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 B

Explanation

A. "I can expect my eyelids to be bruised after this procedure." – Bruising of the eyelids is not a typical postoperative effect of cataract surgery. The procedure is minimally invasive and does not cause significant trauma to surrounding tissues.

B. "I know the provider will replace the lens in my eyes during this procedure." – This is the correct statement. Cataract surgery involves removing the cloudy lens and replacing it with an artificial intraocular lens (IOL) to restore vision.

C. "I will see dark spots in my vision after this procedure." – Visual disturbances such as dark spots or floaters are not expected. Some clients may experience mild blurriness, but this should improve as the eye heals.

D. "I will receive general anesthesia for this procedure." – Cataract surgery is typically performed under local anesthesia with sedation, not general anesthesia. The client remains awake but does not feel pain.

A. Irritability B. Increased head circumference C. Hypotonicity D. Decreased auditory startle response

Correct Answer is A

Explanation

A. Irritability – This is the expected finding. Newborns exposed to cocaine in utero often exhibit irritability, hypertonia, tremors, and a high-pitched cry due to withdrawal symptoms and central nervous system excitability.

B. Increased head circumference – Cocaine use is associated with intrauterine growth restriction (IUGR), leading to smaller head circumferences rather than increased head size.

C. Hypotonicity – Cocaine-exposed newborns typically exhibit hypertonicity (increased muscle tone) rather than hypotonia.

D. Decreased auditory startle response – These newborns usually have an exaggerated Moro (startle) reflex rather than a decreased response.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is preoperative for cataract removal. Which of the following statements by the client indicates an understanding of the procedure?

Correct Answer is B

Explanation

A nurse is performing a physical assessment of a newborn whose mother used cocaine throughout the pregnancy. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

A client on an acute mental health unit states to a nurse. "Tie a bow. Row the boat. Now I know. Whoa! I see you, yo." The nurse should document that the client is exhibiting which of the following speech alterations?

A nurse is assessing a child who is postoperative following a tonsillectomy. Which of the following findings should the nurse identify as the priority?

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?

A nurse is teaching a class of newly licensed nurses about infectious diseases that nurses are required to report to the health department. Which of the following diseases should the nurse include in the teaching?

A nurse is implementing seizure precautions for a newly admitted client. Which of the following equipment should the nurse place in the client's room?

A nurse is teaching a client who has a new prescription for sertraline to treat depression. For which of the following findings should the nurse instruct the client to monitor and report immediately as indicating serotonin syndrome?

A nurse on a medical-surgical unit is accepting a telephone prescription for a client who requires medication for insomnia. Which of the following actions should the nurse take?

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?