A nurse is reviewing charts for clients who have a diagnosis of placental abruption. Which of the following clients needs an emergent cesarean section?
Client who is at 32 weeks of gestation, has a blood pressure of 138/86 mm Hg, and a heart rate of 71/min with a category I fetal heart tracing.
Client who is at 39 weeks of gestation, has a blood pressure of 122/88 mm Hg, and a pulse of 88/min with a fetal demise.
Client who is at 38 weeks of gestation, has a fetal demise and is hemorrhaging, and has a cervix dilated at 4 cm.
Client who is at 37 weeks of gestation, has a blood pressure of 116/68 mm Hg, a pulse of 72/min, and has a category I fetal heart tracing with cervical dilation at 3 cm.
The Correct Answer is C
Choice A rationale
This client's vital signs are within normal ranges for 32 weeks of gestation. A category I fetal heart tracing indicates normality, suggesting no immediate need for an emergent cesarean section.
Choice B rationale
A fetal demise at 39 weeks of gestation does not necessitate an emergent cesarean section, as the fetus is no longer viable, and other delivery methods can be considered based on the mother's condition.
Choice C rationale
Hemorrhaging at 38 weeks with a fetal demise and cervix dilated at 4 cm indicates a medical emergency. Rapid intervention, including a cesarean section, is necessary to control bleeding and protect the mother’s life.
Choice D rationale
Normal vital signs and a category I fetal heart tracing with cervical dilation at 3 cm at 37 weeks indicate no immediate need for an emergent cesarean section, as labor can proceed naturally under observation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Skin lesions are not typically associated with gonorrheal infections, they are more indicative of other infections like congenital syphilis.
Choice B rationale
Vaginal or penile discharge indicates a localized infection rather than a systemic issue like neonatal conjunctivitis.
Choice C rationale
Thrush is a fungal infection caused by Candida, not related to gonorrheal infection.
Choice D rationale
Eye infection, specifically conjunctivitis (ophthalmia neonatorum), is common in newborns exposed to gonorrhea during birth.
Correct Answer is B
Explanation
Choice A rationale
Decrease proteinuria is not the primary goal for magnesium sulfate therapy. It's an indicator of kidney function and hypertension severity. Therapy focuses on neuroprotection and seizure prevention. Proteinuria reflects preeclampsia's renal impact, not neuroprotection.
Choice B rationale
Prevent maternal seizures is magnesium sulfate's primary goal. It stabilizes neuronal membranes, reducing seizure risk in severe preeclampsia. By inhibiting NMDA receptors and calcium channels, it prevents seizures, critical for maternal-fetal safety.
Choice C rationale
Reduce deep tendon reflexes is not magnesium sulfate's primary goal, but a side effect. It signifies therapeutic levels, indicating potential toxicity. Reflex reduction helps assess magnesium toxicity risk, ensuring safe neuroprotective dosing.
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