A nurse is caring for a client who is in labor at 40 weeks of gestation and reports that she has saturated two perineal pads with blood in the past 30 min. The nurse caring for her suspects placenta previa. Which of the following is an appropriate nursing action?
Initiation of pushing
Examination to determine cervical status
Preparation for cesarean birth
A magnesium sulfate infusion
The Correct Answer is C
Choice A reason: Initiation of pushing is not an appropriate nursing action, as it can increase the bleeding and the risk of placental separation, which can cause fetal hypoxia, hemorrhage, or shock. Pushing is contraindicated in clients with placenta previa, which is a condition where the placenta covers the cervical opening and can cause painless, bright red bleeding in the third trimester.
Choice B reason: Examination to determine cervical status is not an appropriate nursing action, as it can cause trauma and perforation of the placenta, which can lead to severe bleeding and infection. Examination is contraindicated in clients with placenta previa, unless it is confirmed by ultrasound that the placenta is not low-lying or covering the cervix.
Choice C reason: Preparation for cesarean birth is an appropriate nursing action, as it is the preferred mode of delivery for clients with placenta previa, especially if the bleeding is heavy, the fetus is mature, or the fetal distress is present. Cesarean birth can prevent the complications of placenta previa, such as fetal hypoxia, hemorrhage, or shock.
Choice D reason: A magnesium sulfate infusion is not an appropriate nursing action, as it is a drug that prevents seizures and lowers the blood pressure in clients with severe preeclampsia, which is a hypertensive disorder of pregnancy. Magnesium sulfate is not indicated for clients with placenta previa, unless they also have severe preeclampsia or eclampsia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.5"]
Explanation
To calculate the number of tablets, the nurse should use the following formula:
Number of tablets = (Desired dose / Available dose) x (Available form / Desired form)
In this case, the desired dose is 50 mg, the available dose is 100 mg, the available form is 1 tablet, and the desired form is 1 tablet. Therefore, the formula becomes:
Number of tablets = (50 mg / 100 mg) x (1 tablet / 1 tablet)
Number of tablets = 0.5 x 1
Number of tablets = 0.5
The nurse should round the answer to the nearest tenth, which is 0.5. The nurse should use a leading zero if the answer is less than 1, which is 0.5. The nurse should not use a trailing zero, which means 0.5 and not 0.50.
Correct Answer is B
Explanation
Choice A reason: Missed miscarriage is not the type of abortion that the client is experiencing, because it is characterized by the absence of fetal heart activity and the retention of the products of conception in the uterus. The client would not have heavy bleeding or tissue expulsion.
Choice B reason: Incomplete miscarriage is the type of abortion that the client is experiencing, because it is characterized by the partial expulsion of the products of conception from the uterus, with some tissue remaining inside. The client would have heavy bleeding, open cervical os, and tissue present.
Choice C reason: Inevitable miscarriage is not the type of abortion that the client is experiencing, because it is characterized by the rupture of membranes and dilation of the cervical os, but no expulsion of the products of conception. The client would have moderate bleeding and cramping, but no tissue present.
Choice D reason: Complete miscarriage is not the type of abortion that the client is experiencing, because it is characterized by the complete expulsion of the products of conception from the uterus. The client would have mild bleeding and cramping, and a closed cervical os.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.