NCLEX-PN

Category - Reduction of Risk

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A nurse is assessing a client who is at 30 weeks gestation. During the examination, the client complains of dizziness. The immediate action of the nurse is:

Assist the client in semi-Fowler’s position
Assist the client in left side-lying position
Assess for the fetal heart rate
Administer oxygen, as ordered

Explanation

Answer: B - The immediate action of the nurse is to turn the client to the left side. This position relieves the pressure on the vena cava, regaining the normal venous return. Option A promotes adequate gas exchange, which is not a priority intervention for the client. The other options may be done after the client is turned on her left side.

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