A client who is 32 weeks gestation arrives at the clinic reporting nausea and vomiting for the past 24 hours. The nurse reviews the record and observes there has been a rapid weight gain over six weeks. Which action should the nurse implement next?

Inspect for pedal edema.

Obtain a blood pressure.

Listen to fetal heart rate.

Ask for a 24-hour diet recall.

Answer and Explanation

The Correct Answer is B

A. Inspect for pedal edema. While pedal edema can be a sign of preeclampsia, obtaining blood pressure is a more immediate and crucial assessment.

B. Obtain a blood pressure. This is the correct next step, as rapid weight gain and nausea/vomiting can be symptoms of preeclampsia, which is often accompanied by hypertension.

C. Listen to foetal heart rate. This is important but secondary to assessing the mother's condition, especially when preeclampsia is suspected.

D. Ask for a 24-hour diet recall. This might be relevant for nutritional assessment but is not the priority when preeclampsia is suspected.

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Correct Answer is D

Explanation

A. Blood urea nitrogen (BUN): Elevated BUN can indicate kidney problems, but it's not the primary test for melena (black, tarry stools) which suggests upper gastrointestinal bleeding.

B. Glucose: Glucose levels might be abnormal in some conditions that can cause bleeding, but it's not the most specific test for melena.

C. White blood cell count (WBC): WBC might be elevated in response to infection or inflammation, but it's not the most specific test for melena.

D. Hematocrit: Hematocrit measures the percentage of red blood cells in the blood. Melena can indicate significant blood loss, and monitoring hematocrit helps assess the severity of bleeding and potential need for blood transfusions.

A. Takes a first step alone. B. Sits alone unsupported. C. Can feed self finger food. D. Pulls self to sitting position.

Correct Answer is D

Explanation

A. Takes a first step alone: This is typically achieved closer to 12 months.

B. Sits alone unsupported: Some 8-month-olds might achieve this, but pulling to sit is a more consistent milestone at this age.

C. Can feed self finger food: While some babies might explore finger foods at 8 months, independent feeding is usually a skill developed later.

D. Pulls self to sitting position: This demonstrates developing upper body strength and coordination, commonly seen around 8-9 months.

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A client who is 32 weeks gestation arrives at the clinic reporting nausea and vomiting for the past 24 hours. The nurse reviews the record and observes there has been a rapid weight gain over six weeks. Which action should the nurse implement next?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

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