A nurse is assessing a client for pre-term labor.
Which assessment finding would be most concerning and require immediate intervention?
Infection on speculum examination
Bleeding on speculum examination
Positive fetal fibronectin test (FFN)
Normal fetal heart rate and activity
The Correct Answer is A
Infection on speculum examination.
Infection is a major cause of preterm labor and can lead to serious complications for the mother and the fetus.
Infection can be detected by a speculum examination that shows signs of inflammation, such as erythema, edema, discharge, or odor.
Infection can also be confirmed by laboratory tests, such as culture, gram stain, or polymerase chain reaction. Infection should be treated promptly with antibiotics and other supportive measures.
Choice B. Bleeding on speculum examination is wrong because bleeding is not a direct cause of preterm labor, but rather a sign of other conditions that may increase the risk of preterm labor, such as placenta previa, placental abruption, or cervical trauma. Bleeding should be evaluated further to determine the source and severity of the hemorrhage and to manage any complications.
Choice C. Positive fetal fibronectin test (FFN) is wrong because a positive FFN test indicates the presence of fetal fibronectin in the cervical or vaginal secretions, which is a marker of increased risk of preterm labor, but not a definitive marker.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
All of the above.
Respiratory distress syndrome (RDS) is a condition that affects preterm newborns who have immature lungs and lack sufficient surfactant.
Surfactant is a substance that helps keep the alveoli open and prevents them from collapsing.
Without enough surfactant, the newborn has difficulty breathing and may develop hypoxia and acidosis.
Choice A is wrong because tachypnea and grunting are signs of respiratory distress, but they are not specific to RDS.
They can also be caused by other conditions such as transient tachypnea of the newborn, pneumonia, or congenital heart defects.
Choice B is wrong because bradycardia and cyanosis are also signs of respiratory distress, but they are not specific to RDS.
They can also be caused by other conditions such as hypothermia, hypoglycemia, or sepsis.
Choice C is wrong because apnea and nasal flaring are also signs of respiratory distress, but they are not specific to RDS.
They can also be caused by other conditions such as intracranial ...
Correct Answer is D
Explanation
Terbutaline can cause low potassium levels in the blood, which can lead to muscle weakness, cramps, and cardiac arrhythmias.
This is a potential adverse effect of the medication that should be reported to the provider.
Choice A is wrong because tachycardia is a common side effect of terbutaline that does not usually require medical attention.
Terbutaline works by stimulating beta-adrenergic receptors, which can increase the heart rate.
Choice B is wrong because hypotension is not a typical side effect of terbutaline.Terbutaline can actually cause elevated blood pressure in some cases.
Choice C is wrong because hyperglycemia is not a common side effect of terbutaline.Terbutaline can cause transient hyperglycemia in pregnant women, but this is not a reason to stop the medication.
Normal ranges for potassium are 3.5-5.0 mEq/L and for blood glucose are 70-110 mg/dL.
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