The labor of a pregnant woman with preeclampsia is going to be induced. Before initiating the oxytocin (Pitocin) infusion, the nurse reviews the woman's latest laboratory test findings, which reveal a platelet count of 90,000 mm3, an elevated aspartate aminotransferase (AST) level, and a falling hematocrit. The laboratory results are indicative of which condition?

Disseminated intravascular coagulation (DIC) syndrome

Eclampsia

Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome

Idiopathic thrombocytopenia

Answer and Explanation

The Correct Answer is C

Choice A reason: Disseminated intravascular coagulation (DIC) syndrome is not the correct answer, as it is a coagulation disorder that causes widespread clotting and bleeding in the body. DIC can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. DIC would cause a low platelet count, but also a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), and a low fibrinogen level.

Choice B reason: Eclampsia is not the correct answer, as it is a seizure disorder that occurs in clients with severe preeclampsia. Eclampsia can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. Eclampsia would cause a high blood pressure, but also a proteinuria, edema, and hyperreflexia.

Choice C reason: Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome is the correct answer, as it is a variant of severe preeclampsia that affects the blood and the liver. HELLP syndrome is indicated by the laboratory results, as it causes a low platelet count, an elevated AST level, and a falling hematocrit. HELLP syndrome would also cause a high blood pressure, a proteinuria, and a right upper quadrant pain.

Choice D reason: Idiopathic thrombocytopenia is not the correct answer, as it is an autoimmune disorder that causes the destruction of platelets by antibodies. Idiopathic thrombocytopenia can affect pregnant women, but it is not related to severe preeclampsia or the laboratory results. Idiopathic thrombocytopenia would cause a low platelet count, but not an elevated AST level or a falling hematocrit.

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Correct Answer is B

Explanation

Choice A reason: This order does not require clarification, as it is an appropriate and standard order for a client who has severe preeclampsia, which is a hypertensive disorder of pregnancy that can cause fetal distress, growth restriction, or demise. Continuous fetal monitoring can help detect and evaluate the fetal heart rate, variability, accelerations, decelerations, and contractions, and guide the management and intervention.

Choice B reason: This order requires clarification, as it is an inappropriate and contraindicated order for a client who has severe preeclampsia, which is a hypertensive disorder of pregnancy that can cause seizures, stroke, or organ failure. Ambulation can increase the blood pressure, stimulate the labor, and worsen the condition. The client should be on bed rest, with the head of the bed elevated, and receive medications to lower the blood pressure and prevent seizures.

Choice C reason: This order does not require clarification, as it is an appropriate and standard order for a client who has severe preeclampsia, which is a hypertensive disorder of pregnancy that can cause edema, proteinuria, or oliguria. Obtaining a daily weight can help monitor the fluid status, the severity of the edema, and the response to the treatment.

Choice D reason: This order does not require clarification, as it is an appropriate and standard order for a client who has severe preeclampsia, which is a hypertensive disorder of pregnancy that can cause hyperreflexia, clonus, or seizures. Assessing deep tendon reflexes every hour can help evaluate the neuromuscular irritability, the risk of eclampsia, and the effect of magnesium sulfate.

A. "It promotes fetal lung maturity." B. "It halts cervical dilation." C. "It increases the fetal heart rate." D. "It is used to stop preterm labor contractions."

Correct Answer is A

Explanation

Choice A reason: This statement is correct, as betamethasone is a corticosteroid that is given to pregnant women who are at risk of delivering before 34 weeks of gestation. Betamethasone stimulates the production of surfactant, which is a substance that prevents the alveoli from collapsing and improves the lung function of the fetus.

Choice B reason: This statement is incorrect, as betamethasone does not affect the cervical dilation, which is a sign of labor progression. Betamethasone does not stop or delay labor, but rather reduces the complications of prematurity, such as respiratory distress syndrome, intraventricular hemorrhage, or necrotizing enterocolitis.

Choice C reason: This statement is incorrect, as betamethasone does not increase the fetal heart rate, which is a measure of fetal well-being. Betamethasone may cause transient fetal bradycardia, which is a decrease in the fetal heart rate, due to the increased vagal tone and blood pressure. The nurse should monitor the fetal heart rate and notify the provider if there are any signs of fetal distress.

Choice D reason: This statement is incorrect, as betamethasone is not used to stop preterm labor contractions, which are caused by the uterine muscle activity. Betamethasone does not have any tocolytic effect, which is the ability to inhibit uterine contractions. Other medications, such as magnesium sulfate, nifedipine, or indomethacin, may be used to stop preterm labor contractions.

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Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who has severe preeclampsia at 35 weeks of gestation and is reviewing the provider's orders. Which of the following orders requires clarification?

Correct Answer is B

Explanation

A nurse is admitting a client who is at 30 weeks of gestation and is in preterm labor. The client has a new order for betamethasone and asks the nurse about the purpose of this medication. The nurse should provide which of the following explanations?

Correct Answer is A

Explanation

A nurse is admitting a client who is at 37 weeks of gestation and has severe gestational hypertension. Which of the following actions should the nurse expect to implement? (Select all that apply.)

A nurse is assessing a newborn who has developmental dysplasia of the hip (DDH). Which of the following findings should the nurse expect?

A nurse in the antepartum unit is caring for a client who is at 36 weeks of gestation and has pregnancy-induced hypertension. Suddenly, the client reports continuous abdominal pain and vaginal bleeding. The nurse should suspect which of the following complications?

A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first?

A nurse is planning care for a preterm newborn. Which of the following nursing interventions to promote development should be included in the plan of care?

A nurse in a clinic is assessing a client who is at 8 weeks of gestation and has been diagnosed with hyperemesis gravidarum. Which of the following is not a risk factor for hyperemesis gravidarum?

Which assessments are included in the fetal biophysical profile (BPP)? (Select all that apply.)