A nurse is caring for several clients. The nurse should recognize that it is safe to administer tocolytic therapy to which of the following clients?
A client who is experiencing preterm labor at 26 weeks of gestation
A client who is experiencing fetal death at 32 weeks of gestation
A client who has a post-term pregnancy at 42 weeks of gestation
A client who is experiencing Braxton-Hicks contractions at 36 weeks of gestation
The Correct Answer is A
Choice A reason: A client who is experiencing preterm labor at 26 weeks of gestation is a suitable candidate for tocolytic therapy, because it can help delay the delivery and allow time for fetal lung maturation and transfer to a tertiary care center. Tocolytic therapy is indicated for clients who have regular uterine contractions and cervical changes before 37 weeks of gestation.
Choice B reason: A client who is experiencing fetal death at 32 weeks of gestation is not a suitable candidate for tocolytic therapy, because it has no benefit for the mother or the fetus. Tocolytic therapy is contraindicated for clients who have fetal demise, as it can increase the risk of infection and coagulation disorders.
Choice C reason: A client who has a post-term pregnancy at 42 weeks of gestation is not a suitable candidate for tocolytic therapy, because it can harm the mother and the fetus. Tocolytic therapy is contraindicated for clients who have post-term pregnancy, as it can increase the risk of placental insufficiency, fetal distress, and meconium aspiration.
Choice D reason: A client who is experiencing Braxton-Hicks contractions at 36 weeks of gestation is not a suitable candidate for tocolytic therapy, because it is not necessary or effective. Braxton-Hicks contractions are irregular and painless contractions that do not cause cervical changes or labor. They are normal and harmless, and do not require any intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Asymmetric thigh folds is a common finding in newborns who have DDH, because the affected hip is dislocated or subluxated, causing the thigh to appear shorter and the skin folds to be uneven. The nurse should compare the number and depth of the skin folds on both sides of the groin and buttocks.
Choice B reason: Absent plantar reflexes is not a typical finding in newborns who have DDH, because it is not related to the hip joint. The plantar reflex is a normal reflex that causes the toes to curl when the sole of the foot is stroked. The nurse should assess the plantar reflex in all newborns, regardless of their hip status.
Choice C reason: Lengthened thigh on the affected side is not a usual finding in newborns who have DDH, because the opposite is true. The affected thigh is usually shorter than the unaffected thigh, due to the displacement of the femoral head from the acetabulum. The nurse should measure the length of both thighs from the anterior superior iliac spine to the medial malleolus.
Choice D reason: Inwardly turned foot on the affected side is not a specific finding in newborns who have DDH, because it can be caused by other conditions, such as metatarsus adductus or clubfoot. The inward turning of the foot is not a direct result of the hip disorder, but rather a secondary effect of the abnormal positioning of the leg. The nurse should examine the alignment and mobility of the foot and ankle.
Correct Answer is C
Explanation
Choice A reason: Glipizide is not an appropriate medication for the client, because it is a sulfonylurea that can cross the placenta and cause fetal hypoglycemia, hyperinsulinemia, and macrosomia. Glipizide is contraindicated in pregnancy.
Choice B reason: Acarbose is not an appropriate medication for the client, because it is an alpha-glucosidase inhibitor that can cause gastrointestinal side effects, such as flatulence, diarrhea, and abdominal pain. Acarbose is not recommended in pregnancy.
Choice C reason: Glyburide is an appropriate medication for the client, because it is a sulfonylurea that has a low placental transfer and a minimal risk of fetal hypoglycemia. Glyburide is considered safe and effective in pregnancy.
Choice D reason: Repaglinide is not an appropriate medication for the client, because it is a meglitinide that can cross the placenta and cause fetal hypoglycemia and teratogenic effects. Repaglinide is contraindicated in pregnancy.
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