A nurse is caring for a client at the clinic.
Complete the following sentence by using the lists of options.
The client is at risk for
The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}
Rationale for correct choices
• Spontaneous abortion: The client is presenting at 10 weeks gestation with moderate, bright red vaginal bleeding and a history of risk factors including type 1 diabetes mellitus and recurrent infections. The open cervix on examination indicates that the pregnancy may not be viable and suggests impending or ongoing miscarriage.
• Cervical dilation: Cervical dilation is a key clinical sign of spontaneous abortion, as it indicates that the body is preparing to expel the pregnancy. The presence of an open cervix in conjunction with vaginal bleeding and cramping directly supports the risk for miscarriage. Monitoring cervical changes helps the healthcare team assess the progression and urgency of intervention.
Rationale for incorrect choices
• Molar pregnancy: Molar pregnancy typically presents with markedly elevated hCG levels, larger-than-expected uterine size, and absence of a viable embryo. Although the client has an elevated hCG, the level is not excessively high, and there is no indication of vesicular tissue or characteristic ultrasound findings, making molar pregnancy unlikely.
• Ectopic pregnancy: Ectopic pregnancy generally presents with unilateral abdominal pain, shoulder pain, and sometimes hypotension or signs of internal bleeding. The client’s bleeding is bright red, moderate, and accompanied by cervical dilation, which is not typical for an ectopic pregnancy. No abdominal mass or unilateral tenderness is reported, reducing the likelihood of this diagnosis.
• Lower abdominal cramping: While cramping is a symptom associated with miscarriage, it alone is not sufficient evidence to determine the risk for spontaneous abortion. Cervical dilation is a more definitive clinical sign indicating that the miscarriage may be occurring or imminent.
• hCG levels: The client’s hCG level of 30,000 IU/L is within the expected range for 10 weeks gestation and does not specifically indicate miscarriage. Unlike cervical dilation, hCG levels alone cannot confirm the risk for spontaneous abortion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Metoclopramide: Metoclopramide is an antiemetic and prokinetic agent used to treat nausea and gastroparesis. It is not classified as a controlled substance because it does not have potential for abuse or dependence.
B. Dantrolene: Dantrolene is a muscle relaxant used to treat spasticity and malignant hyperthermia. It is not a controlled substance as it has low potential for abuse or addiction.
C. Midazolam: Midazolam is a benzodiazepine used for sedation, anesthesia, and seizure management. Benzodiazepines are classified as controlled substances due to their potential for dependence, abuse, and misuse, making midazolam a controlled drug.
D. Ketorolac: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term pain management. It is not a controlled substance because it has minimal risk for abuse or dependence.
Correct Answer is C
Explanation
Rationale:
A. Serum calcium level: Cushing’s disease does not typically cause elevated calcium levels. Calcium levels are usually normal unless there is an underlying bone disorder or concurrent condition affecting calcium metabolism.
B. Lymphocyte count: Cortisol excess in Cushing’s disease suppresses the immune system, leading to lymphopenia rather than an increased lymphocyte count. A decreased lymphocyte count is more consistent with the disease process.
C. Serum glucose level: Elevated cortisol levels increase gluconeogenesis and decrease glucose uptake by cells, resulting in hyperglycemia. Clients with Cushing’s disease often exhibit elevated blood glucose as a direct effect of excess cortisol.
D. Serum potassium level: Cortisol has mineralocorticoid activity, promoting potassium excretion by the kidneys. As a result, clients with Cushing’s disease commonly have hypokalemia rather than increased serum potassium levels.
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