A nurse is caring for a client in an acute care setting.

Exhibits

Complete the following sentence by using the list of options.

The client is at risk for
dropdown
as evidenced by the client's
dropdown

Answer and Explanation

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

The client is at risk for hypostatic pneumonia as evidenced by the client's immobility

Rationale

The combination of paraplegia (which leads to limited mobility) and symptoms such as productive cough, tachycardia, and confusion suggest a respiratory issue, likely hypostatic pneumonia.

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Correct Answer is ["A","E"]

Explanation

A. Sepsis
Sepsis is a systemic infection that can occur during pregnancy, particularly if there is an infection such as chorioamnionitis (infection of the amniotic sac) or endometritis (infection of the uterine lining). The client's fever (38.4°C) could be indicative of infection, which is a risk factor for sepsis.
B. Placenta Previa
Placenta previa occurs when the placenta implants in the lower part of the uterus, covering the cervix. This can cause vaginal bleeding and may lead to complications during labor. However, this is not related to the client's current symptoms.
C. Disseminated Intravascular Coagulation (DIC)
DIC is a serious condition that can occur due to pregnancy complications like abruptio placentae, infection, or severe preeclampsia. However, the client’s symptoms do not indicate bleeding, bruising, or other signs of DIC. The client's blood pressure (130/78) is normal, and there are no indications of placental abruption.
D. Preeclampsia
Preeclampsia is characterized by hypertension and proteinuria. The client’s blood pressure (130/78) is normal, and there are no signs of significant swelling or other symptoms commonly associated with preeclampsia.
E. Preterm Premature Rupture of Membranes (PPROM)
PPROM is the rupture of the membranes (amniotic sac) before 37 weeks gestation, leading to the risk of infection, preterm labor, and other complications. While the client’s membranes are intact at this time, preterm labor at 33 weeks is a risk factor for PPROM.
F. Seizures
Seizures in pregnancy are most commonly seen in conditions like eclampsia, which is a complication of preeclampsia. However, the client does not have the signs of preeclampsia (high blood pressure, proteinuria, edema) that typically lead to eclampsia.

A. "Use an incentive spirometer every 4 hours." B. "Remain on bed rest for 24 hours following the procedure." C. "Participate in range-of-motion exercises." D. "Place a pillow under your knees while in bed."

Correct Answer is C

Explanation

A. The incentive spirometer should be used more frequently (every 1-2 hours) to promote lung expansion and reduce the risk of pneumonia.
B. Bed rest should be minimized to promote circulation and reduce the risk of deep vein thrombosis (DVT).
C. Range-of-motion exercises improve circulation, prevent joint stiffness, and promote overall mobility.
D. Placing a pillow under the knees can interfere with circulation and promote flexion contractures.

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A nurse is caring for a client in an acute care setting. Exhibits Complete the following sentence by using the list of options. The client is at risk for dropdownas evidenced by the client's dropdown

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client is at risk for developing which of the following 2 complications? Select 2 complications the client is at risk for developing.

Correct Answer is ["A","E"]

Explanation

A nurse is providing preoperative teaching to a client about promoting circulation during the postoperative period. Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

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A nurse is caring for a client in an acute care setting.

Exhibits

Complete the following sentence by using the list of options.

The client is at risk for
dropdown
as evidenced by the client's
dropdown