For each potential provider's prescription, click to specify if the potential prescription is anticipated or unanticipated for the client.

Administer oxytocin,

Administer terbutaline.

Administer betamethasone.

Maintain bed rest with bathroom privileges.

Limit fluid intake to 3,000 mL/day.

Place client in supine position.

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"}}

1.   Administer oxytocin
Unanticipated: Oxytocin is typically used to induce labor or augment labor by stimulating uterine contractions. Since the client is already experiencing preterm labor, administering oxytocin could exacerbate contractions, leading to a more rapid progression of labor, which is not desired at 33 weeks gestation.
2.   Administer terbutaline
Anticipated: Terbutaline is a tocolytic agent used to stop preterm labor by relaxing the uterus and inhibiting contractions. Given that the client is experiencing preterm labor (with regular contractions), this medication would be used to attempt to stop labor and delay delivery, which is an appropriate action for a 33-week pregnant client with early labor signs.

3.   Administer betamethasone
Anticipated: Betamethasone is a corticosteroid that promotes lung maturity in preterm infants. At 33 weeks gestation, it is common to administer betamethasone if preterm labor is suspected, as it enhances fetal lung development and reduces the risk of respiratory distress syndrome in the newborn.
4.   Maintain bed rest with bathroom privileges
Anticipated: Bed rest is often recommended for clients with preterm labor to reduce uterine activity and promote fetal well-being. While some studies suggest limited benefits, it is still a common non- pharmacological approach to manage preterm labor and reduce the risk of premature delivery.
5.   Limit fluid intake to 3,000 mL/day
Unanticipated: There is no indication that the client is at risk for fluid overload or hyponatremia (which would require fluid restriction). In fact, hydration is often encouraged in preterm labor to prevent dehydration, which can worsen uterine contractions.
6.   Place client in supine position
Unanticipated: Supine position is not recommended during pregnancy, particularly after the first trimester, due to the risk of supine hypotensive syndrome (compression of the vena cava, leading to reduced blood flow to the uterus and fetus). In fact, lateral positioning (e.g., left side-lying) is recommended for optimal circulation.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Providing humidification can help alleviate dry mouth by increasing moisture in the air, which is beneficial for the client experiencing xerostomia.
B. Alcohol-based mouthwash can exacerbate dry mouth and should be avoided.
C. Esophageal speech is typically used for clients who have had laryngectomy, not for those with xerostomia.
D. Saltine crackers are dry and could worsen xerostomia by further drying the mouth. Hydration and saliva substitutes are more appropriate.

A. Pale and a 24-hr fluid deficit of 30 mL B. Decreased appetite and irritability C. Temperature 38° C (100.4° F) and pulse rate 124/min D. Sunken fontanels and dry mucous membranes

Correct Answer is D

Explanation

A. A small fluid deficit of 30 mL is not concerning unless it worsens or additional symptoms develop.
B. Decreased appetite and irritability can be expected with gastroenteritis and may not require immediate intervention.
C. A mild fever and increased pulse rate can be expected, but if these values remain stable and other signs of dehydration or worsening illness are absent, they do not require immediate intervention.
D. Sunken fontanels and dry mucous membranes are signs of dehydration and should be reported to the provider immediately.

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For each potential provider's prescription, click to specify if the potential prescription is anticipated or unanticipated for the client.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who reports xerostomia following radiation therapy to the mandible. Which of the following is an appropriate action by the nurse?

Correct Answer is A

Explanation

A nurse is caring for an infant who has gastroenteritis. Which of the following assessment findings should the nurse report to the provider?

Correct Answer is D

Explanation

A nurse is developing a plan of care for a newborn whose mother tested positive for heroin during pregnancy. The newborn is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse include in the plan?

A nurse is caring for a client. Exhibits Complete the following sentence by using the list of options. After notifying the provider, the nurse should first dropdownand thendropdown

A nurse is conducting health promotion education regarding contraindications to combination oral contraceptive use to a group of women. Which of the following conditions should the nurse include in the teaching?

A nurse is caring for a client who has end-stage liver disease and is undergoing a paracentesis. Which of the following actions should the nurse take to evaluate the effectiveness of the procedure?

A nurse is assessing a client who is postoperative following abdominal surgery and has an indwelling urinary catheter that is draining dark yellow urine at 25 mL/hr. Which of the following interventions should the nurse anticipate?

A nurse is reviewing the laboratory data of a client who received 2 units of packed RBCs. Which of the following laboratory findings should the nurse expect following the transfusion?

A nurse is caring for a client. Exhibits A nurse is reviewing the client's electronic medical record. Which of the following findings require follow up? Select all that apply.

A nurse is providing dietary teaching to a client who has a new diagnosis of irritable bowel syndrome. Which of the following recommendations should the nurse include?