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Questions 158

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Extract:


Question 1 of 5

The client at 28 weeks gestation is admitted with a diagnosis of preterm labor. The physician orders a non-stress test. The nurse should explain to the client that this test is used to:

Correct Answer: C

Rationale: A non-stress test (NST) evaluates fetal well-being by monitoring fetal heart rate accelerations in response to movement. It does not assess lung maturity contractions or maternal hypertension.

Question 2 of 5

A client with a history of rheumatoid arthritis is admitted with complaints of fatigue. The nurse should give priority to:

Correct Answer: A

Rationale: Fatigue in rheumatoid arthritis may indicate anemia of chronic disease, so monitoring for anemia is the priority.

Question 3 of 5

Which stage of labor lasts from delivery of the baby to delivery of the placenta?

Correct Answer: B

Rationale: This stage is from complete dilatation of the cervix to delivery of the fetus. This is the correct stage for the definition. This stage lasts for about 2 hours after the delivery of the placenta. There is no fifth stage of labor.

Question 4 of 5

A normal 3-year-old child is suspected of having meningitis. The doctor has ordered a lumbar puncture. In light of this procedure and developmental characteristics of this age group, which nursing measure is most appropriate?

Correct Answer: A

Rationale: The nurse should emphasize what is required to elicit cooperation and help to develop a sense of autonomy. The child may express discomfort verbally and should be encouraged to express his feelings. Selecting nonthreatening words to explain a procedure will prevent misinterpretation. When explaining the procedure to the parent with the child present, the nurse should use words that the child can understand to avoid misunderstanding.

Question 5 of 5

The client with a cervical dilation of 8cm suddenly becomes short of breath,cyanotic and hypotensive. The nurse should suspect which of the following complications?

Correct Answer: A

Rationale: Amniotic fluid embolus is a rare but life-threatening complication characterized by sudden dyspnea cyanosis and hypotension due to amniotic fluid entering the maternal circulation. These symptoms are not typical of transition phase abruption or cord prolapse.

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