A nurse is attending to a client.
The nurse notes the following vital signs: Heart rate 88/min, Temperature 38.2 C (100.9" F), Respiratory rate 20/min, Blood pressure 122/58 mm Hg. Based on the client’s medical record, what provider prescription should the nurse anticipate?
Prescription A
Prescription B
Prescription C
Prescription D
The Correct Answer is C
Choice A rationale
The client’s vital signs are within normal limits, and there is no indication of a condition that would require Prescription A based on the information provided.
Choice B rationale
The client’s vital signs are within normal limits, and there is no indication of a condition that would require Prescription B based on the information provided.
Choice C rationale
The client’s temperature is slightly elevated, which could indicate an infection or other medical condition. Prescription C might be an antibiotic or other medication to treat the suspected condition.
Choice D rationale
The client’s vital signs are within normal limits, and there is no indication of a condition that would require Prescription D based on the information provided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Maintain the patient on bed rest. This is a common nursing intervention for a patient who is experiencing an inevitable abortion. Bed rest can help reduce the risk of further complications, such as heavy bleeding. It can also provide the patient with a chance to rest and recover physically and emotionally.
Choice B rationale
Offer the option to view products of conception. This intervention may not be appropriate for all patients. While some patients may find it helpful to view the products of conception, others may find it distressing. It’s important to discuss this option with the patient and respect her wishes.
Choice C rationale
Administer oxygen via a nasal cannula. This intervention may not be necessary for all patients experiencing an inevitable abortion. While oxygen therapy can be used to treat hypoxia in patients with heavy bleeding, it’s not typically required unless the patient shows signs of hypoxia.
Choice D rationale
Instruct the patient to increase potassium-rich foods in the diet. This intervention is not typically part of the care plan for a patient experiencing an inevitable abortion. While a balanced diet is important for overall health, there’s no specific need to increase potassium-rich foods in the diet in this situation.
Correct Answer is B
Explanation
Choice A rationale
While determining the viability of the fetus is an important aspect of prenatal care, it is not the primary purpose of an ultrasound in this scenario. The client’s report of feeling the baby moving suggests that the fetus is likely viable.
Choice B rationale
The primary purpose of the ultrasound in this scenario is to locate the placenta. Heavy, red vaginal bleeding at 38 weeks of gestation could indicate a complication such as placenta previa, where the placenta covers the cervix. An ultrasound can help confirm this diagnosis.
Choice C rationale
Measuring the biparietal diameter is a method used to estimate fetal weight and gestational age. However, in this scenario, the client is already known to be at 38 weeks of gestation, and the sudden onset of heavy, red vaginal bleeding is a more immediate concern.
Choice D rationale
Assessing fetal lung maturity is typically done when there is a risk of preterm delivery. In this scenario, the client is already at 38 weeks of gestation, which is considered full term. The immediate concern is the heavy, red vaginal bleeding.
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