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Client at 33 weeks of gestation with preeclampsia.
A nurse is reviewing a laboratory report for a client who is at 33 weeks of gestation and has preeclampsia. Which of the following laboratory results should the nurse expect?
- A. BUN level of 30 mg/dL (normal range: 10 to 20 mg/dL).
- B. Hemoglobin level of 9.9 g/dL (normal range: 11 to 16 g/dL).
- C. Serum uric acid level of 2.5 mg/dL (normal range: 2.7 to 7.3 mg/dL).
- D. Casual blood glucose level of 228 mg/dL (normal range: less than 200 mg/dL).
Correct Answer: A
Rationale: A BUN level of 30 mg/dL is above the normal range of 10 to 20 mg/dL. Elevated BUN is consistent with renal involvement in preeclampsia, which is caused by vascular constriction and reduced renal perfusion.
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Client experiencing preterm labor with a new prescription for terbutaline.
A nurse is caring for a client who is experiencing preterm labor and has a new prescription for terbutaline. Which of the following findings is a contraindication for administration of this medication?
- A. Heart disease.
- B. Cervical dilation of 2 cm.
- C. Gestational age of 34 weeks.
- D. Allergy to penicillin.
Correct Answer: A
Rationale: Terbutaline is contraindicated in heart disease because it can cause tachycardia and arrhythmias, worsening cardiac conditions. Cardiovascular side effects result from its beta-adrenergic agonist action.
Client at 35 weeks of gestation experiencing mild vaginal bleeding due to placenta previa.
A nurse is admitting a client who is at 35 weeks of gestation and is experiencing mild vaginal bleeding due to placenta previa. Which of the following actions should the nurse plan to take?
- A. Initiate continuous monitoring of the FHR.
- B. Administer a dose of betamethasone.
- C. Check the cervix for dilation every 8 hr.
- D. Request that the provider prescribe misoprostol PRN.
Correct Answer: A,B
Rationale: Continuous monitoring of fetal heart rate (A) provides early detection of distress in placenta previa cases. Betamethasone (B) accelerates fetal lung maturity, reducing the risk of respiratory distress syndrome if preterm delivery occurs.
Client at 29 weeks of gestation with phenylketonuria.
A nurse is providing dietary teaching to a client who is at 29 weeks of gestation and has phenylketonuria. Which of the following food suggestions should the nurse include?
- A. Peanut butter sandwich.
- B. Sliced apples.
- C. Glass of skim milk.
- D. Scrambled egg.
Correct Answer: B
Rationale: Apples are low in phenylalanine, making them a safe option for individuals with phenylketonuria. They provide essential nutrients without contributing to phenylalanine accumulation.
Parents of a newborn with an uncircumcised penis.
A nurse is teaching the parents of a newborn how to care for their child's uncircumcised penis. Which of the following instructions should the nurse include?
- A. Retract the foreskin until you feel resistance.
- B. Use a cotton swab to clean under the foreskin.
- C. Apply petroleum jelly to the foreskin.
- D. Wash the penis once per day with soap and water.
Correct Answer: D
Rationale: Daily washing with mild soap and water ensures proper hygiene and prevents infection. This method maintains cleanliness without causing harm to sensitive tissues.
Newborn born vaginally with vacuum extractor assistance, swelling over the newborn's head that crosses the suture line.
A nurse is assessing a newborn who was born vaginally with vacuum extractor assistance. The nurse notes swelling over the newborn's head that crosses the suture line. The nurse should identify the swelling as which of the following findings?
- A. Nevus flammeus.
- B. Caput succedaneum.
- C. Cephalohematoma.
- D. Erythema toxicum.
Correct Answer: B
Rationale: Caput succedaneum involves swelling of the scalp caused by pressure during delivery, often crossing suture lines due to subcutaneous fluid accumulation, a hallmark distinguishing it from other neonatal head conditions.