A nurse is caring for a client who is in premature labor and is receiving terbutaline.The nurse should monitor the client for which of the following adverse effects that should be reported to the provider?
Dyspnea.
Headaches.
Nervousness.
Tremors.
The Correct Answer is A
Choice A rationale
Dyspnea, or difficulty breathing, is a serious adverse effect of terbutaline that should be reported to the provider. Terbutaline can cause bronchospasm and pulmonary edema, leading to respiratory distress.
Choice B rationale
Headaches are a common side effect of terbutaline but are not considered a serious adverse effect that requires immediate reporting to the provider.
Choice C rationale
Nervousness is a common side effect of terbutaline and is usually mild. It does not require immediate reporting to the provider unless it becomes severe.
Choice D rationale
Tremors are a common side effect of terbutaline and are usually mild. They do not require immediate reporting to the provider unless they become severe.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Choice A rationale
Reassuring the client and rapidly completing the admission does not address the urgent symptom of an urge to have a bowel movement, which can indicate imminent delivery. Immediate assessment of labor progress is necessary.
Choice B rationale
Assisting the client to the bathroom to have a bowel movement may not be appropriate because the urge to defecate can signify the onset of the second stage of labor (pushing stage). Moving to the bathroom could risk an unattended delivery.
Choice C rationale
Assessing the fetal heart rate and uterine contractions with a routine tracing is important, but it does not directly address the urgent symptom of the urge to have a bowel movement. Vaginal exam takes priority to assess labor progress.
Choice D rationale
Assessing her progress of labor with a vaginal exam is the priority because the urge to have a bowel movement can signify that the baby is descending in the birth canal. This is the most immediate and necessary action to determine if delivery is imminent.
Correct Answer is A
Explanation
Choice A rationale
Proteinuria and vomiting at 35 weeks gestation are significant symptoms that could indicate preeclampsia, a serious condition that requires immediate assessment and management to prevent complications for both the mother and the baby.
Choice B rationale
Urinary urgency, frequency, and burning at 39 weeks gestation suggest a possible urinary tract infection (UTI), which is concerning but generally not as immediately critical as symptoms suggesting preeclampsia.
Choice C rationale
A fasting blood sugar of 95 mg/dL and a 3-hour glucose of 120 at 30 weeks gestation indicate good control of blood sugar levels, which is not as high-risk as preeclampsia symptoms.
Choice D rationale
A hemoglobin of 12 mg/dL and a potassium level of 3.5 mEq/L at 34 weeks gestation are within normal ranges and do not indicate an immediate high-risk condition compared to the potential for preeclampsia.
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