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A nurse is caring for a client who is pregnant. The nurse is reviewing the client's medical record.

Exhibits
Select 4 findings that indicate a potential prenatal complication

Blood pressure

Urine ketones

Fetal activity

Respiratory rate

Report of headache

Urine protein

Gravida/parity

Answer and Explanation

Correct Answer : A,C,E,F

Rationale:

A. Blood pressure: The reading of 162/112 mm Hg meets the criteria for severe hypertension in pregnancy, which increases the risk of complications such as preeclampsia, placental abruption, and stroke.

B. Urine ketones: Ketones are negative, which rules out dehydration or starvation ketosis. Ketones would be more concerning if elevated alongside hyperemesis or gestational diabetes.

C. Fetal activity: Decreased fetal movement at 31 weeks may indicate fetal hypoxia or distress and requires urgent evaluation with nonstress testing or biophysical profiling.

D. Respiratory rate: The client’s respiratory rate of 16/min is within the normal range (12–20/min) and does not indicate respiratory distress or a complication.

E. Report of headache: A severe, persistent headache that is unrelieved by acetaminophen is a classic warning sign of central nervous system involvement in preeclampsia and may precede seizures (eclampsia).

F. Urine protein: The presence of 3+ proteinuria indicates significant renal involvement, supporting a diagnosis of preeclampsia, particularly when paired with hypertension and neurologic symptoms.

G. Gravida/parity: While a history of preterm birth is a known risk factor, her current symptoms point toward preeclampsia rather than complications directly linked to her obstetric history.

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Correct Answer is D

Explanation

Rationale:

A. "I will set a timer for 10 minutes for each timeout session.": Timeout duration should be age-appropriate, generally one minute per year of the child's age. A 10-minute timeout for a toddler would be too long and ineffective for promoting behavioral correction.

B. "My child will learn rules through physical punishment.": Physical punishment is not recommended for children as it may lead to increased aggression, fear, and long-term emotional harm. Positive discipline strategies like timeouts and redirection are more appropriate.

C. "I will remind my child of their misbehavior to reinforce discipline.": Repeated reminders can reinforce negative behavior by drawing excessive attention to it. Discipline should focus on clear, consistent consequences rather than prolonged discussion of misbehavior.

D. "A timeout session should begin once my child is quiet.": Timeout should start after the child calms down to encourage self-regulation. Starting it during a tantrum may reinforce the behavior, while waiting promotes emotional control and helps the child learn to calm themselves.

A. "Decrease your intake of cranberry juice." B. "Limit your fluid intake to 500 milliliters per day." C. "Plan to urinate every 3 hours while you are awake." D. "Take your diuretic medication with your evening meal."

Correct Answer is C

Explanation

Rationale:

A. "Decrease your intake of cranberry juice.": Cranberry juice is not known to worsen urge incontinence. It is more commonly used for urinary tract health. There is no need to reduce it unless the client finds it personally irritating.

B. "Limit your fluid intake to 500 milliliters per day.": Severely restricting fluids can lead to dehydration and concentrated urine, which may irritate the bladder and worsen incontinence. Adequate hydration is essential for bladder health.

C. "Plan to urinate every 3 hours while you are awake.": Scheduled voiding helps retrain the bladder by establishing regular emptying times and reducing urgency. Over time, this improves bladder control and reduces incontinence episodes.

D. "Take your diuretic medication with your evening meal.": Diuretics should be taken in the morning to avoid nocturia and sleep disturbances. Evening dosing increases the risk of nighttime incontinence due to increased urine production during sleep.

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A nurse is caring for a client who is pregnant. The nurse is reviewing the client's medical record. Exhibits Select 4 findings that indicate a potential prenatal complication

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A nurse is caring for a client who is pregnant. The nurse is reviewing the client's medical record.

Exhibits
Select 4 findings that indicate a potential prenatal complication