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A nurse in the labor and delivery unit is caring for a 31-year-old pregnant female client who is at 31 weeks of gestation.

Exhibits

The nurse is contacting the primary health care provider regarding the client's status. Which of the following interventions should the nurse anticipate? Select the 3 interventions the nurse should anticipate.

Give betamethasone 12 mg IM now and repeat in 24 hr.

Begin loading dose of magnesium sulfate 9 g over 30 min.

Position the client in a lateral position.

Administer terbutaline 0.25 mg subcutaneous stat.

Prepare for an emergency cesarean birth.

Answer and Explanation

Correct Answer : A,B,C

Choice A: Give betamethasone 12 mg IM now and repeat in 24 hr.

Rationale: Betamethasone is administered to accelerate fetal lung maturity in cases of preterm labor. Given the client's gestational age of 31 weeks, this intervention is appropriate to help reduce the risk of respiratory distress syndrome in the newborn.

Choice B: Begin loading dose of magnesium sulfate 9 g over 30 min.

Rationale: Magnesium sulfate is used for neuroprotection of the fetus in preterm labor to reduce the risk of cerebral palsy. The loading dose is typically given to achieve therapeutic levels quickly.

Choice C: Position the client in a lateral position.

Rationale: Positioning the client in a lateral position helps improve uteroplacental blood flow and can reduce the intensity of contractions, which is beneficial in managing preterm labor.

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Correct Answer is ["A","B","C","E"]

Explanation

Choice A rationale:

Rapid weight gain during pregnancy, especially when accompanied by other symptoms, can be a sign of preeclampsia. This condition is characterized by high blood pressure and often occurs after 20 weeks of gestation. Reporting rapid weight gain is important for early detection and management.

Choice B rationale:

Visual disturbances, such as blurred vision, can be a warning sign of preeclampsia. It indicates potential neurological involvement and requires immediate evaluation to prevent complications for both the mother and the fetus.

Choice C rationale:

Elevated blood pressure readings are a critical sign of preeclampsia, a condition that can lead to serious health complications for both the mother and the baby if left untreated. Reporting elevated blood pressure is essential for early intervention and management.

Choice D rationale:

While the respiratory rate is slightly elevated, it is not as critical an indicator of preeclampsia as the other findings. In this case, the focus should be on more concerning symptoms, such as blood pressure and visual disturbances.

Choice E rationale:

Hyperactive deep tendon reflexes (3+) are a clinical sign of preeclampsia. The absence of clonus is a reassuring sign, but the presence of hyperactive reflexes warrants further evaluation and monitoring.

Choice F rationale:

The fetal heart rate (FHT) of 148/min is within the normal range (110-160/min) and does not indicate an immediate concern that needs to be reported. The nurse should focus on the maternal symptoms that suggest preeclampsia.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Explanation

Based on the provided information:

Boggy fundus: This indicates uterine atony, which is a primary cause of postpartum hemorrhage. Addressing this immediately is crucial to prevent excessive bleeding.
Heavy lochia with small clots: This further supports the concern for postpartum hemorrhage, necessitating prompt attention to assess and manage the bleeding.

Therefore, the nurse should first address the client's Fundus (Option A) followed by the client's Lochia (Option C).

So, the completed sentence would be:

"The nurse should first address the client's Fundus followed by the client's Lochia."

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Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is caring for a 32-year-old female client who is pregnant. Exhibits Which of the following assessment findings should the nurse report to the provider? (Select all that apply.)

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is caring for a 28-year-old female client in the fourth stage of labor after a vaginal delivery in the labor and delivery unit. Exhibits Complete the following sentence using the list of options: The nurse should first address the client's dropdown followed by the client's dropdown.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Explanation

A client suspects she is pregnant.The nurse is discussing the probable signs of pregnancy with the client.Which of the following findings should the nurse include?

A nurse is caring for a client during the second trimester of pregnancy.After reviewing the client's blood work, the nurse notes the client is rubella non-immune.When should the client be offered the rubella immunization?

A nurse is assessing a client who is 4 hours postpartum following a vaginal delivery.Which of the following findings should the nurse identify as the priority?

A nurse is caring for a 28-year-old female client in the fourth stage of labor after a vaginal delivery in the labor and delivery unit. Exhibits Complete the following sentence using the list of options: The client is at highest risk for developing dropdown due to dropdown.

The nurse working in a clinic often screens her patients for postpartum depression (PPD). Identify the differences between postpartum depression and postpartum blues.

A nurse in a prenatal clinic is caring for a client who is pregnant and asks the nurse for her estimated date of birth (EDB). The client's last menstrual period began on October 17. What is the client's EDB? (State the date in MMDD. For example, October 17 is 1017)

A nurse is caring for a newborn who is 4 hours old in the newborn unit. Exhibits Complete the following sentence by using the list of options: The newborn most likely has dropdown as evidenced by dropdown.