Exhibits

The nurse is reviewing nurses' notes to determine if there are any variations.

Click to highlight the findings that would indicate the client has developed a complication related to pregnancy.

The client is a 32-year-old multigravida at 28 weeks gestation, who presents to the healthcare provider's office for a routine prenatal visit. Obstetrical history reveals she has given birth three times; once at 35 weeks (twins), once at 38 weeks (singleton) and once at 41 weeks (singleton). All of these children are alive and well. She had one spontaneous abortion at 10 weeks' gestation. Her fourth child weighed 9 pounds (4.08 kg) at 41 weeks gestation.

Client is at 28 weeks. She has been receiving prenatal care since 8 weeks gestation. Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dL (9.1 mmol/L). Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 (9.3 mmol/L) and a two-hour postprandial of 220 mg/dL (12.2 mmol/L).

Her fourth child weighed 9 pounds (4.08 kg) at 41 weeks gestation

Client is at 28 weeks. She has been receiving prenatal care since 8 weeks gestation

Her fasting 1-hour glucose screening level, which was done 1 week prior, is 164 mg/dL (9.1 mmol/L)

Her 3-hour oral glucose tolerance test results reveal a fasting blood sugar of 168 (9.3 mmol/L) and a two-hour postprandial of 220 mg/dL (12.2 mmol/L)

Answer and Explanation

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

Rationale for correct findings:

Fasting 1-hour glucose screen: 164 mg/dL (9.1 mmol/L): The fasting glucose of 164 mg/dL is elevated, indicating impaired glucose metabolism, which suggests the possibility of gestational diabetes.
3-hour glucose tolerance test: Fasting blood sugar 168 mg/dL (9.3 mmol/L): The fasting blood sugar of 168 mg/dL is above the normal threshold of 140 mg/dL, reinforcing the suspicion of gestational diabetes.
2-hour postprandial glucose: 220 mg/dL (12.2 mmol/L): A postprandial glucose level of 220 mg/dL is significantly above the normal limit of 140 mg/dL, further indicating gestational diabetes.
Fourth child with macrosomia: 9 pounds (4.08 kg) at 41 weeks gestation: Macrosomia is often associated with gestational diabetes. The fourth child weighing 9 pounds suggests the possibility of undiagnosed gestational diabetes during the previous pregnancy, which could be recurring in the current pregnancy.

Rationale for incorrect Findings:

Client is at 28 weeks and has been receiving prenatal care since 8 weeks gestation: The client’s consistent prenatal care since 8 weeks indicates early and regular monitoring, reducing the likelihood of other major complications.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}

Explanation

Rationale for Correct Responses:

Before breakfast: Monitoring blood glucose before breakfast (fasting blood glucose) is essential for evaluating how well the body is managing glucose levels overnight. It helps assess baseline blood sugar control before any food intake and provides insights into insulin sensitivity or resistance.
Two hours after all meals: Checking blood glucose two hours post-meal helps determine how well the body is processing food, which is crucial for managing blood sugar spikes after eating.

Rationale for Incorrect Responses:

Before bedtime: Bedtime monitoring isn't routinely necessary unless instructed by the healthcare provider for clients who are at risk of nocturnal hypoglycemia. The focus generally should be on pre-meal and post-meal blood sugar levels for optimal control.
Only when symptomatic: Waiting for symptoms is not sufficient for diabetes management. Regular monitoring is essential to detect asymptomatic hyperglycemia or hypoglycemia before it causes complications.

A. 1+ strength in left upper extremity B. Decreased range of motion C. Coolness of skin D. Reduced pulse distal to injury E. Pain with movement

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A,B"}}

Explanation

Rationale:

1+ strength in left upper extremity: Reduced strength in the affected arm could indicate a humeral fracture, which can impair muscle function and strength. A rotator cuff injury could cause pain, but it doesn’t necessarily lead to a reduction in strength to the extent seen with a humeral fracture.
Decreased range of motion: Decreased range of motion is common with humeral fractures as the bone is likely immobilized and painful to move. A rotator cuff injury can also lead to decreased range of motion due to pain and limited ability to lift or rotate the arm.
Coolness of skin: Coolness to the skin could indicate poor circulation, which can occur if there is vascular injury related to a humeral fracture or if there is significant swelling causing compression of blood vessels.Coolness is less commonly associated with rotator cuff injuries unless there is concurrent trauma affecting blood flow.
Reduced pulse distal to injury: Reduced pulses can suggest vascular injury, which is more likely with a humeral fracture, especially if the bone fragments are displacing or compressing blood vessels.This is unlikely with a rotator cuff injury, as it primarily affects the tendons and muscles without significant impact on vascular structures.
Pain with movement: Pain with movement is a classic symptom of a fracture, particularly when moving the arm or shoulder area. Pain with movement is also a hallmark of a rotator cuff injury, especially when the arm is raised or rotated.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. The diabetic nurse educator instructs the client to perform fingerstick blood glucose (FSBG) monitoring dropdownanddropdown.

Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"A"}

Explanation

Exhibits For each assessment finding, click to indicate whether the findings from the client's assessment are generally associated with rotator cuff injury and/or humeral fracture. Each column must have at least one response selected.

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A,B"}}

Explanation

A pre-school age child with a congenital heart defect is brought to the clinic by the parent because of a fever and an earache. During the assessment, the parent asks the nurse why the child is at the 5th percentile for weight and height for age. Which response is best for the nurse to provide?

When performing suctioning for a client with a tracheostomy, which action should the nurse include?

A parent brings their child, who has a history of asthma, to the emergency room. The child is wheezing and speaking one word between each breath. The child is anxious, tachycardic, and has labored respirations. Which assessment is most important for the nurse to obtain?

Exhibits The nurse considers the brief interaction with the client and the triage report. Which finding(s) should the nurse investigate further? Select all that apply.

Exhibits The nurse reviews the intake information prior to seeing the client. What finding(s) should the nurse recognize as signs of dehydration that require immediate follow up? Select all that apply.