A nurse is caring for a client who is at 33 weeks of gestation.

Medical History Gravida 2 Para 1 Preeclampsia
The nurse is assessing the client 24 hr later. How should the nurse interpret the findings?

For each finding, click to specify whether the finding is unrelated to the diagnosis, an indication that the client's condition is improving, or an indication that the client's condition is worsening.

Platelet count 90.000/mm3

Hematuria

Positive clonus

Proteinuria 2+

Leukorrhea

BUN 40 mg/dL

Answer and Explanation

The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"C"},"C":{"answers":"C"},"D":{"answers":"C"},"E":{"answers":"B"},"F":{"answers":"C"}}

Platelet count 90,000/mm3: Sign of Potential Worsening Condition - A decreased platelet count may indicate worsening preeclampsia and a risk of developing HELLP syndrome or thrombocytopenia.

Hematuria: Sign of Potential Worsening Condition - Hematuria suggests potential kidney involvement, which is a serious complication of preeclampsia, indicating a worsening condition. Positive clonus: Sign of Potential Worsening Condition - Positive clonus is a neurological sign associated with preeclampsia and indicates hyperreflexia, which can lead to seizures if untreated. Proteinuria 2+: Sign of Potential Worsening Condition - Increased proteinuria indicates ongoing kidney dysfunction, which is a worsening sign of preeclampsia.

Leukorrhea: Sign of Potential Improvement - Leukorrhea, an increase in vaginal discharge, may indicate a reduction in cervical mucus plug, which is a normal finding in late pregnancy.

BUN 40 mg/dL: Sign of Potential Worsening Condition - Elevated blood urea nitrogen (BUN) levels indicate impaired kidney function, which is a worsening sign of preeclampsia and can lead to complications such as acute kidney injury.

Nursing Test Bank

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Correct Answer is B

Explanation

Rationale:

A. Gestational diabetes mellitus is not a contraindication for a contraction stress test.

B. A previous classical incision (a vertical uterine incision) increases the risk of uterine rupture during labor, making a contraction stress test contraindicated.

C. A previous stillbirth is not a contraindication for a contraction stress test.

D. A nonreactive nonstress test may indicate the need for further evaluation with a contraction stress test, but it is not a contraindication in itself.

A. Determine the client's apical pulse rate. B. Ask the client if they are taking the medication as prescribed. C. Assess the client's kidney function. D. Check the client's serum medication level.

Correct Answer is B

Explanation

Rationale:

A. Determining the client's apical pulse rate is important for monitoring the effects of digoxin therapy but does not directly assess medication adherence.

B. Asking the client if they are taking the medication as prescribed is a direct way to evaluate medication adherence. Open communication with the client can provide valuable insight into their medication-taking behavior.

C. Assessing the client's kidney function is important for monitoring the effects of digoxin therapy but does not directly assess medication adherence.

D. Checking the client's serum medication level can provide information about medication concentration but may not necessarily indicate adherence, as the level could be within the therapeutic range even if the client is not taking the medication as prescribed.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a prenatal clinic is caring for a group of clients. The nurse should recognize that which of the following clients has a contraindication for a contraction stress test?

Correct Answer is B

Explanation

A nurse is reviewing the prescriptions for a client who is pregnant and is taking digoxin.Which of the following actions should the nurse take to best evaluate the client's medication adherence?

Correct Answer is B

Explanation

A nurse is caring for a client who is at 20 weeks of gestation and has trichomoniasis.Which of the following findings should the nurse expect?

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