During a nonstress test of a 38-week client, the practical nurse (PN) observes the fetal heart rate increases 15 beats above baseline lasting 10 seconds twice during a 20-minute tracing. Which finding should the PN document in the electronic medical record?

Acceleration.

Nonreactive pattern.

Fetal movement.

Positive tracing.

Answer and Explanation

The Correct Answer is A

A. Acceleration refers to a temporary increase in the fetal heart rate of at least 15 beats per minute above the baseline for at least 10 seconds. The observation of the fetal heart rate increasing 15 beats above baseline twice during the test indicates that accelerations are present, which is a reassuring sign of fetal well-being.
B. A nonreactive pattern would indicate that the test did not meet the criteria for accelerations or fetal heart rate reactivity, which is not the case here as the fetal heart rate did exhibit accelerations.
C. Fetal movement could contribute to accelerations but is not the term used to describe the findings of the test itself. The specific observation made was an increase in fetal heart rate, which is classified as an acceleration.
D. A positive tracing indicates that the nonstress test met criteria for fetal well-being, typically with at least two accelerations, but the correct term for the specific observation here is acceleration rather than describing the overall result.

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Correct Answer is D

Explanation

A. Administering half of the missed dose is not generally recommended because it could lead to inconsistent drug levels and potential for breakthrough seizures. The standard practice is to follow the dosing schedule unless otherwise instructed by the healthcare provider.
B. Giving the missed dose with the next scheduled dose may lead to double dosing and could increase the risk of side effects or toxicity. The missed dose should be addressed as soon as possible but not in combination with the next dose.
C. Withholding the missed dose unless seizure activity occurs could put the client at risk for seizures. Anticonvulsants should be administered as per the prescribed schedule to maintain therapeutic drug levels and prevent seizures.
D. Administering the missed dose as soon as possible is the correct approach, following standard guidelines for missed medications. The missed dose should be given promptly unless it is close to the time of the next dose, in which case the next dose should be given as scheduled.

A. Acquire coping skills. B. Conserve energy. C. Adapt self-care skills. D. Improve body image.

Correct Answer is B

Explanation

A. Acquiring coping skills is important, but the immediate focus for discharge planning is on practical goals related to managing daily activities and maintaining independence rather than on long-term psychological coping.
B. Conserve energy is the most important goal for a client with rheumatoid arthritis preparing for discharge. Managing energy effectively helps clients cope with fatigue and pain, which are common challenges in daily life with rheumatoid arthritis.
C. Adapting self-care skills is also important but is a broader goal that includes conserving energy as a component. Effective energy management is a key aspect of self-care for clients with rheumatoid arthritis.
D. Improving body image is a valid goal but is not the most urgent concern for discharge planning. The primary focus should be on practical aspects of managing rheumatoid arthritis in daily life.

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During a nonstress test of a 38-week client, the practical nurse (PN) observes the fetal heart rate increases 15 beats above baseline lasting 10 seconds twice during a 20-minute tracing. Which finding should the PN document in the electronic medical record?

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Naxlex Comprehensive Predictor Exams

At 1200, the practical nurse (PN) learns that a client's 0900 dose of an anticonvulsant was not given. The next scheduled dose is at 2100. Which action should the PN take?

Correct Answer is D

Explanation

The practical nurse (PN) is assigned to provide care for a client with rheumatoid arthritis who is preparing for discharge. While planning the client's care, the PN should identify which client goal as the most important?

Correct Answer is B

Explanation

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