A nurse is assessing a client who is at 37 weeks of gestation and reports sudden, severe abdominal pain with moderate vaginal bleeding and persistent uterine contractions. The client's blood pressure is 88/50 mm Hg and her abdomen is rigid. The nurse should identify these findings as Indicating which of the following complications?

Placental abruption

Amniotic fluid embolus

Placenta previa

Uterine rupture

Answer and Explanation

The Correct Answer is A

A. Placental abruption – This is the correct answer because placental abruption occurs when the placenta detaches prematurely from the uterine wall, leading to severe abdominal pain, vaginal bleeding, uterine rigidity, and signs of hypovolemic shock (low blood pressure). The hallmark sign is a painful, rigid abdomen with contractions.

B. Amniotic fluid embolus – This condition presents with sudden respiratory distress, hypotension, and disseminated intravascular coagulation (DIC), but it does not typically cause uterine rigidity or persistent contractions.

C. Placenta previa – Placenta previa typically presents with painless vaginal bleeding rather than severe abdominal pain and a rigid uterus.

D. Uterine rupture – Uterine rupture is usually associated with a history of uterine surgery (e.g., previous cesarean section). It presents with sudden, severe pain followed by cessation of contractions, not persistent contractions.

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Correct Answer is A

Explanation

A. Muscle twitching – Hypocalcemia (normal range: 8.5–10.5 mg/dL) causes neuromuscular excitability, leading to muscle twitching, tetany, and positive Chvostek's and Trousseau's signs.

B. Hypertension – Hypocalcemia does not cause hypertension; instead, it may lead to hypotension.

C. Bounding pulse – Hypocalcemia does not cause a bounding pulse; it may cause weak and irregular pulses.

D. Hypoactive bowel sounds – Hypocalcemia is more likely to cause hyperactive bowel sounds and diarrhea rather than hypoactive bowel sounds.

A. Switch to a lactose-free formula. B. Reposition the NG tube. C. Increase the rate of formula delivery. D. Add water to the formula.

Correct Answer is D

Explanation

A. Switch to a lactose-free formula – A lactose-free formula is necessary for clients with lactose intolerance but does not address the issue of hyperosmolar dehydration, which results from insufficient free water intake rather than intolerance to lactose.

B. Reposition the NG tube – Repositioning the tube is necessary if there is displacement, but it does not treat dehydration caused by hyperosmolar feedings.

C. Increase the rate of formula delivery – Increasing the rate can worsen dehydration by further increasing the solute load, leading to a greater fluid shift from intracellular to extracellular spaces.

D. Add water to the formula – This is the correct answer because hyperosmolar dehydration occurs when high-solute enteral formulas pull water into the intestines, leading to excessive fluid loss. To prevent this, the nurse should ensure the client receives adequate free water flushes alongside tube feedings.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory results of a client who has hypothyroidism. The client's calcium level is 7.6 mg/dL. When assessing the client, which of the following findings should the nurse expect?

Correct Answer is A

Explanation

A nurse is assessing a client who is receiving enteral feedings via an NG tube. The client has developed hyperosmolar dehydration. Which of the following actions should the nurse take when administering the client's feedings?

Correct Answer is D

Explanation

A nurse is admitting a school-age child who has bacterial meningitis. Which of the following types of precautions should the nurse initiate?

A nurse in a provider's office is talking with an older adult client who tells the nurse that he fears he is "aging badly" and feels "so useless." Which of the following assessment questions is the nurse's priority?

A nurse is caring for a client who has Crohn's disease. The nurse calculates that the client's BMI is 17.2. The nurse should document the client's weight status as being within which of the following categories?

A nurse is planning care for a client prior to an amniocentesis. Which of the following actions should the nurse include in the plan of care?

A nurse is caring for a client who is taking disulfiram for alcohol use disorder and reports ingestion of alcohol. For which of the following adverse effects should the nurse monitor?

A charge nurse is observing an assistive personnel perform delegated tasks. Which of the following actions by the AP requires the charge nurse to intervene?

A nurse is planning care for a client who is undergoing brachytherapy with a low-dose radiation implant. Which of the following interventions should the nurse add to the client's plan of care?

A nurse is caring for a client following an involuntary admission to an acute mental health facility. The client states, "I'm afraid they will give me drugs that put me to sleep." Which of the following statements should the nurse make?