A client at 6-weeks gestation presents to the office with a report of vaginal bleeding for the last 12 hours without cramping. Which action should the nurse take?

Check serum human chorionic gonadotropin.

Verify the date of the last menstrual cycle.

Inquire about the last occurrence of intercourse.

Repeat a urine pregnancy test.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Checking serum human chorionic gonadotropin (hCG) levels is the appropriate action. hCG levels can help determine the viability of the pregnancy. Decreasing hCG levels may indicate a non-viable pregnancy, while increasing levels suggest a viable pregnancy.

Choice B rationale

Verifying the date of the last menstrual cycle is important but not the priority action in this scenario. While it can provide information on gestational age, it does not directly address the concern of vaginal bleeding.

Choice C rationale

Inquiring about the last occurrence of intercourse is not directly related to assessing the cause of vaginal bleeding. It may provide additional history but does not address the immediate concern.

Choice D rationale

Repeating a urine pregnancy test is not necessary in this context. The client is already known to be pregnant, and a urine test will not provide additional information regarding the cause of the bleeding.

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Correct Answer is D

Explanation

Choice A rationale

While encouraging quiet activities like watching television can provide some distraction and temporary relief, it does not address the underlying need for consistent pain management in juvenile idiopathic arthritis. Distraction techniques should be used as an adjunct to proper pain medication rather than a replacement for it. This condition can cause chronic pain, which may negatively impact the child's quality of life if not managed appropriately.

Choice B rationale

Resting when experiencing pain is a common recommendation, but for juvenile idiopathic arthritis, it's essential to balance rest with physical activity to maintain joint mobility and muscle strength. Only encouraging rest can lead to muscle atrophy and joint stiffness, which can exacerbate the condition in the long term. Regular pain management can help the child stay more active.

Choice C rationale

Hot baths can help to some extent by relaxing muscles and reducing stiffness, but they are not sufficient as a sole method for managing pain in juvenile idiopathic arthritis. The condition often requires consistent medication to control inflammation and pain. Non-pharmacological methods like hot baths should be used in conjunction with prescribed medication rather than as an alternative.

Choice D rationale

Giving pain medication around the clock helps control the pain effectively by maintaining a steady level of medication in the body, preventing breakthrough pain. Consistent pain management allows the child to participate in daily activities and physical therapy, which is essential for maintaining joint function and overall quality of life.

A. Ventricular septal defect (VSD) has audible murmurs. B. Patent ductus arteriosus is fatigued after feeding C. Coarctation of aorta has an elevated blood pressure in the upper extremity. D. Tetralogy of Fallot (TOF) with hypercyanotic (Tet) spells is crying.

Correct Answer is D

Explanation

Choice A rationale

An audible murmur in a neonate with a ventricular septal defect (VSD) is a common finding and does not typically require immediate intervention. While it indicates a cardiac anomaly, it is not an emergency.

Choice B rationale

Fatigue after feedings in a neonate with patent ductus arteriosus (PDA) is a sign of increased cardiac workload, but it does not indicate an immediate life-threatening situation. It requires monitoring but not urgent intervention.

Choice C rationale

Elevated blood pressure in the upper extremity in a neonate with coarctation of the aorta is a concerning finding that indicates a narrowing of the aorta. While it requires prompt evaluation and management, it may not be as immediately critical as a hypercyanotic spell.

Choice D rationale

A neonate with Tetralogy of Fallot (TOF) experiencing hypercyanotic (Tet) spells and crying indicates a severe decrease in oxygenation and is an emergency. This condition requires immediate intervention to improve oxygenation and prevent complications such as brain damage or death. .

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A client at 6-weeks gestation presents to the office with a report of vaginal bleeding for the last 12 hours without cramping. Which action should the nurse take?

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Correct Answer is D

Explanation

The nurse who is working on a pediatric unit receives a shift report for four neonates with congenital heart defects. The neonate with which report requires the most immediate intervention?

Correct Answer is D

Explanation

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