A client at 9-weeks gestation informs the nurse that she has reduced her alcohol intake but still consumes at least one alcoholic drink every evening before bedtime.
What action should the nurse take?

Praise the client for her actions and offer to discuss ways to decrease consumption even more.

Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit.

Notify child protective services of the client’s illicit drug use and probable child endangerment.

Refer the client to an outpatient alcohol abuse program for disulfiram therapy.

Answer and Explanation

The Correct Answer is A

The correct answer is A. Praise the client for her actions and offer to discuss ways to decrease consumption even more.

Why? During pregnancy, any amount of alcohol poses a risk to the developing fetus, but abruptly shaming or forcing action may not be effective. The best approach is motivational interviewing, which involves acknowledging the client's reduction while encouraging further progress. A supportive conversation can help guide the client toward complete cessation of alcohol use.

Here’s why the other options are incorrect:

B. Insist that the client stop all alcohol use and draw a blood alcohol level at each prenatal visit – While alcohol cessation is the goal, forcing the client without a supportive approach can lead to resistance. Routine blood alcohol testing is not standard unless substance dependence is suspected.
C. Notify child protective services of the client’s illicit drug use and probable child endangerment – Alcohol is not classified as an illicit drug, and reporting at this stage would be premature unless clear evidence of abuse or harm to the fetus exists.
D. Refer the client to an outpatient alcohol abuse program for disulfiram therapy – Disulfiram (Antabuse) is not recommended in pregnancy, as it may cause adverse effects. Instead, behavioral counseling and support groups are preferred interventions.

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Correct Answer is D

Explanation

Choice A rationale

While multiple gestation can cause an increase in maternal serum alpha-fetoprotein (MS-AFP) levels, it is not the most likely cause of an elevated MS-AFP level at 17 weeks.

Choice B rationale

Fetal hypoxia, or lack of oxygen to the fetus, is not typically associated with an increase in MSAFP levels.

Choice C rationale

Down syndrome is typically associated with lower, not higher, levels of MS-AFP891011.

Choice D rationale

An elevated level of MS-AFP at 17 weeks is most commonly associated with a neural tube defect. Neural tube defects are birth defects of the brain, spine, or spinal cord that occur during the first month of pregnancy.

A. Acetaminophen B. Morphine C. Aspirin D. Albuterol

Correct Answer is ["A","B","C"]

Explanation

Choice A rationale
Acetaminophen is a common medication that can be administered for pain relief and fever reduction. It is often used in a variety of clinical settings, including after the placement of an IV line.
Choice B rationale
Morphine is a strong opioid medication used to treat severe pain. It may be ordered after the placement of an IV line, especially if the patient is experiencing significant discomfort.
Choice C rationale
Aspirin is a medication that can be used for pain relief, fever reduction, and as an antiinflammatory. It may be ordered in a variety of clinical scenarios, including after the placement of an IV line.
Choice D rationale
Albuterol is a bronchodilator used to treat or prevent bronchospasm in people with reversible obstructive airway disease. It is not typically administered following the placement of a 5% dextrose intravenous line unless the patient has a pre-existing respiratory condition.
Choice E rationale
Racemic epinephrine is used to treat croup and asthma attacks. It is not typically administered following the placement of a 5% dextrose intravenous line unless the patient has a pre-existing respiratory condition.

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A client at 9-weeks gestation informs the nurse that she has reduced her alcohol intake but still consumes at least one alcoholic drink every evening before bedtime. What action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client’s maternal serum alpha-fetoprotein level is elevated at 17 weeks. What condition should the nurse identify as the likely cause of this increase?

Correct Answer is D

Explanation

Choice A rationale

Choice B rationale

Choice D rationale

The nurse is reviewing the patient’s condition and vital signs following the placement of a 5% dextrose intravenous line. Which medications should the nurse anticipate the healthcare provider will order? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

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A client at 9-weeks gestation informs the nurse that she has reduced her alcohol intake but still consumes at least one alcoholic drink every evening before bedtime.
What action should the nurse take?