A nurse is assisting with the care of a client who is pregnant.

Complete the diagram by dragging from the choices below to specify what condition the client is meet likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to determine the client's progress.

Answer and Explanation

The Correct Answer is []

Prepare the client for an emergency cesarean birth: Emergency cesarean delivery is indicated in cases of fetal distress or placenta previa with severe bleeding at term. In a hydatidiform mole, there is no viable fetus, and the priority is evacuation of the molar tissue rather than delivery by cesarean section.
Prepare the client for suction curettage: Suction curettage is the treatment of choice for a hydatidiform mole. It allows for the complete evacuation of abnormal trophoblastic tissue, preventing complications such as severe hemorrhage and progression to malignant gestational trophoblastic disease.
Anticipate a prescription for methotrexate: Methotrexate is primarily used to treat ectopic pregnancies or persistent gestational trophoblastic disease after a molar pregnancy, not for initial management. Immediate evacuation of the mole by suction curettage is the first-line intervention for this client.
Remind the client that weekly blood tests are needed to measure pregnancy hormone: Following a molar pregnancy, weekly beta-hCG tests are critical to monitor for residual trophoblastic tissue or the development of choriocarcinoma. A declining beta-hCG confirms the resolution of disease, while a plateau or rise indicates persistent disease.
Administer terbutaline: Terbutaline is a tocolytic medication used to relax the uterus in cases of preterm labor. In the case of a hydatidiform mole, uterine evacuation is necessary rather than uterine relaxation, making terbutaline inappropriate for this situation.
Vaginal bleeding: Clients with a hydatidiform mole are at risk for significant vaginal bleeding due to the abnormal growth of trophoblastic tissue. Monitoring the amount and type of vaginal bleeding helps detect hemorrhage or retained molar tissue requiring urgent intervention.
Blood pressure: Elevated blood pressure is a potential complication of hydatidiform mole, similar to preeclampsia, and can occur even in the first or second trimester. Regular monitoring of blood pressure is essential to detect worsening hypertensive symptoms early.
Uterus for hypertonicity: Hypertonicity of the uterus is typically monitored in cases of labor or uterine rupture concerns. In a hydatidiform mole, the uterus is distended by abnormal tissue but hypertonicity is not a primary concern needing monitoring in this condition.
Unilateral pelvic pain: Unilateral pelvic pain is more characteristic of ectopic pregnancy rather than a molar pregnancy. In hydatidiform mole, generalized uterine enlargement and discomfort are more typical, so unilateral pelvic pain is not a focus for this client.
Cervical dilation per provider: Cervical dilation is not the main indicator of progress or concern with a molar pregnancy. The focus is on removing molar tissue and monitoring beta-hCG levels, not on the progress of cervical changes like in labor.

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Correct Answer is B

Explanation

A. "I limit my time spent out in the sunlight.": While moderate sun exposure can be beneficial for psoriasis, excessive sun exposure can worsen the condition or increase the risk of skin cancer. Limiting sunlight is generally a safe practice unless the client is avoiding it entirely, which is not indicated here.

B. "I try not to look at the scales on my body.": This statement suggests significant emotional distress or poor coping related to body image. Psoriasis can have profound psychological effects, including depression and anxiety, which must be reported to the provider to address the client’s mental health needs alongside physical treatment.

C. "I remove old medication on my skin before applying a new dose.": Proper application of topical medications includes cleaning old residue to promote better absorption of the new dose. This practice is appropriate and demonstrates an understanding of correct medication use.

D. "I do not use fabric softener when I wash my clothing.": Avoiding fabric softeners is a helpful strategy for clients with psoriasis because softeners can leave residues that irritate sensitive skin. This statement reflects good self-care behavior rather than a concern needing provider intervention.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Pneumonia: The preschooler is showing signs of shallow breathing, refusal to use the incentive spirometer, and slightly diminished breath sounds in the bilateral lower lobes, all of which increase the risk of developing pneumonia. Postoperative patients, especially young children, are vulnerable to pneumonia due to pain-limited deep breathing and poor pulmonary expansion.
Wound infection: Although there is some serosanguinous drainage at the incision site, the dressing remains dry overall, and there is no mention of redness, warmth, or purulent discharge typically associated with wound infection. Therefore, wound infection is not the primary concern at this point.
Ileus: Hypoactive bowel sounds are present, but they have been stable throughout the day without worsening abdominal distension or absence of bowel function. While ileus is a postoperative risk, the more pressing concern given the respiratory findings is pneumonia.
Shallow breathing: The child consistently shows shallow, unlabored respirations throughout assessments, which indicate limited lung expansion. Without effective use of the incentive spirometer and adequate deep breathing, shallow breathing places the child at high risk for pulmonary complications such as pneumonia.
Increasing temperature: Although the child's temperature rose slightly by 1600, it remains below 38° C (100.4° F), which is not typically classified as a fever. The minor temperature elevation could be related to inflammation rather than an infectious process at this stage.
Hypoactive bowel sounds: Hypoactive bowel sounds are expected in the early postoperative period, particularly following abdominal surgery due to the effects of anesthesia and manipulation of the bowel during surgery. While they should be monitored, they are not the primary finding indicating the most urgent complication in this situation.

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Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is collecting data from a client who has psoriasis. Which of the following statements by the client should the nurse report to the provider?

Correct Answer is B

Explanation

A nurse is assisting with the care of a preschooler who is postoperative following an appendectomy. Complete the following sentence by using the lists of options. The pre-schooler is at risk for developing dropdown evidenced by the pre-schooler's dropdown

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

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