The clinic nurse is performing phone triage on pregnant patients. Which patient will the nurse refer to the hospital for immediate evaluation?

The patient who is 11 weeks pregnant and nauseous, tired, and sleepy most of the day.

The patient who is 30 weeks pregnant complained of "blurred vision and seeing spots."

The patient who is 40 weeks pregnant and has to urinate every 2 hours.

The patient who is 37 weeks pregnant and has 4 to 5 contractions in an hour.

Answer and Explanation

The Correct Answer is B

Choice A reason: While nausea, tiredness, and sleepiness are common during the first trimester of pregnancy, they are typically not signs of an immediate emergency. This patient does not exhibit any alarming symptoms that would require immediate hospital referral.

Choice B reason: Blurred vision and seeing spots during pregnancy can be symptoms of preeclampsia, a potentially dangerous condition characterized by high blood pressure. Preeclampsia can pose serious health risks to both the mother and the baby and requires immediate medical attention.

Choice C reason: Frequent urination is a common symptom in the later stages of pregnancy due to the pressure the growing baby exerts on the bladder. This symptom alone does not indicate an immediate need for hospital evaluation.

Choice D reason: Having 4 to 5 contractions in an hour at 37 weeks of pregnancy can be a sign of early labor. However, unless the contractions are persistent and intensifying, this may not necessitate an immediate hospital referral. The nurse would likely advise the patient to monitor the contractions and come in if they continue or become stronger.

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Correct Answer is B

Explanation

Choice A reason: Difficulty sleeping and extreme fatigue are common postpartum symptoms, but they do not indicate an immediate emergency. This patient can be seen after addressing more urgent concerns.

Choice B reason: A patient who believes someone is going to steal their baby may be experiencing postpartum psychosis or severe anxiety. This is a serious mental health concern that requires immediate attention from a healthcare provider to ensure the safety and well-being of both the patient and the baby.

Choice C reason: Having a baby in the neonatal intensive care unit is certainly stressful and requires support, but it does not indicate an immediate medical emergency for the postpartum patient themselves. This patient can be seen after more urgent cases are addressed.

Choice D reason: A teenager who is 6 weeks postpartum with the flu requires medical care, but the symptoms of the flu are generally not as urgent as the mental health concerns presented by a patient experiencing severe anxiety or psychosis. This patient can be seen after more critical cases are attended to.

A. Bronchodilator B. Digestive enzyme C. Mucolytic D. Aerosolized antibiotic

Correct Answer is B

Explanation

Choice A reason: Bronchodilators are medications that help open the airways in the lungs, making it easier to breathe. They are often used for managing respiratory symptoms in cystic fibrosis, but they are not typically required specifically before meals.

Choice B reason: Digestive enzymes are essential for children with cystic fibrosis to take before meals. These enzymes help the body digest and absorb nutrients from food, which is crucial because cystic fibrosis can impair the pancreas's ability to produce these enzymes naturally.

Choice C reason: Mucolytics are medications that help thin and loosen mucus in the lungs, making it easier to cough up and clear from the airways. While important for managing respiratory symptoms, they are not specifically needed before meals.

Choice D reason: Aerosolized antibiotics are used to treat or prevent lung infections in individuals with cystic fibrosis. They are administered via inhalation and are not tied to meal times but rather prescribed as part of a daily treatment regimen.

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The clinic nurse is performing phone triage on pregnant patients. Which patient will the nurse refer to the hospital for immediate evaluation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The clinic nurse is triaging postpartum patients. Which patient will the nurse have the healthcare provider see first?

Correct Answer is B

Explanation

A nurse is teaching a 10-year-old child how to manage their cystic fibrosis. What medication will the nurse teach the child to take before their lunch break?

Correct Answer is B

Explanation

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