A nurse is assisting in the care of a client who is admitted for complications associated with intrauterine fetal demise and becomes unresponsive.
Which of the following actions should the nurse take first?
Obtain a set of vital signs.
Assess vaginal bleeding.
Call the rapid response team.
Notify the provider.
The Correct Answer is C
Choice A rationale
Obtaining a set of vital signs is important but not the first action. Assessing responsiveness and activating emergency response takes precedence to ensure prompt intervention.
Choice B rationale
Assessing vaginal bleeding is necessary, but it should follow immediate life-saving actions like calling the rapid response team.
Choice C rationale
Calling the rapid response team should be the first action as it mobilizes a team of healthcare professionals to provide immediate advanced care, which is crucial in an unresponsive patient.
Choice D rationale
Notifying the provider is essential, but it should be done after the rapid response team is activated to ensure timely intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
History of cocaine use increases the risk for placental abruption but is not a direct risk factor for ectopic pregnancy.
Choice B rationale
History of pelvic inflammatory disease (PID) is a significant risk factor for ectopic pregnancy due to the damage and scarring it can cause to the fallopian tubes, leading to implantation outside the uterus.
Choice C rationale
History of three previous cesarean births increases the risk of uterine rupture or placenta previa but not specifically ectopic pregnancy.
Choice D rationale
History of hypertension is not directly related to the risk of ectopic pregnancy; it is more associated with complications like preeclampsia and gestational hypertension.
Correct Answer is A
Explanation
Choice A rationale
0.2 mg is the appropriate transcription as it avoids trailing zeros and clearly indicates the dosage, reducing the risk of overdose.
Choice B rationale
0.20 mg is incorrect because the trailing zero could be misinterpreted as 20 mg, leading to a dangerous overdose.
Choice C rationale
2 mg is incorrect as it represents a tenfold overdose of the intended dosage, potentially resulting in serious harm.
Choice D rationale
0.02 mg is incorrect as it represents a tenfold underdose of the intended dosage, potentially resulting in insufficient therapeutic effect. .
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