Nokea
Which of the following conditions is the client most likely developing?
- A. Pelvic inflammatory.
- B. Ectopic pregnancy.
- C. Pyclonephritis.
- D. C-reactive protein.
- E. Beta hCG.
- F. Urinalysis.
Correct Answer: A
Rationale: [1, 0, 0, 0, 0, 0]
The correct answer is A: Pelvic inflammatory. Pelvic inflammatory disease is an infection of the female reproductive organs, often caused by sexually transmitted infections. It presents with symptoms like pelvic pain, abnormal vaginal discharge, and fever. Ectopic pregnancy (B) is the implantation of a fertilized egg outside the uterus and presents with abdominal pain and vaginal bleeding. Pyelonephritis (C) is a kidney infection, typically causing fever and flank pain. C-reactive protein (D) is a marker for inflammation and infection, not a specific condition. Beta hCG (E) is a hormone produced in pregnancy. Urinalysis (F) is a test to analyze urine composition, not a condition.
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A nurse is planning care for a client who is in labor and is requesting epidural anesthesia for pain control. Which of the following actions should the nurse include in the plan of care?
- A. Place the client in a supine position for 30 min following the first dose of anesthetic solution.
- B. Administer 1,000 mL of dextrose 5% in water prior to the first dose of anesthetic solution.
- C. Monitor the client's blood pressure every 5 min following the first dose of anesthetic solution.
- D. Ensure the client has been NPO 4 hr prior to the placement of the epidural and the first dose of anesthetic solution.
Correct Answer: C
Rationale: Correct Answer: C - Monitor the client's blood pressure every 5 min following the first dose of anesthetic solution.
Rationale: Continuous monitoring of blood pressure is crucial after administering epidural anesthesia to detect any potential hypotension, a common side effect. This frequent monitoring allows for prompt intervention if hypotension occurs, ensuring the client's safety. It is essential to closely monitor the client's vital signs, particularly blood pressure, to prevent complications such as decreased placental perfusion and fetal distress.
Summary:
A: Placing the client in a supine position for 30 min following the first dose of anesthetic solution is not recommended as it can lead to aortocaval compression and compromise blood flow to the fetus.
B: Administering dextrose 5% in water prior to the first dose of anesthetic solution is not necessary for epidural anesthesia.
D: Ensuring the client has been NPO 4 hr prior to the placement of the epidural is
A nurse is caring for a client who is at 10 weeks of gestation. Which of the following findings should the nurse report to the provider?
- A. Frequent vomiting with weight loss of 3 lb in 1 week.
- B. Reports of mood swings.
- C. Nosebleeds occurring approximately 3 times per week.
- D. Increased vaginal discharge.
Correct Answer: A
Rationale: The correct answer is A. Frequent vomiting with weight loss of 3 lb in 1 week can indicate hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy that can lead to dehydration and electrolyte imbalances. This finding is concerning and requires immediate medical attention to prevent complications. Reporting this to the provider allows for timely intervention.
Other choices are incorrect:
B: Reports of mood swings are common during pregnancy due to hormonal changes and are not typically a cause for immediate concern.
C: Nosebleeds occurring approximately 3 times per week can be due to increased blood flow during pregnancy and are usually not a significant concern unless severe or persistent.
D: Increased vaginal discharge is a common symptom in early pregnancy due to hormonal changes and increased blood flow to the pelvic area. It is not typically an urgent issue unless accompanied by other symptoms like itching or foul odor.
A nurse is assessing a newborn 12 hr after birth. Which of the following manifestations should the nurse report to the provider?
- A. Acrocyanosis.
- B. Transient strabismus.
- C. Jaundice.
- D. Caput succedaneum.
Correct Answer: C
Rationale: The correct answer is C: Jaundice. Jaundice in a newborn within the first 24 hours can indicate pathological conditions like hemolytic disease or liver dysfunction, requiring immediate attention. Acrocyanosis (A) and caput succedaneum (D) are common benign conditions in newborns. Transient strabismus (B) is a temporary eye misalignment that often resolves on its own. Other choices are not provided.
complete the following sentence by using the lists of options. The client is at highest risk for developing ---evidenced by the client's ---
- A. Endometritis.
- B. Mastitis.
- C. Postpartum hemorrhage.
- D. Group B streptococcus positive status.
- E. Spontaneous vaginal delivery.
- F. Median episiotomy.
Correct Answer: A
Rationale: Correct Answer: A
Rationale:
1. Endometritis is an infection of the uterine lining, commonly occurring post-delivery.
2. The client's risk for endometritis increases due to factors like prolonged labor, multiple vaginal exams, and retained placental fragments.
3. The client's condition or symptoms may include fever, uterine tenderness, foul-smelling lochia.
4. The other options (B-F) are not directly related to the highest risk for developing endometritis post-delivery.
A nurse in an antepartum clinic is providing weeks of gestation. Upon reviewing the following findings should the nurse report to the provider? (Click on the 'Exhibit' button for additional information about the client. There are three tabs that contain separate categories of data.)
- A. 1-hr glucose tolerance test
- B. Hematocrit
- C. Fundal height measurement
- D. Fetal heart rate (FHR)
Correct Answer: D
Rationale: The correct answer is D: Fetal heart rate (FHR). The nurse should report any abnormal findings related to fetal well-being to the provider. Monitoring the FHR is crucial to assess the baby's status and can indicate potential issues such as fetal distress. In this scenario, if the FHR is abnormal (e.g., too high or too low), it could signal a problem that needs immediate attention.
A: 1-hr glucose tolerance test - This is typically done to screen for gestational diabetes and is not directly related to fetal well-being.
B: Hematocrit - This measures the volume percentage of red blood cells in blood and is more related to maternal health.
C: Fundal height measurement - This assesses fetal growth and position, but abnormal findings may not require immediate provider notification unless significant deviations are noted.
In summary, the other choices are not as time-sensitive or directly indicative of fetal distress as the FHR, making D the correct answer in this context.