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 B
Explanation
A. Match the client’s blood type with the type and cross match specimen: Type and crossmatching are important for allogeneic transfusions, but in autologous transfusions, the focus is on ensuring the unit belongs to the client rather than compatibility testing.
B. Ensure that the client's identification band matches the number on the blood unit: Verifying the client’s ID band against the unique number on the autologous blood unit ensures the right blood is given to the right person, preventing serious transfusion errors.
C. Confirm the provider's prescription matches the number on the blood component: The provider’s order is important, but it does not confirm the identity of the recipient. Matching the blood unit to the client’s ID is more critical for safety.
D. Ask the client to state his blood type and the date of the blood donation: Relying on client self-report is unreliable, especially in high-stress settings. Identification should always be confirmed using objective, verifiable identifiers like wristbands and blood unit labels.
Correct Answer is D
Explanation
A. "You may experience a decrease in your blood pressure while taking this medication.": Orthostatic hypotension is a possible side effect, but it's not as common or specific as sedation-related concerns for this medication.
B. "You may experience weight loss while taking this medication.": Doxepin, a tricyclic antidepressant, is more commonly associated with weight gain due to increased appetite, not weight loss.
C. "You may experience diarrhea while taking this medication.": Doxepin is more likely to cause constipation rather than diarrhea due to its anticholinergic effects.
D. "You may experience insomnia if you take this medication later in the day.": Doxepin has sedative properties. Taking it late in the day can disrupt the natural sleep-wake cycle, paradoxically leading to sleep disturbances or difficulty initiating restful sleep.
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