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 A

Explanation

A. A client who developed a pressure ulcer on the sacrum: The development of a pressure ulcer during hospitalization is considered a preventable adverse event and requires an incident report. It reflects a potential lapse in standard care practices related to skin integrity and client repositioning.

B. A client who refused to take a prescribed stool softener: Clients have the right to refuse medications. This occurrence should be documented in the medical record, but it does not require an incident report since it is an exercise of client autonomy.

C. A client who reported feeling dizzy while ambulating: Feeling dizzy during ambulation should be documented and addressed with safety measures, but if no fall or injury occurred, it typically does not necessitate a formal incident report.

D. A client who received medication 1 hr after it was due: A slight delay in medication administration may need to be documented depending on the medication's importance, but a 1-hour delay, unless involving critical medication like insulin or anticoagulants, usually does not require a formal incident report.

A. "Let's review hormonal contraceptives first" B. "I will provide you with more information about this” C. "Have you considered other alternatives” D. "Natural family planning is not beneficial for everyone.”

Correct Answer is B

Explanation

A. "Let's review hormonal contraceptives first": Redirecting the conversation to hormonal contraceptives ignores the client’s expressed preference. Effective communication involves respecting client choices and supporting informed decision-making rather than pushing alternative methods first.

B. "I will provide you with more information about this": This response supports the client’s autonomy by offering information tailored to their expressed interest. Providing education about natural family planning, including techniques and effectiveness, allows the client to make an informed and empowered decision.

C. "Have you considered other alternatives": While exploring options is sometimes appropriate, immediately questioning the client's choice may feel dismissive. It is important to first respect and address the client's initial interest before introducing other possibilities if needed.

D. "Natural family planning is not beneficial for everyone.": Although this statement may be true in some cases, it is not an appropriate initial response. It risks discouraging the client prematurely rather than fostering an open, supportive discussion about how to use natural family planning effectively.

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Naxlex Comprehensive Predictor Exams

A nurse is assisting in the care of a group of clients. Which of the following occurrences should the nurse identify as requiring an incident report?

Correct Answer is A

Explanation

A nurse is assisting with the care of a client who is verbalizing their desire for natural family planning as a method of contraception. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

The nurse is continuing to assist with the care of the client. The nurse is assisting with initiating the client's plan of care. Which of the following interventions should the nurse include? Select all that apply.

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