal methods, they address the STI risk directly.

Choice D rationale

A contraceptive implant is a highly effective long-acting reversible contraceptive. However, it does not protect against sexually transmitted infections. Given the client's multiple partners, STI protection is a primary concern that the implant does not address. .

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Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who is at 30 weeks of gestation and is in preterm labor.The client has a new prescription for betamethasone and asks the nurse about the purpose of this medication.The nurse should provide which of the following explanations?

Correct Answer is B

Explanation

Correct Answer is C

Explanation

Which assessment findings might raise the nurse's suspicion of endometriosis in the client they are evaluating?

The nurse is reviewing fetal and maternal circulation with a group of nursing students.Which statement by a student demonstrates a need for further clarification?

A nurse is educating a pregnant client about the differences between Braxton Hicks contractions and true labor contractions.Which statement should the nurse include?

A nurse is caring for a client who is at 37 weeks of gestation and has placenta previa.The client asks the nurse why the provider does not do an internal examination.Which of the following explanations of the primary reason should the nurse provide?

Which interventions should the nurse include in the plan of care for a client with the nursing diagnosis of acute pain related to breast engorgement?

A male client reports to the nurse that he took sildenafil for erectile dysfunction but did not achieve an erection.Which of the following considerations should the nurse evaluate to determine possible reasons for the lack of response?