A nurse is assessing a client who is at 37 weeks of gestation and reports sudden, severe abdominal pain with moderate vaginal bleeding and persistent uterine contractions. The client's blood pressure is 88/50 mm Hg and their abdomen is rigid. The nurse should identify these findings as indicating which of the following complications?

Placental abruption

Uterine rupture

Placenta previa

Amniotic fluid embolus

Answer and Explanation

The Correct Answer is A

A. Placental abruption: Placental abruption is characterized by the premature separation of the placenta from the uterine wall before delivery of the fetus. Sudden, severe abdominal pain, moderate to severe vaginal bleeding, persistent uterine contractions, and uterine rigidity are classic signs and symptoms of placental abruption. Hypotension may occur due to hemorrhage, leading to decreased perfusion to vital organs.
B. Uterine rupture: Uterine rupture involves a tear in the uterine wall, which can lead to severe abdominal pain, vaginal bleeding, and signs of shock. However, uterine rupture typically occurs during labor or delivery, particularly in women with a history of uterine surgery or trauma.
C. Placenta previa: Placenta previa is characterized by the implantation of the placenta over or near the internal cervical os. It can cause painless vaginal bleeding in the third trimester, particularly after 20 weeks of gestation. However, it is not typically associated with severe abdominal pain or uterine rigidity.
D. Amniotic fluid embolus: An amniotic fluid embolus occurs when amniotic fluid, fetal cells, hair, or other debris enter the maternal circulation, leading to a potentially life-threatening reaction. Symptoms may include sudden dyspnea, hypotension, cardiovascular collapse, and disseminated intravascular coagulation (DIC). While it can cause severe complications, the symptoms described in the scenario are more consistent with placental abruption.

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Correct Answer is C

Explanation

A. Disulfiram: Disulfiram is used in the treatment of alcohol dependence by creating unpleasant effects (such as nausea and vomiting) when alcohol is consumed. It is not indicated for the management of seizures associated with alcohol withdrawal.
B. Acamprosate: Acamprosate is used in the treatment of alcohol dependence to help maintain abstinence by reducing cravings for alcohol. It is not indicated for the management of seizures associated with alcohol withdrawal.
C. Diazepam: Diazepam is a benzodiazepine medication commonly used to treat seizures associated with alcohol withdrawal due to its anticonvulsant properties. It helps to prevent and control seizures by enhancing the effects of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain.
D. Naltrexone: Naltrexone is used in the treatment of alcohol dependence by reducing the pleasurable effects of alcohol and decreasing the desire to drink. It is not indicated for the management of seizures associated with alcohol withdrawal.

A. Measure the legs with a tape measure to determine stocking size. B. Remove the stockings every 24 hr. C. Massage the legs before applying the stockings. D. Fold the stockings at the top if they are too long.

Correct Answer is A

Explanation

A. Measure the legs with a tape measure to determine stocking size: Antiembolic stockings should fit properly to provide therapeutic compression without causing discomfort or impairing circulation. Measuring the legs accurately with a tape measure ensures the stockings fit appropriately and exert the correct amount of pressure to prevent deep vein thrombosis (DVT) and promote venous return.
B. Remove the stockings every 24 hr: Antiembolic stockings are typically worn continuously, especially during periods of immobility, to maintain consistent compression and prevent blood clots. Removing the stockings every 24 hours would interrupt the therapeutic effect and increase the client's risk of developing DVT.
C. Massage the legs before applying the stockings: Massaging the legs before applying antiembolic stockings is contraindicated, as it can dislodge blood clots and increase the risk of embolism. Additionally, massaging may cause trauma to the skin and exacerbate any existing circulatory issues.
D. Fold the stockings at the top if they are too long: Folding the stockings at the top if they are too long can create pressure points and compromise circulation, leading to discomfort and potentially exacerbating vascular issues. It is essential to ensure the stockings fit properly by selecting the appropriate size rather than folding them.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is experiencing seizures due to alcohol withdrawal. Which of the following medications should the nurse plan to administer?

Correct Answer is C

Explanation

A nurse is caring for a client who has deep-vein thrombosis and a new prescription for antiembolic stockings. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is caring for a client who is taking antihypertensive medication and is moving from a supine to a sitting position. Which of the following findings should indicate to the nurse that the client is experiencing orthostatic hypotension?

A nurse is caring for a client who is postpartum and expresses concern about how her preschool-age son will react to having a baby sister. Which of the following strategies should the nurse suggest?

A charge nurse observes smoke coming from a trash receptacle in the unit's waiting room. Which of the following actions should the nurse take first?

A nurse is teaching a client who has a new prescription for sertralihe to treat depression. For which of the following findings should the nurse instruct the client to monitor and report immediately as indicating serotonin syndrome?

A nurse is caring for a preschooler who is in an acute care facility. Which of the following actions should the nurse take?

A nurse is assessing a client who is postoperative following orthopedic surgery. Which of the following findings should the nurse identify as an indication of paralytic ileus?

A nurse is teaching a client who has major depressive disorder about what to expect when undergoing electroconvulsive therapy. Which of the following information should the nurse give the client?

A nurse is teaching a client who is pregnant about nonstress testing. Which of the following statements by the client indicates an understanding of the teaching?