Exhibits

The nurse is reviewing nurses' notes to determine if there are any variations.

Click to highlight the findings that would indicate the client has developed a complication related to pregnancy.

The client is a 32-year-old multigravida at 28 weeks gestation, who presents to the healthcare provider's office for a routine prenatal visit. Obstetrical history reveals she has given birth three times; once at 35 weeks (twins), once at 38 weeks (singleton) and once at 41 weeks (singleton). All of these children are alive and well. She had one spontaneous abortion at 10 weeks' gestation. Her fourth child weighed 9 pounds (4.08 kg) at 41 weeks gestation.

Client is at 28 weeks. She has been receiving prenatal care since 8 weeks gestation. Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dL (9.1 mmol/L). Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 (9.3 mmol/L) and a two-hour postprandial of 220 mg/dL (12.2 mmol/L).

Her fourth child weighed 9 pounds (4.08 kg) at 41 weeks gestation

Client is at 28 weeks. She has been receiving prenatal care since 8 weeks gestation

Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dL (9.1 mmol/L)

Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 (9.3 mmol/L) and a two-hour postprandial of 220 mg/dL (12.2 mmol/L)

Answer and Explanation

The Correct Answer is ["A","C","D"]

Rationale for correct findings:

Fasting 1-hour glucose screen: 164 mg/dL (9.1 mmol/L): The fasting glucose of 164 mg/dL is elevated, indicating impaired glucose metabolism, which suggests the possibility of gestational diabetes.
3-hour glucose tolerance test: Fasting blood sugar 168 mg/dL (9.3 mmol/L): The fasting blood sugar of 168 mg/dL is above the normal threshold of 140 mg/dL, reinforcing the suspicion of gestational diabetes.
2-hour postprandial glucose: 220 mg/dL (12.2 mmol/L): A postprandial glucose level of 220 mg/dL is significantly above the normal limit of 140 mg/dL, further indicating gestational diabetes.
Fourth child with macrosomia: 9 pounds (4.08 kg) at 41 weeks gestation: Macrosomia is often associated with gestational diabetes. The fourth child weighing 9 pounds suggests the possibility of undiagnosed gestational diabetes during the previous pregnancy, which could be recurring in the current pregnancy.

Rationale for incorrect Findings:

Client is at 28 weeks and has been receiving prenatal care since 8 weeks gestation: The client’s consistent prenatal care since 8 weeks indicates early and regular monitoring, reducing the likelihood of other major complications.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. The woman is timid and speaks softly when asked about the accident: Timid behavior may suggest fear or anxiety, but it's nonspecific and may be due to trauma or emotional distress, not necessarily abuse.

B. Spiral fracture on the woman's arm and wrist: Spiral fractures occur from twisting injuries and are often associated with non-accidental trauma, especially when the injury doesn't match the reported mechanism.

C. The woman is hyperventilating and appears to be in pain: Hyperventilation and visible pain may indicate anxiety or physical injury, but they are expected after trauma and not unique to domestic violence.

D. Fresh bruises on the woman's shoulder and chest: Bruising is a possible sign of abuse, but bruises alone can result from a car accident. The type and location must be assessed in context.

A. "Yoga is not the subject of this group." B. "What do you want to know about it?" C. "Wait, let her finish talking." D. "Do not interrupt in group again."

Correct Answer is B

Explanation

A. "Yoga is not the subject of this group": This response dismisses the client's curiosity and could shut down the conversation. Shutting down the discussion abruptly can make clients feel unheard and discourage participation, hindering the therapeutic environment.

B. "What do you want to know about it?": This response validates the client's interest and encourages open discussion. The nurse can provide a brief explanation without derailing the group session.

C. "Wait, let her finish talking": This response may seem dismissive and could discourage engagement. It is important to address the interruption respectfully while also encouraging dialogue.

D. "Do not interrupt in group again": This kind of response can create a hostile environment, shut down communication, and damage the therapeutic relationship between the nurse and the clients, especially in a mental health setting where trust and open expression are vital.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A woman and her live-in significant other come in the emergency department following a motor vehicle collision. Which finding should alert the nurse to assess for the possibility of domestic violence?

Correct Answer is B

Explanation

The mental health nurse is leading a group about relaxation and explains the benefits of deep breathing for relaxation. As a female client begins to explain how she uses yoga to relax, another client interrupts and asks, "What's yoga?" Which is the nurse's best response?

Correct Answer is B

Explanation

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