Which of the following gravid clients is most appropriate for a charge nurse to assign to a new nurse with no obstetric (OB) experience?

32-week patient with preeclampsia receiving magnesium sulfate

9-week client with hyperemesis receiving IV therapy

34-week client with no fetal heartbeat

38-week client with complete previa

Answer and Explanation

The Correct Answer is B

A. 32-week patient with preeclampsia receiving magnesium sulfate – Magnesium sulfate requires close monitoring for toxicity (e.g., respiratory depression, loss of deep tendon reflexes), making this client inappropriate for a nurse with no OB experience.

B. 9-week client with hyperemesis receiving IV therapy – This client is the most stable and requires routine care, such as IV fluid administration and antiemetics, making them the best assignment for a new nurse without OB experience.

C. 34-week client with no fetal heartbeat – This client requires significant emotional support and possibly induction of labor, making them inappropriate for a nurse unfamiliar with OB care.

D. 38-week client with complete previa – Placenta previa poses a high risk for hemorrhage, and this client requires close monitoring. A new nurse without OB experience would not be the best choice for this assignment.

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Correct Answer is ["B","C","D"]

Explanation

A. Unexplained weight gain
This is incorrect because weight gain is not a characteristic symptom of endometriosis. Endometriosis primarily affects the reproductive organs and is associated with pain and infertility rather than metabolic or weight-related changes.

B. Pain during menstrual period
This is correct because dysmenorrhea (painful menstruation) is a hallmark symptom of endometriosis due to the presence of ectopic endometrial tissue responding to hormonal changes.

C. Pain during intercourse
This is correct because dyspareunia (pain during intercourse) is a common symptom of endometriosis due to the inflammatory and fibrotic changes caused by ectopic endometrial tissue.

D. Infertility
This is correct because endometriosis can lead to infertility due to scarring, adhesions, and inflammation affecting the fallopian tubes and ovaries. Many clients with endometriosis seek medical attention due to difficulty conceiving.

A. Liver function tests B. Blood pressure C. Heartburn D. Headache E. Gestational age F. Cardiac assessment

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

Explanation

Priority concerns:

Liver function tests: The client has elevated ALT (75 U/L), AST (78 U/L), alkaline phosphatase (184 U/L), and LDH (250 U/L), which are consistent with liver involvement in preeclampsia with severe features. This suggests hepatic dysfunction and possible progression to HELLP syndrome.

Blood pressure: The client’s BP is 168/100 mmHg, which meets the criteria for severe preeclampsia (≥160/110 mmHg). Uncontrolled hypertension increases the risk of stroke, placental abruption, and progression to eclampsia.

Headache: The persistent headache could indicate severe preeclampsia with neurological involvement due to cerebral vasospasm and increased risk of stroke or seizure. A headache that does not resolve with usual measures is a warning sign, and magnesium sulfate should be considered for seizure prophylaxis.

Not a Priority Concern

Heartburn is a common symptom in pregnancy due to gastric reflux and increased progesterone levels, which relax the lower esophageal sphincter. While it can be uncomfortable, it is not immediately life-threatening.

Gestational age: The client is at 37 weeks’ gestation, which is considered early term but not preterm. While gestational age is important for delivery planning, it is not the most immediate concern compared to the client’s hypertensive crisis.

Cardiac assessment: The apical pulse is 77 bpm, regular, and lungs are clear, indicating that there is no immediate cardiac or respiratory compromise.

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Which of the following gravid clients is most appropriate for a charge nurse to assign to a new nurse with no obstetric (OB) experience?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which assessment findings might raise the nurse's suspicion of endometriosis in the client they are evaluating?

Correct Answer is ["B","C","D"]

Explanation

G1P1, 37 weeks' gestation patient with a scheduled nonstress test (NST) Identify which of the following findings is a priority concern or not for the patient.

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

Explanation

A nurse is monitoring a client who is receiving magnesium sulfate for severe preeclampsia. The client asks, "How will I know if the medication is working?" Which response by the nurse is most appropriate?

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A 56-year-old menopausal woman reports to the registered nurse that she has been experiencing vaginal itching, burning, and an increase in vaginal infections over the past 3 years. What important factor should the nurse consider before responding to the client's concerns?

A nurse is reviewing the different signs of pregnancy with a client who is in her first trimester. Which of the following symptoms should the nurse classify as a positive sign of pregnancy?

While caring for a client in labor, which assessment finding best indicates fetal well-being to the nurse?

A male client reports to the nurse that he took sildenafil for erectile dysfunction but did not achieve an erection. Which of the following considerations should the nurse evaluate to determine possible reasons for the lack of response?

Exhibits Select a condition, the assessment cues, and anticipated solutions for this client.