A nurse is measuring the fundal height of a client who is at 36 weeks of gestation. The client suddenly reports nausea. Which of the following actions should the nurse take?
Administer propranolol IV to the client
Position the client on her side.
Ask the client to increase her daily calcium intake.
Use Leopold maneuvers to determine the fetal position.
The Correct Answer is B
A. Administer propranolol IV to the client: Propranolol is a beta-blocker used to treat hypertension and certain cardiac conditions. It is not indicated for sudden nausea during pregnancy and could be harmful if administered without cause.
B. Position the client on her side: At 36 weeks, the gravid uterus can compress the inferior vena cava when the client lies flat, reducing venous return and causing supine hypotensive syndrome, which often presents as nausea. Turning the client to her side relieves pressure and restores circulation.
C. Ask the client to increase her daily calcium intake: Calcium is important during pregnancy, especially for bone health, but increasing intake is not an acute intervention for nausea caused by positional blood flow issues.
D. Use Leopold maneuvers to determine the fetal position: Leopold maneuvers assess fetal position but do not address the client’s immediate symptom of nausea, which may indicate compromised circulation from lying supine. Position change is the priority action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["200"]
Explanation
Total volume to be infused = 100 mL.
Infusion time in minutes = 30 min.
- Convert the infusion time from minutes to hours.
Infusion time in hours = 30 min / 60 min/hr
= 0.5 hr.
- Calculate the infusion rate in mL per hour.
Infusion rate (mL/hr) = Total volume (mL) / Infusion time (hr)
= 100 mL / 0.5 hr
= 200 mL/hr.
Correct Answer is C
Explanation
A. Email the client's health information to the facility in an unencrypted file: Sending unencrypted files by email is a breach of confidentiality and violates HIPAA regulations. Protected health information must be securely transmitted.
B. Discuss the client's response to the transfer with another staff nurse: Unless the staff nurse is directly involved in the client’s care, this discussion would be inappropriate and a violation of the client’s privacy.
C. Provide a verbal report of the client’s condition to the paramedic performing the transfer: Sharing necessary health information with personnel directly involved in the client’s care and transport is appropriate and ensures continuity of care without violating confidentiality.
D. Fax the client's name and identifiable information to the rehabilitation facility: Faxing may be permitted if secured, but the question implies sending identifiable information without confirming secure transmission. This could risk unauthorized disclosure.
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