For each potential provider's prescription, click to specify if the potential prescription is anticipated or unanticipated for the client.
Administer oxytocin,
Administer terbutaline.
Administer betamethasone.
Maintain bed rest with bathroom privileges.
Limit fluid intake to 3,000 mL/day.
Place client in supine position.
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"}}
1. Administer oxytocin
Unanticipated: Oxytocin is typically used to induce labor or augment labor by stimulating uterine contractions. Since the client is already experiencing preterm labor, administering oxytocin could exacerbate contractions, leading to a more rapid progression of labor, which is not desired at 33 weeks gestation.
2. Administer terbutaline
Anticipated: Terbutaline is a tocolytic agent used to stop preterm labor by relaxing the uterus and inhibiting contractions. Given that the client is experiencing preterm labor (with regular contractions), this medication would be used to attempt to stop labor and delay delivery, which is an appropriate action for a 33-week pregnant client with early labor signs.
3. Administer betamethasone
Anticipated: Betamethasone is a corticosteroid that promotes lung maturity in preterm infants. At 33 weeks gestation, it is common to administer betamethasone if preterm labor is suspected, as it enhances fetal lung development and reduces the risk of respiratory distress syndrome in the newborn.
4. Maintain bed rest with bathroom privileges
Anticipated: Bed rest is often recommended for clients with preterm labor to reduce uterine activity and promote fetal well-being. While some studies suggest limited benefits, it is still a common non- pharmacological approach to manage preterm labor and reduce the risk of premature delivery.
5. Limit fluid intake to 3,000 mL/day
Unanticipated: There is no indication that the client is at risk for fluid overload or hyponatremia (which would require fluid restriction). In fact, hydration is often encouraged in preterm labor to prevent dehydration, which can worsen uterine contractions.
6. Place client in supine position
Unanticipated: Supine position is not recommended during pregnancy, particularly after the first trimester, due to the risk of supine hypotensive syndrome (compression of the vena cava, leading to reduced blood flow to the uterus and fetus). In fact, lateral positioning (e.g., left side-lying) is recommended for optimal circulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Encouraging the client to spend time in the dayroom may increase stimulation and worsen manic symptoms. A quiet, calm environment is typically more beneficial.
B. Withdrawing privileges is punitive and may escalate agitation or irritability in a client with mania.
C. Seclusion should only be used if the client is a danger to themselves or others. It is not a first-line intervention for anxiety or manic symptoms.
D. Encouraging the client to take frequent rest periods helps manage manic symptoms by preventing fatigue and promoting some level of structure and control over their activities.
Correct Answer is ["A","B","C","D","E"]
Explanation
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.
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