As a nurse caring for a group of clients on an intrapartum unit, which of the following findings should be immediately reported to the provider?

A client diagnosed with preeclampsia reports epigastric pain and unresolved headache

A tearful client at 32 weeks of gestation experiencing irregular, frequent contractions

A client diagnosed with preeclampsia has 2+ proteinuria and 2+ patellar reflexes

A client at 28 weeks of gestation receiving terbutaline reports fine tremors

Answer and Explanation

The Correct Answer is A

Choice A rationale

A client diagnosed with preeclampsia reporting epigastric pain and unresolved headache is a serious concern. Epigastric pain could indicate severe liver involvement, and a persistent headache could be a sign of progressing neurological involvement, both of which are severe features of preeclampsia. These symptoms suggest the condition may be worsening to eclampsia, a life-threatening complication characterized by the onset of seizure activity or coma in a woman with preeclampsia. Immediate medical attention is necessary to prevent further complications.

Choice B rationale

A tearful client at 32 weeks of gestation experiencing irregular, frequent contractions could be experiencing preterm labor. However, emotional distress and contractions do not necessarily indicate a medical emergency. It’s important to monitor the situation, but it does not need to be immediately reported to the provider.

Choice C rationale

A client diagnosed with preeclampsia having 2+ proteinuria and 2+ patellar reflexes are expected findings. Proteinuria is a common sign of preeclampsia, and hyperreflexia can occur due to increased neuromuscular irritability. While these should be monitored, they do not need to be immediately reported to the provider.

Choice D rationale

A client at 28 weeks of gestation receiving terbutaline reporting fine tremors is an expected side effect of the medication. Terbutaline, a beta-adrenergic agonist, can cause tremors by stimulating the nervous system. While it may be uncomfortable for the client, it is not a medical emergency.

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Correct Answer is C

Explanation

Choice A rationale

The client who has an indwelling urinary catheter to gravity drainage is not at risk for hypokalemia. The kidneys regulate the balance of potassium by removing excess potassium into the urine. The use of a urinary catheter would not affect this process.

Choice B rationale

The client who has a chest tube to water seal is not at risk for hypokalemia. Chest tubes are used to treat conditions that can cause the lung to collapse, such as pneumothorax, hemothorax, or pleural effusion. They do not affect the body’s potassium levels.

Choice C rationale

The client who has a nasogastric (NG) tube to suction is at risk for hypokalemia. Hypokalemia, or low potassium levels, can occur with loss of gastric fluids because these fluids contain potassium. With an NG tube to suction, these fluids are being removed from the body, which can lead to a decrease in potassium levels.

Choice D rationale

The client who has a tracheostomy tube attached to humidified oxygen is not at risk for hypokalemia. A tracheostomy tube allows air to enter the lungs. It does not affect the body’s potassium levels.

A. Sweat test B. Haptoglobin C. Schilling test D. Antinuclear antibodies .

Correct Answer is C

Explanation

Choice A rationale

A sweat test is used to diagnose cystic fibrosis, a genetic disorder that affects the lungs and digestive system. It is not used to diagnose pernicious anemia.

Choice B rationale

Haptoglobin is a protein produced by the liver that binds to hemoglobin in the blood to prevent it from being excreted through the kidneys. While it can be used to diagnose conditions that cause the destruction of red blood cells, it is not used to diagnose pernicious anemia.

Choice C rationale

The Schilling test is used to determine whether the body absorbs vitamin B12 normally, which is crucial for the diagnosis of pernicious anemia. Pernicious anemia is a condition where the body is unable to absorb vitamin B12 due to a lack of intrinsic factor, a protein made in the stomach.

Choice D rationale

Antinuclear antibodies (ANAs) are a type of autoantibody that can attack the body’s own tissues. While they can be present in various autoimmune diseases, they are not used to diagnose pernicious anemia.

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As a nurse caring for a group of clients on an intrapartum unit, which of the following findings should be immediately reported to the provider?

Nursing Test Bank

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Correct Answer is C

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