The home care nurse visits a pregnant client who has a diagnosis of mild preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the primary health care provider (PHCP)?

Blood pressure reading is at the prenatal baseline.

Dependent edema has resolved.

Urinary output has increased.

The client complains of a headache and blurred vision.

Answer and Explanation

The Correct Answer is D

A. Blood pressure reading is at the prenatal baseline. If blood pressure remains stable, it does not indicate worsening preeclampsia.

B. Dependent edema has resolved. A decrease in edema suggests an improvement, not worsening, of preeclampsia.

C. Urinary output has increased. Decreased urinary output is concerning in preeclampsia, while increased output suggests better kidney function.

D. The client complains of a headache and blurred vision. These are signs of severe preeclampsia, indicating possible cerebral edema or hypertensive crisis, which requires immediate medical attention.

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Correct Answer is C

Explanation

A. No displacement of the gravid uterus is necessary during CPR on a pregnant woman. Displacement of the uterus is necessary in a pregnant woman (especially after 20 weeks gestation) to prevent supine hypotension syndrome.

B. Apply pressure on the abdomen above the umbilicus to displace the uterus. Applying pressure above the umbilicus is not an effective method of uterine displacement. The correct technique involves manual displacement to the left or tilting the woman to the left.

C. Tilt the woman's pelvis to the left to relieve pressure on the inferior vena cava. Tilting the uterus to the left helps relieve compression on the inferior vena cava, improving venous return and cardiac output. This is essential during CPR to optimize blood flow to the mother and fetus.

D. Apply pressure directly on the gravid uterus to maintain blood flow to the fetus. Applying direct pressure on the uterus could further compromise circulation rather than improving it.

A. "I need to stay on the diabetic diet." B. "I need to be aware of any infections and report signs of infection immediately to my primary health care provider (PHCP)." C. "I would avoid exercise because of the negative effects on insulin production." D. "I need to perform glucose monitoring at home."

Correct Answer is C

Explanation

A. "I need to stay on the diabetic diet." Dietary management is the first-line treatment for GDM and helps maintain blood glucose levels within the target range.

B. "I need to be aware of any infections and report signs of infection immediately to my primary health care provider (PHCP)." Infections can increase insulin resistance and lead to hyperglycemia. Clients with GDM should monitor for signs of infection (e.g., fever, urinary symptoms) and seek prompt treatment.

C. "I would avoid exercise because of the negative effects on insulin production." Regular exercise improves insulin sensitivity and helps control blood glucose levels. Clients with GDM are encouraged to engage in moderate physical activity unless contraindicated.

D. "I need to perform glucose monitoring at home." Home glucose monitoring is essential for assessing glycemic control and guiding treatment decisions.

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The home care nurse visits a pregnant client who has a diagnosis of mild preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the primary health care provider (PHCP)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During CPR on a pregnant woman, what is the correct method for displacing the gravid uterus?

Correct Answer is C

Explanation

The nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes mellitus. Which statement made by the client indicates a need for further teaching?

Correct Answer is C

Explanation

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