A client who is primigravida at term comes to the prenatal clinic and tells the practical nurse (PN) that she is having contractions every 5 minutes. The PN monitors the client for one hour using an external fetal monitor, and determines that the client's contractions are 7 to 15 minutes apart, lasting 20 to 30 seconds, with mild intensity by palpation. Which action should the PN take?

Tell the client to go directly to the hospital for admission to labor and delivery for active labor.

Send the client home and instruct her to call the clinic when her contractions occur 5 minutes apart for one hour.

Direct the client to check into the hospital within the next hour for evaluation of possible urinary tract infection.

Send the client home and tell her to drink at least 1,000 mL of fluid each day to flush her bladder.

Answer and Explanation

The Correct Answer is B

A. The client's contractions are not regular or intense enough to indicate active labor, so immediate hospital admission is not necessary.
B. Instructing the client to call the clinic when her contractions occur 5 minutes apart for one hour ensures she is monitored for the progression of labor and can seek timely assistance when labor becomes more active.
C. While a urinary tract infection could cause contractions, the primary focus should be on monitoring labor progression, not diagnosing a UTI at this stage.
D. Hydration is important, but the primary instruction should relate to monitoring contraction patterns for signs of active labor.

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Free Nursing Study Resources

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

Explanation

Coarse breath sounds are typically associated with respiratory distress, indicating fluid or secretions in the airways.

Irritability can be a sign of both cerebral edema and respiratory distress as it may stem from hypoxia or increased intracranial pressure.

Seizure activity is more specifically related to cerebral edema, which can increase intracranial pressure and provoke seizures.

Decreased level of consciousness can occur in both conditions: cerebral edema (due to increased intracranial pressure) and respiratory distress (due to hypoxia).

Bradycardia is more indicative of cerebral edema, especially when associated with increased intracranial pressure and resultant autonomic dysregulation.

A. 50% dextrose B. 0.45% sodium chloride C. 20% dextrose D. 5% dextrose E. 5% dextrose with 0.45% sodium chloride F. 5% dextrose with lactated Ringer's G. lactated Ringer's H. 0.9% sodium chloride

Correct Answer is ["G","H"]

Explanation

A. 50% dextrose
50% dextrose is not isotonic; it is a hypertonic solution. Hypertonic solutions have a higher concentration of solutes compared to the cells, causing water to move out of the cells and into the extracellular space, which does not treat fluid volume deficit effectively.
B. 0.45% sodium chloride
0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution. Hypotonic solutions have a lower concentration of solutes compared to the cells, which would cause water to move into the cells rather than stay in the extracellular space to address fluid volume deficit.
C. 20% dextrose
20% dextrose is a hypertonic solution. It contains a higher concentration of dextrose compared to the extracellular fluid, which draws water into the extracellular space but is not used for treating fluid volume deficits.
D. 5% dextrose
5% dextrose (D5W) is initially isotonic but becomes hypotonic once metabolized, as the dextrose is used up and only water remains. It is not suitable for continuous isotonic fluid therapy for fluid volume deficit.
E. 5% dextrose with 0.45% sodium chloride
5% dextrose with 0.45% sodium chloride is a hypertonic solution. While it starts isotonic, it becomes hypotonic once the dextrose is metabolized, making it unsuitable for long-term isotonic fluid replacement.
F. 5% dextrose with lactated Ringer's
5% dextrose with lactated Ringer's is a hypertonic solution. It contains both dextrose and electrolytes, which are not purely isotonic and may not be ideal for addressing fluid volume deficits on their own.
G. Lactated Ringer's
Lactated Ringer's is an isotonic solution. It has a similar osmolarity to plasma and is used for fluid volume replacement, helping to restore blood volume and maintain electrolyte balance.
H. 0.9% sodium chloride
0.9% sodium chloride, or normal saline, is an isotonic solution. It has the same osmolarity as plasma and is commonly used for fluid volume replacement and maintaining hydration

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Naxlex Comprehensive Predictor Exams

Exhibits Click to mark whether the following are signs and symptoms of cerebral edema, respiratory distress, or both.

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

Explanation

Exhibits The practical nurse (PN) notifies the healthcare provider that the client continues to have signs of fluid volume deficit. The health care provider prescribes a continuous infusion of isotonic fluids. Which fluid(s) is/are classified as isotonic? Select all that apply.

Correct Answer is ["G","H"]

Explanation

Which location should the practical nurse (PN) palpate to determine if a client's submandibular lymph nodes are enlarged?

Before administering zolpidem at bedtime, which client assessment should the practical nurse (PN) complete?

The parents of a child with pre-diabetes report to the practical nurse (PN) that the child wants to join a soccer team. Which action is best for the PN to implement?

Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the practical nurse (PN) should take to address that condition, and two parameters the PN should monitor to assess the client's progress.

Which assessment finding indicates to the practical nurse that a Venturi face mask is producing the desired effect?

Exhibits The practical nurse (PN) re-educates the client on methicillin-resistant Staphylococcus aureus (MRSA). Click to indicate whether the client's statement(s) indicate understanding or no understanding. Each row must have one option selected.

As seen in the picture, the practical nurse (PN) begins to remove a pair of sterile gloves after changing a client's dressing. Which action should the PN take next?

The practical nurse (PN) is preparing to transfer an unresponsive client from the bed to a stretcher. Which client data is most important for the PN to obtain before beginning the transfer?