and reproductive systems hesi eaq neurologic and se
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NURSING
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HESI EAQ - Pregnancy, Labor,
Childbirth, Postpartum - At Risk
A client with a history of endometriosis gives birth to a healthy infant. She expresses
concern that the problems associated with endometriosis will return now that her
pregnancy is over. What is the best response by the nurse?
"Pregnancy usually cures the problem."
"Endometriosis usually causes early menopause."
"You may need a hysterectomy if the problems recur."
"Breast-feeding will delay the return of the endometriosis."
Lactation delays ovarian function during the postpartum period; therefore lactation will
delay the return of endometriosis. Pregnancy temporarily suppresses ovarian function;
the aberrant endometrial tissue is still present. Endometriosis may lead to sterility; it
does not cause menopause. Conservative medical therapy will be used first;
hysterectomy is a last resort.
Which assessment finding should the nurse consider to be of concern in a client at 35
weeks' gestation?
Frequent painless urination
Painful intermittent contractions
Increased fetal movement after eating
Lower back pain that results in insomnia
Painful contractions at this time may indicate preterm labor or the presence of
preparatory contractions (also known as Braxton Hicks contractions). The client's painful
intermittent contractions must be assessed further to distinguish between the two types.
Frequent urination is common during the last trimester because of the pressure of the
enlarging fetus; painful urination may indicate a urinary tract infection. Fetal movement
usually increases after the mother eats. Difficulty sleeping and lower back pain are both
common adaptations during the third trimester.
A client with class I heart disease has reached 34 weeks' gestation. Which problem
should the nurse anticipate now that the client is in her third trimester?
Dyspnea at rest
, Vasovagal syncope
Progressive dependent edema
Shortness of breath on exertion
Dyspnea at rest is associated with cardiopulmonary disorders and may be a sign of
impending decompensation. Vasovagal syncope is an expected physiologic change.
The client with heart disease is more likely to have exertional syncope. Dependent
edema commonly occurs in women with uncomplicated pregnancies as they progress
toward term. The client with heart disease is more likely to experience generalized
edema. In the third trimester, clients with uncomplicated pregnancies complain of
shortness of breath on exertion; this is caused by compression of the diaphragm by the
enlarging uterus.
After receiving a diagnosis of placenta previa, the client asks the nurse what this
means. What is the nurse's best response?
"It's premature separation of a normally implanted placenta."
"Your placenta isn't implanted securely in place on the uterine wall."
"You have premature aging of a placenta that is implanted in your uterine fundus."
"The placenta is implanted in the lower uterine segment, and it's covering part or all of
the cervical opening."
Implantation of the placenta in the lower uterine segment is the accepted definition of
placenta previa. Premature separation of a normally implanted placenta is known as
abruptio placentae; it occurs because the placenta is attached insecurely to the uterine
wall. Premature aging of a placenta may not lead to placenta previa but will put the fetus
in jeopardy.
The nurse admits a client with preeclampsia to the high-risk prenatal unit. What is the
next nursing action after the vital signs have been obtained?
Calling the primary healthcare provider
Checking the client's reflexes
Determining the client's blood type
Administering the prescribed intravenous (IV) normal saline
The client is exhibiting signs of preeclampsia. The presence of hyperreflexia indicates
central nervous system irritability, a sign of a worsening condition. Checking the client's
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