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The nurse is caring for a client seven hours postoperative following a subtotal thyroidectomy. The client reports peripheral numbness and tingling, muscle twitching, and spasms. The nurse anticipates a prescription for
- A. levothyroxine
- B. hydrocortisone
- C. thiamine
- D. calcium gluconate
Correct Answer: D
Rationale: These symptoms suggest hypocalcemia, a common complication post-thyroidectomy due to parathyroid gland disruption. Calcium gluconate is the appropriate treatment.
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The nurse is caring for a client with suspected placenta previa. The nurse anticipates an order for which diagnostic test to confirm this finding?
- A. Manual cervical exam
- B. Transvaginal ultrasound
- C. Contraction stress test
- D. Nonstress test
Correct Answer: B
Rationale: Transvaginal ultrasound is the safest and most accurate method to confirm placenta previa, avoiding risky manual exams.
The nurse is demonstrating the appropriate use of a car seat to a client. The nurse is demonstrating which level of prevention?
- A. Primary
- B. Secondary
- C. Tertiary
- D. Quaternary
Correct Answer: A
Rationale: Car seat education prevents injury, a primary prevention strategy.
The following scenario applies to the next 1 items
The nurse in the obstetrics department is caring for a 29-year-old primigravida client.
Item 1 of 1
History and Physical
2300: Client is a primigravida at 33 weeks gestation, who awoke to moderate bright red vaginal bleeding. She reports noticing light spotting earlier in the day, which she dismissed as benign. She denies abdominal pain, cramping, or contractions. Her pregnancy has been uncomplicated until recently. She reports increased fetal movement over the last 48 hours. One week ago, she presented to the ED with fever, fatigue, and body aches, and was diagnosed with influenza A. She was treated supportively and discharged home with hydration instructions. Over the past 24 hours, she has experienced nasal congestion and fatigue.
Four days ago, a transabdominal ultrasound showed:
• Fetus in cephalic position
• Normal amniotic fluid volume
Exam findings
• Abdomen: Soft, non-tender
• No uterine contractions noted on palpation
• Moderate amount of dried bright red blood was seen on the undergarments
• 1+ pedal edema
• Peripheral pulses 2+
•
Diagnostics
2342: Fetal Heart Rate (FHR): 144 bpm, moderate variability, no decelerations
Vital Signs
• Temperature: 99.5°F (37.5°C)
• HR 88 bpm
• BP 137/78 mmHg
• RR 18/min
• Pulse oximetry 98% on room air
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, two (2) actions the nurse should take to address that condition, and two (2) parameters the nurse should monitor to assess the client's progress.
- A. Request a prescription for indomethacin, Prepare the client for a transvaginal ultrasound, Place the client in the lithotomy position for a manual cervical exam, Establish a peripheral vascular access device, Place the client in a room with monitored negative airflow
- B. Placental abruption, Preeclampsia, Placenta previa, Influenza recurrence
- C. Fetal heart rate pattern, Pedal edema, Amount and color of vaginal bleeding, Temperature, Nasal congestion and fatigue level
Correct Answer: C (placenta previa), A (prepare for transvaginal ultrasound, establish peripheral vascular access device), C (fetal heart rate pattern, amount and color of vaginal bleeding)
Rationale: Moderate bright red vaginal bleeding without pain at 33 weeks suggests placenta previa. Transvaginal ultrasound confirms the diagnosis, peripheral access prepares for potential intervention, and monitoring fetal heart rate and bleeding assesses progress.
The nurse is caring for a child immediately following a nephrectomy in the postanesthesia care unit (PACU). Which assessment should the nurse initially perform?
- A. pain level
- B. peripheral vascular access device
- C. surgical incision
- D. vital signs
Correct Answer: D
Rationale: Vital signs are the initial priority in the PACU to assess stability post-nephrectomy.
The nurse is teaching a group of students about incident reports. Which of the following statements made by the student would require further teaching?
- A. Reporting can only be completed if it is within one hour after the event.
- B. Witnesses to an incident should be mentioned in the report.
- C. A client eloping does not require an incident report.
- D. A slip and fall by a client should be reported.
- E. Incidents involving visitors do not have to be reported.
Correct Answer: A, C, E
Rationale: Incident reports can be filed anytime, elopement requires reporting, and visitor incidents should be reported.