A nurse manager on a labor and delivery unit is discussing care of clients who have vaginal bleeding due to placenta previa with a newly licensed nurse. Which of the following statements should the nurse manager make?
"Administer corticosteroids if the client is at more than 34 weeks of gestation."
"Initiate continuous monitoring of the FHR and uterine contractions."
"Administer terbutaline subcutaneously if the client experiences uterine atony."
"Perform a vaginal exam to determine cervical dilation."
The Correct Answer is B
Choice A rationale:
Administering corticosteroids is relevant for clients at risk of preterm labor, not specifically for placenta previa.
Choice B rationale:
Placenta previa can lead to bleeding and potential fetal distress. Continuous monitoring of fetal heart rate (FHR) and uterine contractions is essential to promptly identify any signs of distress.
Choice C rationale:
Terbutaline is a tocolytic medication used to suppress uterine contractions, and it's not relevant for managing uterine atony associated with placenta previa.
Choice D rationale:
Performing a vaginal exam can further increase the risk of bleeding in cases of placenta previa and is generally contraindicated due to the risk of disturbing the placental site.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Assessing for the presence of command hallucinations is a priority, as they can pose a risk to the client's safety and the safety of others.
Choice B rationale:
Consistent staff assignments can be important for clients with schizophrenia, but immediate safety concerns should take precedence.
Choice C rationale:
Administering medication is not the priority action unless there is a specific reason to do so based on the assessment.
Choice D rationale:
Using the client's name is respectful and helpful, but it is not the priority action in this scenario.
Correct Answer is {"xRanges":[299.765625,329.765625],"yRanges":[366.609375,396.609375]}
Explanation
Choice A rationale: This is incorrect because at about one hour after child birth the fundus should be around the belly button (where it was at 20 weeks of gestation).
Choice B rationale: This is incorrect because at about one hour after child birth the fundus should be around the belly button (where it was at 20 weeks of gestation). It then decreases steadily at approximately 1 cm every 24 hours.
Choice C rationale: One-week post-partum, the fundal height should be about 7 cm below the umbilicus (belly button). This means that the uterus is still larger than normal, but it is contracting and healing. The fundal height may vary depending on factors such as the size and position of the baby, the amount of amniotic fluid, and the mother's body type.
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