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 A

Explanation

A. Decreased impulsiveness: Methylphenidate is a central nervous system stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD) in children. One of the therapeutic effects of methylphenidate is the reduction of impulsiveness, hyperactivity, and inattention, which are hallmark symptoms of ADHD. Therefore, a decrease in impulsiveness would indicate that the medication is effective.
B. Increased urine output: Methylphenidate is not expected to affect urine output. Increased urine output is not a typical finding indicating the effectiveness of methylphenidate.
C. Increased appetite: Methylphenidate commonly causes appetite suppression as a side effect. Therefore, an increase in appetite would not be indicative of the medication's effectiveness. In fact, a decrease in appetite is a common adverse effect of methylphenidate.
D. Decreased abdominal pain: Methylphenidate is not typically used to treat abdominal pain, and its effectiveness is not evaluated based on the relief of abdominal pain. The primary therapeutic effect of methylphenidate in ADHD is the improvement of attention, focus, and impulse control. Therefore, decreased abdominal pain would not be a reliable indicator of the medication's effectiveness.

A. "You should wear a snug-fitting bra continuously for 72 hours." B. "You should apply moist heat to your breasts four times per day." C. "You should limit your fluid intake to 1 liter per day." D. "You should manually express milk when engorgement occurs."

Correct Answer is A

Explanation

A. "You should wear a snug-fitting bra continuously for 72 hours": Wearing a snug-fitting bra continuously for 72 hours can help suppress lactation by providing support and reducing stimulation to the breasts. This can help prevent milk production and engorgement.
B. "You should apply moist heat to your breasts four times per day": Moist heat can stimulate milk production and should be avoided when trying to suppress lactation.
C. "You should limit your fluid intake to 1 liter per day": Adequate hydration is important for overall health, and limiting fluid intake to 1 liter per day is not advisable, especially postpartum when hydration needs may be higher.
D. "You should manually express milk when engorgement occurs": Manual expression of milk can stimulate milk production and should be avoided when attempting to suppress lactation. If engorgement occurs, cold compresses or ice packs can be used to reduce discomfort without stimulating milk production.

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Naxlex Comprehensive Predictor Exams

A nurse is evaluating the progress of a school-age child who takes methylphenidate. Which of the following findings indicates the effectiveness of the medication?

Correct Answer is A

Explanation

A nurse is teaching about how to suppress lactation with a client who is postpartum and bottle feeding their newborn. Which of the following instructions should the nurse include in the teaching?

Correct Answer is A

Explanation

A nurse is teaching a class about providing care within the legal stope of practice to a group of nurses. The nurse should include that which of the following procedures is outside the legal scope of practice for an RN?

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 caring for a client who has a peritoneal catheter that requires a dressing change. Identify the sequence of actions the nurse should take. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

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?

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?

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A nurse is teaching a client who has a new prescription for metformin extended release tablets. Which of the following statements by the client indicates an understanding of the teaching?

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