A nurse in an antepartum clinic is caring for a client who is pregnant. Select the assessment findings the nurse should report to the provider.
Gravida 4 Para 3 33 weeks of gestation.
Allergies: Sulfa.
Height 165 cm (66 in) Weight 82 kg (180 lb) BMI 30.6.
32 kg(7 lb) weight gain over the last 2 weeks.
The Correct Answer is D
Choice A rationale
Gravida 4 Para 3 at 33 weeks of gestation is not an alarming finding. It simply indicates that the woman is pregnant for the fourth time and has had three previous deliveries. This is a normal part of the woman’s obstetric history and does not need to be reported to the provider.
Choice B rationale
Allergies, such as a sulfa allergy, are important to note in the patient’s medical history. However, unless the patient is being prescribed a medication that she is allergic to, this information does not need to be urgently reported to the provider.
Choice C rationale
A height of 165 cm (66 in), weight of 82 kg (180 lb), and BMI of 30.6 are all within normal ranges for a pregnant woman. These measurements are part of routine prenatal care and do not need to be urgently reported to the provider.
Choice D rationale
A weight gain of 32 kg (7 lb) over the last 2 weeks is concerning. Rapid weight gain can be a sign of preeclampsia, a serious pregnancy complication characterized by high blood pressure. This should be reported to the provider immediately.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Methylergonovine is a medication used to prevent postpartum hemorrhage. It works by causing the uterus to contract, which helps to control bleeding and expel any remaining placental fragments.
Choice B rationale
While infection control is important in the postpartum period, methylergonovine is not specifically used to prevent postpartum infection.
Choice C rationale
Methylergonovine does not prevent hypertension. In fact, it can cause hypertension as a side effect.
Choice D rationale
Methylergonovine is not used to prevent thromboembolic events. Its primary use is to prevent and control postpartum hemorrhage.
Correct Answer is D
Explanation
The correct answer is choiced. Slightly above the umbilicus.
Choice A rationale:
At 22 weeks of gestation, the fundus is not typically 5 cm above the umbilicus. This measurement would be more consistent with a later stage of pregnancy, around 28 weeks.
Choice B rationale:
The fundus being slightly below the umbilicus is more consistent with an earlier stage of pregnancy, around 20 weeks. At 22 weeks, the fundus should be higher.
Choice C rationale:
The fundus being 3 cm below the umbilicus is also indicative of an earlier stage of pregnancy, not 22 weeks. This would be expected around 18-20 weeks.
Choice D rationale:
At 22 weeks of gestation, the fundus is typically located slightly above the umbilicus.This corresponds with the general rule that the fundal height in centimeters should match the number of weeks of pregnancy, give or take 2 cm.
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