A nurse in an obstetric clinic has received messages from four clients. Which of the following clients should the nurse call first?
A 33-year-old client who is pregnant and experiencing dysuria.
A 29-year-old client who is pregnant and experiencing nausea.
A 41-year-old client who is pregnant and experiencing no fetal movement.
A 35-year-old client who is pregnant and experiencing a cough.
The Correct Answer is C
Choice A rationale
Dysuria, while concerning, is typically less urgent compared to the complete absence of fetal movement, which can indicate fetal distress or demise.
Choice B rationale
Nausea is a common symptom during pregnancy and generally less urgent compared to the absence of fetal movement, which may indicate a serious issue.
Choice C rationale
No fetal movement is a critical concern as it may indicate fetal demise or severe distress requiring immediate assessment and intervention to ensure fetal well-being.
Choice D rationale
A cough in pregnancy can be bothersome but is generally not as urgent compared to the absence of fetal movement, which can indicate potential fetal demise.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Choice A rationale
Evaluating the fetal heart rate does not address maternal symptoms of supine hypotensive syndrome. Moving the client first corrects the underlying issue. Fetal evaluation can follow once maternal circulation improves, ensuring both are assessed.
Choice B rationale
Checking recent food and fluid intake does not immediately address the likely cause of supine hypotensive syndrome. Correcting maternal positioning is urgent to improve venous return and prevent adverse effects, then other assessments can follow.
Choice C rationale
Measuring blood pressure and pulse can confirm hypotension but does not address its cause. Immediate repositioning to lateral position alleviates the compression on the inferior vena cava, improving blood flow before measuring vitals.
Choice D rationale
Turning to a lateral position relieves the vena cava from compression by the gravid uterus, reducing symptoms of supine hypotensive syndrome. This action improves venous return, stabilizing maternal hemodynamics and alleviating dizziness and pallor.
Correct Answer is D
Explanation
Choice A rationale
Enlarged uterus is a probable sign of pregnancy, often caused by uterine growth. Probable signs are those observed by the examiner but not definite.
Choice B rationale
Positive fetal cardiac activity on ultrasound is a positive sign of pregnancy. Positive signs are definitive proof of pregnancy, observed via imaging or hearing fetal heart tones.
Choice C rationale
Auscultation of fetal heart tones is a positive sign of pregnancy, indicating fetal presence. Positive signs confirm pregnancy through direct observation or hearing the fetus.
Choice D rationale
Amenorrhea is a presumptive sign of pregnancy, commonly due to hormonal changes. Presumptive signs are subjective symptoms experienced by the woman, like nausea or breast tenderness.
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