A nurse is caring for a client who has just been admitted to the medical-surgical unit from the emergency department.
The nurse is reviewing the client’s medical records.
Which of the following conditions is the client most likely experiencing, based on the client’s notes and actions to be taken?

Choice A rationale

A client diagnosed with preeclampsia reporting epigastric pain and unresolved headache is a serious concern. Epigastric pain could indicate severe liver involvement, and a persistent headache could be a sign of progressing neurological involvement, both of which are severe features of preeclampsia. These symptoms suggest the condition may be worsening to eclampsia, a life-threatening complication characterized by the onset of seizure activity or coma in a woman with preeclampsia. Immediate medical attention is necessary to prevent further complications.

Choice B rationale

A tearful client at 32 weeks of gestation experiencing irregular, frequent contractions could be experiencing preterm labor. However, emotional distress and contractions do not necessarily indicate a medical emergency. It’s important to monitor the situation, but it does not need to be immediately reported to the provider.

Choice C rationale

A client diagnosed with preeclampsia having 2+ proteinuria and 2+ patellar reflexes are expected findings. Proteinuria is a common sign of preeclampsia, and hyperreflexia can occur due to increased neuromuscular irritability. While these should be monitored, they do not need to be immediately reported to the provider.

Choice D rationale

A client at 28 weeks of gestation receiving terbutaline reporting fine tremors is an expected side effect of the medication. Terbutaline, a beta-adrenergic agonist, can cause tremors by stimulating the nervous system. While it may be uncomfortable for the client, it is not a medical emergency.

Choice A rationale

While followers demonstrating high critical thinking are valuable, passive contribution may not be as beneficial to a nurse leader’s performance. Active participation is often more beneficial in a healthcare setting, as it allows for the exchange of ideas and collaborative problem-solving.

Choice B rationale

Followers who are dependent and passive when they disagree may not contribute effectively to the team’s performance. Constructive disagreement can lead to better decision-making and innovation. Therefore, passive disagreement may not be the most beneficial trait for a nurse leader.

Choice C rationale

Followers who are active contributors and participate in developing and analyzing ideas are highly beneficial to a nurse leader’s performance. Active participation fosters a collaborative environment, encourages the exchange of ideas, and leads to innovative solutions. This type of follower can significantly enhance the performance of a nurse leader and the overall team.

Choice D rationale

While participation in developing and analyzing ideas is important, not being an active contributor can limit the effectiveness of this participation. Active contribution is key to fostering a collaborative and innovative environment.