A nurse is caring for a client who has an abruptio placentae. Which of the following findings should the nurse expect?
First trimester bleeding
Severe abdominal pain
Nausea
Delayed menses
The Correct Answer is B
A. First trimester bleeding. Abruptio placentae typically occurs in the third trimester, not the first. First trimester bleeding is more commonly associated with miscarriage or ectopic pregnancy.
B. Severe abdominal pain. Abruptio placentae involves the premature separation of the placenta from the uterine wall, often leading to sudden, severe abdominal pain and possibly vaginal bleeding. It is a medical emergency requiring immediate attention.
C. Nausea. While nausea can occur during pregnancy, it is not a hallmark symptom of abruptio placentae and does not assist in differentiating it from other complications.
D. Delayed menses. Delayed menses may indicate early pregnancy, but it is not related to abruptio placentae, which occurs later in pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D"]
Explanation
A. Remove the thermometer from client's room for use on another client. Clients with C. difficile should have dedicated equipment (e.g., thermometers, stethoscopes) to prevent cross-contamination. Reusing equipment between patients increases the risk of infection transmission.
B. Wear a gown when providing care. Contact precautions are required for clients with C. difficile, including wearing a gown to protect against contamination from infectious material or surfaces.
C. Wear an N95 respirator when providing care. C. difficile is spread through the fecal-oral route, not airborne. A surgical mask is not required, and an N95 respirator is unnecessary unless another airborne condition is present.
D. Change gloves after contact with infectious material. Gloves must be changed after contact with contaminated materials to prevent spreading spores to other surfaces or clients. This is a standard part of contact precaution practices.
E. Wash hands with an alcohol-based cleaner. Alcohol-based hand sanitizers are ineffective against C. difficile spores. Handwashing with soap and water is required after caring for a client with this infection to properly remove the spores.
Correct Answer is A
Explanation
A. Determine if the stockings are binding. It is important to assess that antiembolic stockings are not too tight, especially around the top, as this can impair circulation. Proper fit ensures they function effectively to promote venous return and prevent deep vein thrombosis.
B. Fold the top of the stocking over neatly. Folding or rolling the tops can cause constriction and act like a tourniquet, reducing circulation and increasing the risk of complications such as venous stasis or skin breakdown.
C. Apply the stockings after the client is in a chair. Antiembolic stockings should be applied while the client is lying down, before getting up, to prevent blood pooling in the legs. Applying them after the client is upright may reduce their effectiveness.
D. Massage the client's legs once every 8 hr while the stockings are in place. Massaging the legs, especially in clients at risk for thrombosis, is not recommended as it could dislodge a clot and lead to embolism. Passive or active leg movement is safer and more effective.
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