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Exhibits

Click to highlight the findings that indicate improvement in the client's condition. To deselect a finding, click on the finding again.

Assessment

Findings

Nurses' Notes

Client rates lower back pain a 0 on a scale from 0 to 10. No reports of vaginal discharge.

Membranes intact

No uterine contractions noted.

FHR baseline 138, minimal variability.

No further reports of burning with urination.

Laboratory Results

WBC 12,000/mm2 (5,000 to 10,000/mm3)

Platelet count 188,000/mm3 (150,000 to 400,000/mm3)

Vital Signs

Temperature 37.1° C (98.7° F)

Blood pressure 120/78 mm Hg

Client rates lower back pain a 0 on a scale from 0 to 10. No reports of vaginal discharge.

No uterine contractions noted.

No further reports of burning with urination.

WBC 12,000/mm2 (5,000 to 10,000/mm3)

Temperature 37.1° C (98.7° F)

Membranes intact

FHR baseline 138, minimal variability.

Platelet count 188,000/mm3 (150,000 to 400,000/mm3)

Blood pressure 120/78 mm Hg

Answer and Explanation

The Correct Answer is ["A","B","C","D","E"]

Client rates lower back pain as 0 on a scale from 0 to 10:

On Day 1, the client reported lower back pain, which could be associated with uterine contractions or other complications. By Day 2, the pain has resolved completely, with the client reporting a pain level of 0/10. This is a clear sign of improvement in her condition, especially since pain is often a key indicator of progress in antepartum care.

No reports of vaginal discharge:

On Day 1, the client reported pinkish vaginal discharge, which can be indicative of preterm labor or other complications. By Day 2, the absence of vaginal discharge suggests that the situation has improved, and the risk of preterm labor may be decreasing.

No uterine contractions noted:

On Day 1, the client had uterine contractions occurring every 8 minutes, which could be indicative of early labor or preterm labor. By Day 2, the absence of uterine contractions is a positive sign that the client is no longer experiencing early labor signs. This indicates that the situation is improving.

No further reports of burning with urination:

On Day 1, the client reported burning with urination, which was indicative of a urinary tract infection (UTI). On Day 2, the client no longer reports this symptom, suggesting that the urinary symptoms have resolved, and the infection may be improving, especially in light of ongoing treatment (e.g., antibiotics).

Laboratory Results Indicating Improvement:

WBC count 12,000/mm³ (Day 2) vs. 16,000/mm³ (Day 1):

The WBC count has decreased from 16,000/mm³ on Day 1 (which indicated infection or inflammation) to 12,000/mm³ on Day 2. Although the WBC count is still slightly elevated above the normal range (5,000-10,000/mm³), the decrease in WBC count suggests that the client's body is responding to treatment, and the infection or inflammation may be resolving.

Vital Signs Indicating Improvement:

Temperature 37.1° C (98.7°F) (Day 2) vs. 38.4° C (101.1°F) (Day 1):

The client’s fever has resolved, with a temperature decrease from 38.4°C (101.1°F) on Day 1 to 37.1°C (98.7°F) on Day 2. Fever is a common sign of infection, and the reduction in temperature suggests that the infection (likely a urinary tract infection) is being controlled and is improving.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Excessive sweating is a common side effect of selective serotonin reuptake inhibitors (SSRIs), including sertraline.
B. A metallic taste is more commonly associated with medications like certain antibiotics, not sertraline.
C. A dry cough is not a known side effect of sertraline; this might be seen with ACE inhibitors, for example.
D. Increased urinary frequency is not typically an adverse effect of sertraline.

A. preterm spontaneous vaginal birth at 30 weeks gestation B. lower back pain and pinkish vaginal discharge C. Uterine contractions every 8 minutes, palpate strong, duration 30 seconds D. minimal variability E. Cervical exam indicates 2 cm, 50% effaced, 0 station

Correct Answer is ["A","C","D","E"]

Explanation

Rationale
1. History and Physical
Last pregnancy resulted in a preterm spontaneous vaginal birth at 30 weeks
The client's history of a preterm birth at 30 weeks in a previous pregnancy is a significant risk factor for preterm labor in the current pregnancy. A history of preterm labor increases the likelihood of recurrence, and close monitoring is essential. This information alone does not require immediate follow- up but is important in guiding the overall care plan and risk assessment for preterm labor.
2. Nurses' Notes
Lower back pain and pinkish vaginal discharge.
Lower back pain and pinkish vaginal discharge are common symptoms of preterm labor. The pinkish vaginal discharge could indicate bloody show, which is sometimes seen with cervical dilation or preterm labor.
Uterine contractions every 8 minutes, palpate strong, duration 30 seconds.
Regular uterine contractions (every 8 minutes) in a client at 33 weeks gestation could indicate preterm labor. Contractions every 8 minutes with strong palpation and 30-second duration should be further assessed for their frequency, intensity, and impact on cervical dilation. This finding requires follow-up to determine whether these contractions are progressing to actual labor.
Minimal variability.
Minimal variability can sometimes be a sign of fetal distress or hypoxia, but it can also be seen in some normal circumstances. However, it is a finding that requires closer observation and may warrant further investigation to assess fetal well-being, especially in the context of preterm labor.
Finding: Cervical exam indicates 2 cm, 50% effaced, 0 station.
The cervix is 2 cm dilated, 50% effaced, and at a station of 0. This indicates that the cervix is beginning to open and efface, which is a sign of early labor. Since the client is at 33 weeks gestation, this is concerning for preterm labor, and the client should be closely monitored for further cervical changes and labor progression.

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System	Findings
General	Adult child accompanying parent reports decline in client, expressing concern over memory and thought process, appetite, and self-care. Adult child states, "My sibling and I hired help at home for my parent. We thought that would help but it has not. I found the title to the car today, signed over to me."
Physical	Client makes poor eye contact, speaks in a monotone voice, and has a lack of facial expression. Client reports sleeping 7 hr a night and getting up "once or twice per night to go to the bathroom." Client reports not wanting to eat anymore. Client's child reports their parent has lost about 8 lb in the past month. Heart rate 68/min
Affect	Client says, "Why don't you just leave me? I am of no use."

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client about the adverse effects of sertraline. Which of the following adverse effects should the nurse include?

Correct Answer is A

Explanation

Correct Answer is ["A","C","D","E"]

Explanation

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A nurse is planning care for a client who has a prescription for continuous enteral feedings through an NG tube. Which of the following actions should the nurse plan to take?

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A nurse is providing teaching about digoxin administration to the parents of a toddler who has heart failure. Which of the following statements should the nurse include in the teaching?

A nurse is assessing a child who has bacterial pneumonia. Which of the following manifestations should the nurse expect?

A nurse is caring for a client who has given informed consent for electroconvulsive therapy. Just before the procedure, the client tells the nurse she is considering not going forward with the treatment. Which of the following statements by the nurse is appropriate?