The nurse is assessing a gravid client. Which finding is of greatest concern in planning care for this client?

A decrease in urine production.

2% decrease in hematocrit.

Sensitive, bleeding gums.

Glycosuria at one prenatal exam.

Answer and Explanation

The Correct Answer is A

A. A decrease in urine production: A decrease in urine output may indicate renal impairment or dehydration, which can be serious during pregnancy. It could also suggest preeclampsia or other complications that require immediate attention and monitoring.
B. 2% decrease in hematocrit: A slight decrease in hematocrit (within the normal range for pregnancy) is often expected due to the increase in plasma volume during pregnancy. While anemia should be monitored, a 2% decrease is typically not of immediate concern.
C. Sensitive, bleeding gums: Sensitive and bleeding gums can be a common pregnancy-related condition due to hormonal changes. While it is bothersome, it is not usually a serious concern and typically resolves after pregnancy.
D. Glycosuria at one prenatal exam: Glycosuria can occur in pregnancy but is not necessarily a sign of gestational diabetes, especially if it is found only in one prenatal exam. Further testing would be needed to evaluate for gestational diabetes, but it is not an immediate cause for concern.

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Correct Answer is B

Explanation

A. Provide guidance to identify triggering behaviors: While identifying triggering behaviors can be helpful for future prevention, the immediate priority is ensuring the client’s safety. This is effectively achieved through a rapid exit plan, especially in cases of repeated assaults.

B. Develop a plan for initiating a rapid exit: The highest priority is ensuring the client's safety. A rapid exit plan, which involves knowing how to leave the abusive situation quickly and safely, is essential for protecting the client from immediate harm and planning for their long-term safety.

C. Advise couple's counseling as the next step: While counseling may be useful later, it is not appropriate to suggest it immediately after an assault. The client’s safety is the priority, and counseling should not be recommended until the client is in a safe environment.

D. Complete a Patient Health Questionnaire-9 (PHQ9): The PHQ9 is useful for assessing depression, but the immediate priority is addressing the client's safety and planning for protection, which should come before assessing for mental health concerns.

A. Notify the healthcare provider. B. Instruct the client to use deep breathing during a contraction. C. Discontinue the oxytocin infusion. D. Medicate the client with an additional 1 mg of butorphanol tartrate IV push.

Correct Answer is B

Explanation

A. Notify the healthcare provider: There's no immediate need to notify the healthcare provider as the client is still in early labor, and pain relief can be managed with non-pharmacological methods.

B. Instruct the client to use deep breathing during a contraction: Non-pharmacological techniques, like deep breathing, should be used first to manage pain, allowing time for the medication effects to take place.

C. Discontinue the oxytocin infusion: The oxytocin infusion is still appropriate as labor is progressing, and there are no signs of complications.

D. Medicate the client with an additional 1 mg of butorphanol tartrate IV push: The client has already been medicated recently, so additional doses could lead to excessive sedation. Waiting for current medication effects is safer.

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The nurse is assessing a gravid client. Which finding is of greatest concern in planning care for this client?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client in the emergency department (ED) after an assault by the spouse. The client has a history of similar emergency visits. Which action best assists the client?

Correct Answer is B

Explanation

Correct Answer is B

Explanation

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