A nurse is planning to administer betamethasone to a gravid client. Which client is most likely to receive this prescription?

A client who is 16-weeks gestation and is experiencing vaginal bleeding and cramping.

A client who is 37-weeks gestation and whose cervix is 7 cm dilated, 100% effaced, and a -1 station.

A client who is 38-weeks gestation and whose amniotic membranes ruptured at home 24 hours ago.

A client who is 30-weeks gestation and is contracting regularly and exhibiting cervical change.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Betamethasone is a corticosteroid used to accelerate fetal lung maturation by stimulating the production of surfactant. It is not indicated for treating threatened abortion, which is characterized by vaginal bleeding and cramping before 20 weeks gestation. The primary goal in this scenario is to maintain the pregnancy, not to prepare for a preterm birth.

Choice B rationale

At 37 weeks gestation, the fetus is considered full term. At this point, the fetal lungs are mature, and the administration of betamethasone is unnecessary. The client is in active labor, and the primary focus is on monitoring the labor progress and preparing for a vaginal delivery.

Choice C rationale

Prolonged rupture of membranes at term (38 weeks gestation) increases the risk of infection. While betamethasone could be used for fetal lung maturity, it is not indicated at term. The primary intervention is to monitor for signs of infection and initiate labor to prevent ascending bacterial infection to the fetus.

Choice D rationale

Betamethasone is indicated for clients at risk for preterm delivery between 24 and 34 weeks gestation. The medication crosses the placenta to accelerate fetal lung maturity by inducing surfactant synthesis. This intervention reduces the incidence and severity of respiratory distress syndrome, a major complication of prematurity.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A rationale

The primary goal of magnesium sulfate therapy in preeclampsia is seizure prophylaxis, not solely blood pressure reduction. While a decrease in blood pressure is a beneficial effect, the client’s pressures remain elevated (normal range is 120/80 mm Hg). Discontinuing the infusion would remove the anticonvulsant effect, potentially increasing the risk of a seizure, which is a major complication of severe preeclampsia.

Choice B rationale

Decreasing the dosage of magnesium sulfate would reduce the therapeutic serum magnesium level. This could compromise the anticonvulsant effect needed to prevent eclamptic seizures. The current dosage should be maintained to achieve and sustain the target therapeutic range, which is typically 4.8 to 8.4 mg/dL.

Choice C rationale

The nurse should continue to monitor the client's vital signs and the effectiveness of the magnesium sulfate. The observed decrease in blood pressure from 146/90 to 141/86 mm Hg within a 10-minute interval suggests a positive therapeutic trend. This indicates the medication is having its intended effect of vasodilation. Continued monitoring is crucial to assess for further improvement or signs of toxicity.

Choice D rationale

Increasing the frequency of blood pressure checks is not the most appropriate primary action. While frequent monitoring is essential, the blood pressure values are showing a positive response. The current monitoring schedule is likely adequate. There is no immediate indication of a new complication or an acute deterioration that would warrant more frequent checks.

A. A normal, expected fluctuation in lab values. B. The client's fluid status is improving. C. The client is at increased risk for hemorrhage. D. The client is experiencing a worsening anemic state.

Correct Answer is D

Explanation

Choice A rationale

A decrease of 0.8 g/dL in hemoglobin over two days is a significant change, not a normal fluctuation. Normal daily fluctuations are typically less than 0.5 g/dL. This magnitude of change indicates a pathological process, such as blood loss or hemodilution, which requires further investigation to determine the underlying cause.

Choice B rationale

An improvement in fluid status, such as a decrease in hypervolemia, would typically lead to an increase in hemoglobin concentration due to a reduction in the diluting effect of excess plasma volume. A decrease in hemoglobin, as observed here, suggests either blood loss or worsening fluid retention, which dilutes the red blood cell count.

Choice C rationale

While a decrease in hemoglobin can be a sign of hemorrhage, it does not, in itself, directly indicate an increased risk for future hemorrhage. It indicates that blood loss has likely already occurred or that there is an underlying issue causing the decrease. The decrease is a result of a process, not a risk factor for a future event.

Choice D rationale

The decrease in hemoglobin from 11.2 g/dL to 10.4 g/dL over a short period indicates a worsening anemic state. Anemia is a condition characterized by a deficit of red blood cells or hemoglobin. This change suggests that the underlying cause, whether it is blood loss or a physiological process, is worsening and requires intervention.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is planning to administer betamethasone to a gravid client. Which client is most likely to receive this prescription?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with severe preeclampsia is receiving magnesium sulfate. The nurse notes the following vital signs: blood pressure 146/90 mm Hg at 1220 and 141/86 mm Hg at 1230. What is the most appropriate action for the nurse to take?

Correct Answer is C

Explanation

A nurse is reviewing a client’s lab results. Two days ago, the hemoglobin was 11.2 g/dL, and today it is 10.4 g/dL. What does this change indicate?

Correct Answer is D

Explanation

At 0600 while admitting a woman for a scheduled repeat cesarean section (C-section), the client tells the nurse that she drank a cup of coffee at 0400 because she wanted to avoid getting a headache. Which action should the nurse take first?

A client with preeclampsia is admitted to the hospital. The client's laboratory results indicate a lactate dehydrogenase (LDH) level of 525 U/L and uric acid of 5.8 mg/dL. Which intervention should the nurse anticipate?

A client at 17-weeks gestation expels the products of conception in her bed. Which intervention is most important for the nurse to implement?

The nurse is reviewing the client's laboratory results. The client is reporting a severe headache, nausea, and right-sided upper abdominal pain. The nurse notes deep tendon reflexes are 4+. What is the priority nursing intervention?

A client who is HIV positive is receiving zidovudine during labor. Which information should the nurse provide to the client?

A breastfeeding mother returns to work when her infant is 5 months old. She is having difficulty pumping enough milk to meet her infant's dietary requirements. Which suggestion should the nurse provide to this mother?

A nurse reviews the history and physical and the nurse’s note for a child. Which action is most appropriate for the nurse caring for this child?