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 D
Explanation
Rationale:
A. Polyuria is not a common adverse effect of opioid analgesics administered via epidural block.
B. Bilateral crackles are not typically associated with opioid analgesics administered via epidural block.
C. Hyperglycemia (high blood sugar levels) is not a common adverse effect of opioid analgesics administered via epidural block.
D. Hypotension is a common adverse effect of opioid analgesics administered via epidural block. Opioids can cause peripheral vasodilation and decreased systemic vascular resistance, leading to a drop in blood pressure.
Correct Answer is D
Explanation
A. Subconjunctival hemorrhage is common in newborns due to birth trauma and usually resolves without intervention. It does not typically require reporting.
B. Rust-stained urine in the first few days of life is caused by uric acid crystals and is considered a normal finding during neonatal adaptation.
C. Transient circumoral cyanosis (bluish discoloration around the mouth) can occur immediately after birth due to immature peripheral circulation and generally resolves quickly with warming and oxygenation.
D. A single palmar crease, especially if present on one hand, can be associated with chromosomal abnormalities such as trisomy 21 (Down syndrome). This finding warrants further evaluation and should be reported to the provider for assessment and potential diagnostic follow-up.
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