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. Vital signs should be monitored every 15 minutes because naloxone has a short duration and the client may experience opioid re-sedation as the antagonist wears off.

B. Naloxone should be administered over 2 minutes, not 15 seconds, to reduce abrupt opioid withdrawal symptoms.

C. Naloxone has a rapid onset (1-2 minutes IV, 2-5 minutes IM).

D. The effects of naloxone last only 30-90 minutes, requiring repeated doses if opioids are still in the system.

A. Emptying an indwelling urinary catheter bag for a client while wearing clean gloves B. Performing a simple dressing change on a client's foot C. Providing postmortem care for a client who has recently died D. Washing hands with alcohol-based hard rub after bathing a client who has Clostridium difficile

Correct Answer is D

Explanation

A. Emptying an indwelling urinary catheter bag with clean gloves is appropriate and does not require intervention.

B. Performing a simple dressing change on a client’s foot is within the AP's scope of practice if the dressing is not complex or sterile.

C. Providing postmortem care is within the AP's role and does not require intervention unless specific contraindications exist.

D. Clostridium difficile (C. diff) spores are resistant to alcohol-based hand rubs. The AP must use soap and water for hand hygiene to effectively remove spores. This is an infection control breach that requires immediate intervention.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer naloxone IV bolus to a client who has opioid use disorder and has developed acute opioid toxicity. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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?

Correct Answer is D

Explanation

A nurse is teaching about leg and foot care to a client who has peripheral vascular disease of the lower extremities. Which of the following instructions should the nurse include?

A nurse is teaching a client who has GERD about appropriate dietary choices. Which of the following food choices by the client indicates an understanding of the teaching?

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 who is undergoing alcohol withdrawal and is receiving diazepam. Which of the following interventions should the nurse include in the plan?

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?

A school nurse is using Weber's test to check a child's hearing acuity. Which of the following actions should the nurse take?

A nurse is caring for four children in an emergency department. Which of the following clients should the nurse assess first?