A nurse is caring for a female client, age 32, at 28 weeks of gestation, admitted to the antepartum unit with a diagnosis of HELLP syndrome.

The nurse is assessing the client 15 minutes later. 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.

Moderate maternal bleeding

Client reports ringing in ears

BP 180/100 mm Hg

Client reports sharp, stabbing abdominal pain

FHR 80/min with absent variability

PT 12 seconds

Answer and Explanation

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

Moderate maternal bleeding: Worsening condition. HELLP syndrome involves platelet consumption and liver dysfunction that can cause coagulopathy and bleeding risk. New or increased bleeding signals disease progression and possible disseminated intravascular coagulation (DIC).
Client reports ringing in ears: Worsening condition. Tinnitus can be a sign of hypertensive encephalopathy or central nervous system involvement from severe preeclampsia/HELLP, indicating neurological deterioration.
BP 180/100 mm Hg: Worsening condition. A significant increase from baseline hypertension signals uncontrolled blood pressure and heightened risk for stroke, organ damage, and progression of HELLP.
Client reports sharp, stabbing abdominal pain: Worsening condition. This could indicate hepatic hematoma or infarction, a serious complication of HELLP syndrome due to liver injury.
FHR 80/min with absent variability: Worsening condition. Fetal bradycardia with absent variability indicates fetal distress, often from placental insufficiency related to maternal vascular compromise.
PT 12 seconds: Indication of improving condition. Normal prothrombin time (PT range ~11-13.5 seconds) suggests stable coagulation status, indicating no worsening coagulopathy or bleeding tendency at this moment.

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

Explanation

Moderate maternal bleeding: Worsening condition. HELLP syndrome involves platelet consumption and liver dysfunction that can cause coagulopathy and bleeding risk. New or increased bleeding signals disease progression and possible disseminated intravascular coagulation (DIC).
Client reports ringing in ears: Worsening condition. Tinnitus can be a sign of hypertensive encephalopathy or central nervous system involvement from severe preeclampsia/HELLP, indicating neurological deterioration.
BP 180/100 mm Hg: Worsening condition. A significant increase from baseline hypertension signals uncontrolled blood pressure and heightened risk for stroke, organ damage, and progression of HELLP.
Client reports sharp, stabbing abdominal pain: Worsening condition. This could indicate hepatic hematoma or infarction, a serious complication of HELLP syndrome due to liver injury.
FHR 80/min with absent variability: Worsening condition. Fetal bradycardia with absent variability indicates fetal distress, often from placental insufficiency related to maternal vascular compromise.
PT 12 seconds: Indication of improving condition. Normal prothrombin time (PT range ~11-13.5 seconds) suggests stable coagulation status, indicating no worsening coagulopathy or bleeding tendency at this moment.

Correct Answer is ["8"]

Explanation

Step 1 is to convert grams to milligrams. 2 g × (1000 mg ÷ 1 g) = 2000 mg.

Step 2 is to divide the total milligrams needed by the milligrams per tablet. 2000 mg ÷ 250 mg = 8 tablets. The nurse should administer 8 tablets.

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Naxlex Comprehensive Predictor Exams

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

Explanation

A nurse is preparing to administer metronidazole 2 g PO to a client who has trichomoniasis. Available is metronidazole 250 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["8"]

Explanation

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