A 28-year-old female client is admitted to the labor and delivery unit at 0700hrs. She is 34 weeks pregnant and reports having low back pain and frequent urination since last night. She mentions that urination is painful and she can only pass a small amount each time.

Exhibits

Given the client’s symptoms and the progression of her condition, the nurse suspects that the client may be experiencing complications related to preterm labor and a possible urinary tract infection (UTI). For each characteristic in the table, select whether it is more likely to be associated with preterm labor, a urinary tract infection (UTI), or both. Each column must have at least one response option selected. Candidates can select as many options as apply for each column.

Frequent urination

Low back pain

Temperature of 38.3°C (101°F)

Strong urge to push

Contractions every 1.5 minutes

Pain level of 8 on a scale of 0 to 10

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A,B"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"B"}}

•   Frequent urination: This is more likely to be associated with a UTI, as frequent urination is a common symptom of UTIs.
•   Low back pain: This can be associated with both preterm labor and a UTI. Low back pain can be a sign of labor, and it can also be a symptom of a UTI.
•   Temperature of 38.3°C (101°F): This is more likely to be associated with a UTI, as fever is a common symptom of infections, including UTIs.
•   Strong urge to push: This is more likely to be associated with preterm labor, as an urge to push can be a sign of labor.
•   Contractions every 1.5 minutes: This is more likely to be associated with preterm labor, as frequent contractions are a sign of labor.
•   Pain level of 8 on a scale of 0 to 10: This can be associated with both preterm labor and a UTI. Severe pain can be a sign of labor, and it can also be a symptom of a UTI. Please note that these are potential associations and the healthcare provider should be informed immediately for further evaluation and management. It’s important to continue following the provider’s prescriptions and closely monitor the client’s condition.

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Correct Answer is C

Explanation

Choice A rationale
The fundus should not be soft or to the right of the umbilicus 12 hours postpartum. A soft or displaced fundus could indicate uterine atony or a full bladder, both of which require intervention.
Choice B rationale
The fundus should not be soft or above the umbilicus 12 hours postpartum. This could indicate uterine atony, which could lead to postpartum hemorrhage.
Choice C rationale
The fundus should be firm and at the level of the umbilicus 12 hours postpartum. This indicates that the uterus is contracting properly to prevent excessive bleeding.
Choice D rationale
The fundus should not be to the left of the umbilicus 12 hours postpartum. This could indicate a full bladder, which can displace the uterus and interfere with uterine contractions

A. Insert an indwelling urinary catheter. B. Initiate IV access. C. Witness the signature for informed consent for surgery. D. Prepare the abdominal and perineal areas.

Correct Answer is B

Explanation

Choice A rationale
Inserting an indwelling urinary catheter is not the priority nursing action. While it may be necessary later, especially if the client goes to surgery, it is not the immediate concern.
Choice B rationale
Initiating IV access is the correct action. The client is losing blood rapidly, has hypotension, and tachycardia. IV access will allow IV fluids and blood to be administered quickly if hypovolemia develops.
Choice C rationale
Witnessing the signature for informed consent for surgery is not the priority nursing action. While consent will be necessary if the client needs a cesarean section, the immediate concern is stabilizing the client.
Choice D rationale
Preparing the abdominal and perineal areas is not the priority nursing action. This would be done as part of surgical preparation if a cesarean section is needed, but it is not the immediate concern.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is 12 hours postpartum following a vaginal delivery. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

Correct Answer is B

Explanation

A nurse is caring for a client who is 2 hours postpartum following a vaginal birth. Which of the following findings indicates the client’s bladder is distended?

A nurse receives report about assigned clients at the start of the shift. Which of the following clients should the nurse plan to see first?

A nurse is caring for a client who is gravida 3, para 2, and is in active labor. The fetal head is at 3+ station after a vaginal examination.Which of the following actions should the nurse take?

A nurse is attending to a client who is a first-time mother, at term, and experiencing contractions. She is uncertain if she is in labor.Which of the following would the nurse identify as an indication of true labor?

A nurse admits a woman who is at 38 weeks of gestation and in early labor with ruptured membranes. The nurse determines that the client’s oral temperature is 38.9°C (102°F). Besides notifying the provider, which of the following is an appropriate nursing action?

A nurse is caring for a client who had a vaginal delivery 2 hours ago. Which of the following actions should the nurse anticipate in the care of this client? (Select all that apply.)

A nurse is caring for a new mother who is worried about her newborn’s crossed eyes. Which of the following responses by the nurse would be therapeutic?

Which of the following provider prescriptions should the nurse plan to implement? Select the 3 actions the nurse should plan to take. Exhibits here Exhibits Which of the following provider prescriptions should the nurse plan to implement? Select the 3 actions the nurse should plan to take.