A woman pregnant with twins comes to the clinic for an evaluation. While assessing the client, the nurse would be especially alert for signs and symptoms for which potential problem?

oligohydramnios

preeclampsia

chorioamnionitis

post-term labor

Answer and Explanation

The Correct Answer is B

A. Oligohydramnios:

Oligohydramnios refers to a condition where there is too little amniotic fluid surrounding the fetus in the womb. It can be concerning because amniotic fluid plays a crucial role in protecting and cushioning the fetus, aiding in lung development, and preventing compression of the umbilical cord. While oligohydramnios can be a complication in pregnancy, it's not necessarily more common or specific to twin pregnancies compared to singleton pregnancies.

B. Preeclampsia:

Preeclampsia is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, such as the liver and kidneys. It usually develops after 20 weeks of pregnancy and can lead to serious complications for both the mother and the babies if not managed properly. Multiple pregnancies, including twins, are considered a risk factor for developing preeclampsia. Therefore, pregnant women carrying twins require close monitoring for signs and symptoms of preeclampsia.

C. Chorioamnionitis:

Chorioamnionitis is an infection of the fetal membranes (chorion and amnion) and amniotic fluid. It typically occurs due to bacterial infection ascending from the vagina into the uterus, often during prolonged labor or rupture of membranes. While chorioamnionitis is a concern in pregnancy, it's not necessarily more common in twin pregnancies compared to singleton pregnancies.

D. Post-term labor:

Post-term labor refers to labor that begins after 42 weeks of gestation. Prolonged pregnancy beyond the due date can increase the risks of complications for both the mother and the baby, including fetal distress, macrosomia (large birth weight), and meconium aspiration. Post-term labor can occur in both singleton and multiple pregnancies, but it's not specifically more associated with twin pregnancies.

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Correct Answer is C

Explanation

A. Disseminated intravascular coagulation (DIC):

DIC is a serious condition characterized by abnormal clotting throughout the body's blood vessels, leading to both bleeding and clotting simultaneously. While it can occur in severe cases of HELLP syndrome, it is not a specific finding used to diagnose HELLP syndrome. Instead, it's a complication that can develop due to various underlying conditions, including HELLP syndrome.

B. Elevated platelet count:

In HELLP syndrome, platelet count is typically decreased, not elevated. HELLP syndrome stands for Hemolysis, Elevated Liver enzymes, and Low Platelets. The low platelet count is a key diagnostic feature of HELLP syndrome and contributes to the risk of bleeding complications.

C. Elevated liver enzymes:

Elevated liver enzymes, particularly elevated levels of AST (aspartate aminotransferase) and ALT (alanine aminotransferase), are hallmark features of HELLP syndrome. Liver involvement is a significant component of this syndrome, and elevated liver enzymes are part of the diagnostic criteria.

D. Hyperglycemia:

While hyperglycemia can occur in various conditions, it is not a characteristic finding of HELLP syndrome. HELLP syndrome primarily affects the liver, blood clotting factors, and platelets, leading to features such as elevated liver enzymes, low platelet count, and hemolysis (destruction of red blood cells).

A. Ask, "Have you ever been physically hurt by your partner?" B. Offer the client a pamphlet about the local shelter for victims of intimate partner violence. C. Call the client at home to ask some questions about the marriage. D. Wait until the client comes in a few more times to make a better assessment.

Correct Answer is A

Explanation

A. Ask, "Have you ever been physically hurt by your partner?":

This approach involves directly asking the client about their experience with intimate partner violence. While it's crucial to address the issue openly and directly, some clients may feel uncomfortable or unsafe disclosing abuse, especially during an initial encounter. However, for many clients, this direct approach can be empowering and may facilitate disclosure.

B. Offer the client a pamphlet about the local shelter for victims of intimate partner violence:

Providing informational resources about local shelters and support services can be a supportive and non-confrontational way to offer assistance to a client who may be experiencing intimate partner violence. It allows the client to access resources privately and at their own pace. However, it may not lead to immediate disclosure or intervention.

C. Call the client at home to ask some questions about the marriage:

Calling the client at home to inquire about their relationship may inadvertently escalate the situation and put the client at risk if the abusive partner overhears the conversation. It can also violate the client's privacy and autonomy, as they may not be comfortable discussing sensitive issues over the phone, especially if the abusive partner is present.

D. Wait until the client comes in a few more times to make a better assessment:

Delaying assessment and intervention can potentially prolong the client's exposure to abuse and increase their risk of harm. Intimate partner violence often escalates over time, so it's essential to address suspected abuse as soon as possible to ensure the client's safety and well-being.

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A woman pregnant with twins comes to the clinic for an evaluation. While assessing the client, the nurse would be especially alert for signs and symptoms for which potential problem?

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Naxlex Comprehensive Predictor Exams

A nurse suspects that a client is developing HELLP syndrome. The nurse notifies the health care provider based on which finding?

Correct Answer is C

Explanation

Which approach would be most appropriate when counseling a client who is a suspected victim of intimate partner violence?

Correct Answer is A

Explanation

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