A client who is anovulatory and has hyperprolactinemia is undergoing infertility treatment with metformin, menotropins, and human chorionic gonadotropin.
What side effect should the nurse instruct the client to report immediately?

Episodes of headache and irritability.

Persistent daytime fatigue.

Nausea and vomiting.

Rapid increase in abdominal girth.

Answer and Explanation

The Correct Answer is D

Choice A rationale

While episodes of headache and irritability can occur as side effects of metformin and menotropins, they are not typically severe enough to warrant immediate reporting.

Choice B rationale

Persistent daytime fatigue can be a side effect of these medications, but it is also a common symptom in pregnancy and is not typically a cause for immediate concern.

Choice C rationale

Nausea and vomiting can occur as side effects of these medications. However, they are common side effects and are not typically a cause for immediate concern unless they are severe or persistent.

Choice D rationale

A rapid increase in abdominal girth can be a sign of ovarian hyperstimulation syndrome, a rare but potentially serious side effect of fertility treatments. This condition can cause rapid weight gain, abdominal pain, and bloating, and should be reported immediately.

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Correct Answer is A

Explanation

Choice A rationale

A postpartum client experiencing severe pain and a sensation of pressure in her perineum, along with the formation of a perineal hematoma, is in a potentially serious situation. The nurse should first assess the client’s heart rate and blood pressure. This is because a perineal hematoma can lead to significant blood loss, which could cause changes in these vital signs.

Choice B rationale

While monitoring urinary output and IV fluid intake can be important in the overall assessment of a postpartum client, these are not the most immediate concerns when a perineal hematoma is forming.

Choice C rationale

Checking hemoglobin and hematocrit levels can provide information about the client’s blood volume and potential blood loss. However, this would likely be done after initial vital signs are assessed and stabilized.

Choice D rationale

Assessing abdominal contour and bowel sounds would not be the most immediate concern in this situation. These assessments would be more relevant if there were concerns about postpartum complications related to the client’s gastrointestinal system.

A. Reassure the client that the AFP results could be a false reading. B. Discuss options for intrauterine surgical correction of congenital defects. C. Inform her that a repeat AFP test should be conducted. D. Explain that a sonogram should be scheduled for definitive results.

Correct Answer is D

Explanation

Choice A rationale

While it’s true that AFP results can sometimes be false readings, it’s not the most appropriate advice for the nurse to give in this situation. Simply reassuring the client without suggesting further investigation could potentially overlook a serious condition.

Choice B rationale

Discussing options for intrauterine surgical correction of congenital defects at this stage is premature. The elevated AFP level alone does not confirm the presence of congenital defects, and suggesting surgical intervention may cause unnecessary anxiety.

Choice C rationale

Informing the client that a repeat AFP test should be conducted is a reasonable suggestion. However, it’s not the most appropriate next step in this case. A repeat test would provide more information, but it wouldn’t give definitive results about the cause of the elevated AFP level.

Choice D rationale

Explaining that a sonogram should be scheduled for definitive results is the most appropriate advice. An ultrasound can provide a more detailed view of the fetus and help identify any potential issues that might have led to the elevated AFP level. This would be the most informative next step and would guide further actions based on the findings.

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A client who is anovulatory and has hyperprolactinemia is undergoing infertility treatment with metformin, menotropins, and human chorionic gonadotropin.What side effect should the nurse instruct the client to report immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a postpartum client who is experiencing severe pain and a sensation of pressure in her perineum.Her uterus is firm, and she has a moderate flow of lochia.Upon inspection, the nurse discovers that a perineal hematoma is starting to form. What should the nurse assess first?

Correct Answer is A

Explanation

An 18-week pregnant client was informed this morning that she has an elevated alpha-fetoprotein (AFP) level. After the healthcare provider leaves the room, the client asks about the next steps.What should the nurse advise?

Correct Answer is D

Explanation

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A client who is anovulatory and has hyperprolactinemia is undergoing infertility treatment with metformin, menotropins, and human chorionic gonadotropin.
What side effect should the nurse instruct the client to report immediately?