A nurse on an antepartum unit is reviewing the medical records for four clients. Which of the following clients should the nurse assess first?
A client who has placenta previa and a hematocrit of 36%.
A client who has hyperemesis gravidarum and a sodium level of 110 mEq/L.
A client who has diabetes mellitus and an HbA1c of 5.8%.
A client who has preeclampsia and a creatinine level of 1.1 mg/dL.
The Correct Answer is B
Choice A rationale:
A client with placenta previa and a hematocrit of 36% should be monitored closely due to the risk of bleeding, but it is not an immediate priority compared to the client with hyperemesis gravidarum and a low sodium level.
Choice B rationale:
Hyperemesis gravidarum is a severe form of morning sickness characterized by excessive vomiting, leading to dehydration and electrolyte imbalances. A sodium level of 110 mEq/L is dangerously low and requires immediate attention to correct the electrolyte disturbance and prevent further complications.
Choice C rationale:
A client with diabetes mellitus and an HbA1c of 5.8% is within a normal range, indicating good glycemic control. This client's condition can be managed on an outpatient basis and does not require urgent assessment compared to the others.
Choice D rationale:
A client with preeclampsia and a creatinine level of 1.1 mg/dL should be closely monitored, but it is not the priority over the client with hyperemesis gravidarum and severe electrolyte imbalance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Fresh citrus fruits are not a good source of vitamin B12. They are rich in vitamin C but do not contain vitamin B12.
Choice B rationale:
Brown rice is not a good source of vitamin B12. While it is a nutritious grain, it does not contain vitamin B12.
Choice C rationale:
Raw carrots are not a good source of vitamin B12. Carrots provide essential nutrients but do not contain vitamin B12.
Choice D rationale:
Fortified soy milk is the correct choice as it is a suitable option for someone on a vegan diet looking to increase their vitamin B12 intake. Many brands of soy milk are fortified with vitamin B12, making it a reliable source for vegans. Vitamin B12 is essential for nerve function and red blood cell production, making it especially important during pregnancy.
Correct Answer is D
Explanation
Choice A rationale:
This statement is incorrect. An indirect Coombs' test is not used to determine the risk of hypoglycemia in a baby after birth. It is used to detect antibodies against red blood cells, particularly in the context of blood incompatibility between a pregnant woman and her fetus.
Choice B rationale:
This statement is incorrect. An indirect Coombs' test is not related to determining the amount of amniotic fluid around the fetus. It is used primarily to assess for Rh incompatibility between the mother and fetus.
Choice C rationale:
This statement is incorrect. The test described here is a Doppler ultrasound, not an indirect Coombs' test. Doppler ultrasound is used to study blood flow in the fetus and placenta using ultrasound waves.
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