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    Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph
    Select All That Apply

    A nurse is caring for a client who is at 32 weeks of gestation. Exhibits After reviewing the client’s health record, which of the following actions should the nurse take? Select all that apply

    Explanation & Rationale

    Rationale: A. Administer betamethasone IM to enhance fetal lung maturity in case of preterm delivery (<34 weeks). B. Immediate cesarean birth is not indicated unless there is heavy bleeding or fetal distress. The client is stable with normal FHR and moderate variability. C. Vaginal examinations are contraindicated in placenta previa because they can cause placental separation and severe hemorrhage. D. Continuous external fetal heart monitoring helps assess fetal well-being and detect distress due to bleeding or hypoxia. E. Activity limitation reduces uterine activity and the risk of further bleeding. The client should avoid sexual activity and strenuous exercise. F. Monitoring intake and output helps assess renal perfusion, especially if bleeding increases or the client develops hypotension. G. Transfusing A-positive blood is inappropriate because the client’s type is A-negative; incompatible transfusion would cause hemolytic reactions.

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