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 their abdomen is rigid. The nurse should identify these findings as indicating which of the following complications?

Placental abruption

Uterine rupture

Placenta previa

Amniotic fluid embolus

Answer and Explanation

The Correct Answer is A

A. Placental abruption: Placental abruption is characterized by the premature separation of the placenta from the uterine wall before delivery of the fetus. Sudden, severe abdominal pain, moderate to severe vaginal bleeding, persistent uterine contractions, and uterine rigidity are classic signs and symptoms of placental abruption. Hypotension may occur due to hemorrhage, leading to decreased perfusion to vital organs.
B. Uterine rupture: Uterine rupture involves a tear in the uterine wall, which can lead to severe abdominal pain, vaginal bleeding, and signs of shock. However, uterine rupture typically occurs during labor or delivery, particularly in women with a history of uterine surgery or trauma.
C. Placenta previa: Placenta previa is characterized by the implantation of the placenta over or near the internal cervical os. It can cause painless vaginal bleeding in the third trimester, particularly after 20 weeks of gestation. However, it is not typically associated with severe abdominal pain or uterine rigidity.
D. Amniotic fluid embolus: An amniotic fluid embolus occurs when amniotic fluid, fetal cells, hair, or other debris enter the maternal circulation, leading to a potentially life-threatening reaction. Symptoms may include sudden dyspnea, hypotension, cardiovascular collapse, and disseminated intravascular coagulation (DIC). While it can cause severe complications, the symptoms described in the scenario are more consistent with placental abruption.

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Correct Answer is C

Explanation

A. Disulfiram: Disulfiram is used in the treatment of alcohol dependence by creating unpleasant effects (such as nausea and vomiting) when alcohol is consumed. It is not indicated for the management of seizures associated with alcohol withdrawal.
B. Acamprosate: Acamprosate is used in the treatment of alcohol dependence to help maintain abstinence by reducing cravings for alcohol. It is not indicated for the management of seizures associated with alcohol withdrawal.
C. Diazepam: Diazepam is a benzodiazepine medication commonly used to treat seizures associated with alcohol withdrawal due to its anticonvulsant properties. It helps to prevent and control seizures by enhancing the effects of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain.
D. Naltrexone: Naltrexone is used in the treatment of alcohol dependence by reducing the pleasurable effects of alcohol and decreasing the desire to drink. It is not indicated for the management of seizures associated with alcohol withdrawal.

A. Loss of central vision B. Increased intraocular pressure C. Decrease in peripheral vision D. A bluish-white colored pupil

Correct Answer is D

Explanation

A. Loss of central vision: While loss of central vision can occur with various eye conditions, such as age-related macular degeneration, it is not specific to cataracts. Cataracts typically cause clouding of the lens, leading to blurred or dimmed vision rather than loss of central vision.
B. Increased intraocular pressure: Increased intraocular pressure is characteristic of conditions such as glaucoma, not cataracts. Cataracts involve clouding of the lens rather than elevated pressure within the eye.
C. Decrease in peripheral vision: Decreased peripheral vision is associated with conditions like retinitis pigmentosa or glaucoma but is not a typical finding in cataracts. Cataracts primarily affect visual acuity and clarity rather than peripheral vision.
D. A bluish-white colored pupil: A bluish-white appearance of the pupil, known as leukocoria or a white pupil reflex, can be indicative of cataracts. It occurs due to light scattering by the cloudy lens of the eye, resulting in an abnormal reflection from the pupil. This finding is characteristic of cataracts and warrants further evaluation by an ophthalmologist.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is experiencing seizures due to alcohol withdrawal. Which of the following medications should the nurse plan to administer?

Correct Answer is C

Explanation

A nurse is performing an eye examination on a client. Which of the following findings should indicate to the nurse that the client might have cataracts?

Correct Answer is D

Explanation

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