A client at 32 weeks gestation is being seen for routine prenatal care. Which of the following assessments will the nurse perform during the exam? Select all that apply
Blood pressure
Blood glucose
Fetal heart rate
Pap Smear
Pelvic ultrasound
Fundal height
Correct Answer : A,C,F
A. Blood pressure: Monitoring blood pressure regularly during pregnancy is crucial to detect any signs of hypertension or preeclampsia, which can develop later in pregnancy, particularly after 20 weeks.
B. Blood glucose: A glucose challenge test is performed between 24 and 28 weeks of gestation to screen for gestational diabetes. While a client might have an indication for a repeat or individual blood glucose check at 32 weeks, it is not a routine assessment at this gestational age
C. Fetal heart rate: Checking the fetal heart rate helps assess the baby's well-being and ensures there are no signs of distress. It is a standard part of every prenatal visit to monitor fetal health.
D. Pap Smear: A Pap smear is typically performed early in pregnancy, not at 32 weeks, unless there is a specific concern. It is usually done during the first prenatal visit or in the early second trimester.
E. Pelvic ultrasound: While ultrasound can be used for specific concerns, such as assessing fetal growth or position, it is not routinely performed at 32 weeks unless there is a medical reason for it, like assessing for fetal anomalies. A routine comprehensive ultrasound (anatomy scan) is usually performed between 18 and 22 weeks gestation.
F. Fundal height: Measuring the fundal height is essential to track fetal growth. At 32 weeks, this measurement helps determine whether the baby is growing appropriately in relation to the gestational age.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["1418"]
Explanation
Convert the child's weight from pounds (lb) to kilograms (kg).
Weight in kg = 52 lb / 2.2 lb/kg
= 23.636 kg.
Maximum safe dose per kilogram per administration = 15 mg/kg.
Calculate the maximum single dose in milligrams (mg).
Maximum single dose (mg) = Maximum dose per administration (mg/kg) × Weight (kg)
= 15 mg/kg × 23.636 kg
= 354.54 mg.
Determine the number of times the medication can be administered per day.
Given every 6 hours, Number of doses per day = 24 hours / 6 hours/dose
= 4 doses/day.
Calculate the maximum safe daily dose of the medication.
Maximum safe daily dose (mg) = Maximum single dose (mg) × Number of doses per day
= 354.54 mg × 4 doses
= 1418.16 mg.
Round the answer to the nearest whole number.
= 1418 mg.
Correct Answer is A
Explanation
A. FLACC: The FLACC scale (Face, Legs, Activity, Cry, Consolability) is specifically designed for assessing pain in infants and young children who are unable to communicate their pain. It is based on observing physical and behavioral indicators of pain.
B. Symptom log: A symptom log is a tool typically used by older children or adults to track symptoms over time. It is not suitable for assessing pain in infants, as they cannot self-report or track symptoms.
C. Oucher: The Oucher scale is designed for children aged 3-12 years who are able to understand and use the scale, which involves comparing pain intensity to pictures of facial expressions. It is not suitable for infants.
D. FACES: The FACES pain scale is typically used for older children who can point to or choose a facial expression to indicate their pain level. Infants are too young to use this scale effectively.
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