A nurse in a provider's office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption?
Cigarette smoking
Hypertension
Blunt force trauma
Cocaine use
The Correct Answer is B
Choice A rationale
This is incorrect because cigarette smoking is not the most common risk factor for abruption. Cigarette smoking can increase the risk of abruption by causing vasoconstriction and reducing placental blood flow, but it is less prevalent and less severe than hypertension.
Choice B rationale
This is correct because hypertension is the most common risk factor for abruption. Hypertension can cause damage to the uterine vessels and lead to bleeding and separation of the placenta from the uterine wall. Hypertension affects about 40% of clients who experience abruption and can be chronic or pregnancy-induced.
Choice C rationale
This is incorrect because blunt force trauma is not the most common risk factor for abruption. Blunt force trauma can cause abruption by applying direct pressure or shear force to the placenta, but it is less common and less predictable than hypertension. Blunt force trauma can result from motor vehicle accidents, falls, or physical abuse.
Choice D rationale
This is incorrect because cocaine use is not the most common risk factor for abruption. Cocaine use can increase the risk of abruption by causing vasoconstriction and uterine contractions, but it is less common and less consistent than hypertension. Cocaine use can also cause other complications, such as fetal growth restriction, preterm labor, or stillbirth.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
This is incorrect because respirations 16/min are within the normal range and do not indicate magnesium toxicity. The nurse should monitor the client's respiratory rate and report any signs of respiratory depression, such as less than 12/min.
Choice B rationale
This is incorrect because fetal heart rate 158/min is within the normal range and does not indicate fetal distress. The nurse should monitor the fetal heart rate and report any signs of bradycardia, tachycardia, or decreased variability.
Choice C rationale
This is incorrect because headache for 30 min is a common symptom of pre-eclampsia and does not indicate magnesium toxicity. The nurse should administer analgesics as prescribed and report any signs of increased intracranial pressure, such as blurred vision, confusion, or seizures.
Choice D rationale
This is correct because urinary output 40 mL in 2 hr is below the expected amount and indicates renal impairment. The nurse should report this finding to the provider and monitor the client's fluid intake and output, serum creatinine, and blood urea nitrogen levels. The nurse should also assess the client for signs of fluid overload, such as edema, crackles, or dyspnea.
Correct Answer is B
Explanation
Choice A rationale
Gestational hypertension is not the most likely diagnosis for the client. Gestational hypertension is a condition where the blood pressure is elevated after 20 weeks of gestation, without any signs of proteinuria or end-organ damage. The client has a history of chronic hypertension for 5 years, which means that the hypertension existed before the pregnancy. The client also has proteinuria, which is a sign of preeclampsia.
Choice B rationale
Chronic hypertension with superimposed preeclampsia is the most likely diagnosis for the client. Chronic hypertension with superimposed preeclampsia is a condition where the blood pressure is elevated before 20 weeks of gestation, and the hypertension worsens or the proteinuria develops or increases after 20 weeks of gestation. The client has a history of chronic hypertension for 5 years, and the blood pressure is very high at 34 weeks of gestation. The client also has 3+ proteinuria, which indicates severe preeclampsia.
Choice C rationale
Eclampsia is not the most likely diagnosis for the client. Eclampsia is a condition where the preeclampsia progresses to cause seizures or coma in the pregnant woman. The client has no signs of seizures or coma, but only signs of preeclampsia.
Choice D rationale
HELLP syndrome is not the most likely diagnosis for the client. HELLP syndrome is a condition where the preeclampsia causes hemolysis, elevated liver enzymes, and low platelets in the pregnant woman. The client has no signs of hemolysis, liver damage, or thrombocytopenia, but only signs of preeclampsia.
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