A nurse at an antepartum clinic is caring for four clients. Which of the following clients should the nurse assess first?
A client who is at 36 weeks of gestation and reports back pain following intercourse
A client who is at 8 weeks of gestation and reports severe vomiting
A client who is at 10 weeks of gestation and reports frequent urination
A client who is at 24 weeks of gestation and reports periodic tingling of the fingers
The Correct Answer is B
Rationale:
A. Back pain following intercourse at 36 weeks of gestation may be common and is not typically indicative of an urgent issue.
B. Severe vomiting in early pregnancy could indicate hyperemesis gravidarum, which may require immediate assessment and intervention to prevent dehydration and electrolyte imbalances.
C. Frequent urination at 10 weeks of gestation is common due to hormonal changes and increased pressure on the bladder from the growing uterus, but it does not typically require immediate assessment unless accompanied by other concerning symptoms.
D. Periodic tingling of the fingers at 24 weeks of gestation could be due to carpal tunnel syndrome, which is common in pregnancy but does not usually require urgent assessment unless severe or accompanied by other symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Dinoprostone vaginal inserts (e.g., Cervidil) should be kept frozen until use and do not require thawing or warming before insertion. Allowing the medication to reach room temperature is unnecessary and could compromise its stability and effectiveness.
B. Verifying that informed consent is obtained is essential before administering dinoprostone. The client must understand the purpose, potential risks, and alternatives to labor induction, ensuring ethical and legal standards are met.
C. Semi-Fowler’s positioning may be used during labor but is not a priority immediately after insertion. Positioning is secondary to consent and safety considerations.
D. Instructing the client to avoid urinary elimination is not required for dinoprostone administration and does not impact the safety or effectiveness of labor induction.
Correct Answer is C,A,B,D,E
Explanation
C. Instruct the client to empty their bladder.
A. Position the client supine with knees flexed and place a small rolled towel under one of their hips.
B. Palpate the fetal part positioned in the fundus.
D. Palpate the fetal parts along both sides of the uterus.
E. Palpate the fetal part positioned above the symphysis pubis.
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