Correct Answer: B

Rationale: The nurse should initiate seizure precautions because severe preeclampsia poses a high risk for seizures (eclampsia), ensuring the safety of the client.

Correct Answer: A

Rationale: Lower back pain, especially if accompanied by uterine contractions or pressure, can be a sign of preterm labor. The client should report this immediately to prevent complications or early delivery.

Correct Answer: C

Rationale: The correct course of action after missing oral contraceptive pills depends on how many pills are missed. If three pills are missed, the client should not 'double up' but rather follow the manufacturer's instructions and use an alternative form of contraception until the next cycle. Taking too many pills at once increases the risk of side effects without restoring contraceptive protection.

Correct Answer: C

Rationale: In cases of respiratory distress, the nurse should first suction the newborn's airway to clear any obstructions. This is a non-invasive procedure that can quickly improve breathing.

Correct Answer: A

Rationale: Yellow-tinged skin (jaundice) in a newborn can indicate hyperbilirubinemia. The priority action is to assess the infant's bilirubin levels to determine the severity of the jaundice and the need for further interventions, such as phototherapy.