Magnesium sulfate is given to a pregnant client for which of the following reasons? (Select all that apply) Provide fetal neuroprotection Improve patellar reflexes and increase respiratory efficiency Induction of labor Prevent seizures Stop/decrease uterine contractions The clinical nurse talks with a client about her possible pregnancy. The client has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. What are these symptoms best described as? Possible signs of pregnancy Positive signs pregnancy Presumptive signs of pregnancy Probable signs of pregnancy The clinic nurse talks with a patient about her possible pregnancy. The patient has experienced amenorrhea for 2 months, nausea during the day with vomiting every other morning, and breast tenderness. She is convinced she is pregnant and is reluctant to pay for a pregnancy test. Which action by the nurse is best?

Correct Answer: C

Rationale: The best action for the nurse to take in this situation is to explain to the patient that these symptoms can be caused by other conditions besides pregnancy. It is important for the nurse to educate the patient that while these symptoms are commonly associated with pregnancy, they are not definitive signs and can also be attributed to other factors or medical conditions. Encouraging the patient to undergo a pregnancy test can help confirm or rule out pregnancy and provide appropriate care and guidance moving forward.

Correct Answer: B

Rationale: Neonatal opioid withdrawal syndrome, also known as neonatal abstinence syndrome (NAS), can occur in newborns who were exposed to opioids in utero. Symptoms of NAS can include tremors, irritability, high-pitched crying, poor feeding, vomiting, diarrhea, sweating, and sneezing. The severity of symptoms can vary depending on the type of opioid exposure, dosage, and duration of exposure. In this case, the nurse should expect to see moderate tremors of the extremities in the newborn experiencing opioid withdrawals at 48 hours old. It is important for the nurse to monitor and manage the newborn's withdrawal symptoms closely to ensure their safety and well-being.

Correct Answer: A

Rationale: The patient should be informed that emergency contraception is a temporary measure and they need a long-term contraceptive plan. Choice B, while important for overall sexual health, is not the priority immediately after administering emergency contraception. Choice C is not necessary unless there are complications or a follow-up consultation is needed. Choice D about drinking fluids is unnecessary and not specific to the effectiveness of emergency contraception.

Correct Answer: A

Rationale: Pitocin is a medication commonly used to induce or augment labor by stimulating uterine contractions. It is critical for the nurse to monitor the client closely for potential adverse effects. Fetal distress is a serious concern when Pitocin is being administered. A fetal heart rate of 180 beats per minute without variability may indicate fetal distress due to uteroplacental insufficiency. This is a sign of fetal hypoxia and warrants immediate intervention, including stopping the infusion of Pitocin, repositioning the mother, administering oxygen, and notifying the healthcare provider. It is crucial for the nurse to act promptly to ensure the safety and well-being of both the fetus and the mother.

Correct Answer: C

Rationale: Excessive amniotic fluid increases the risk of cord prolapse, especially after membrane rupture.