A case manager in a rehabilitation facility is discussing discharge plans with a client who has a pressure injury and requires a special bed at home. Which of the following statements should the nurse make first?

Choice A reason: Assessing the bladder for distention is an important action, but not the first one. The nurse should first check the uterine tone and position, as a boggy or displaced uterus can indicate uterine atony, the most common cause of postpartum hemorrhage.

Choice B reason: Massaging the client's fundus is the first action to take. The nurse should apply firm, circular pressure to the fundus to stimulate uterine contractions and reduce bleeding. The nurse should also monitor the amount and character of lochia.

Choice C reason: Preparing to administer a prescribed oxytocic preparation is a necessary action, but not the first one. The nurse should first attempt to control the bleeding by massaging the fundus and assessing the bladder. If the bleeding persists, the nurse should administer medications such as oxytocin, methylergonovine, or carboprost to enhance uterine contractions.

Choice D reason: Assessing the client's blood pressure is an important action, but not the first one. The nurse should first manage the bleeding by massaging the fundus and preparing to administer medications. The nurse should also monitor the client's vital signs, including blood pressure, pulse, and temperature, for signs of shock or infection

Choice A reason: This statement is not the best answer, as the National Institutes of Health (NIH) is not the primary agency responsible for regulating or enforcing environmental standards. The NIH is a research agency that supports biomedical and public health research.

Choice B reason: This statement is the best answer, as the Environmental Protection Agency (EPA) is the federal agency that protects human health and the environment by setting and enforcing standards for air, water, and land quality. The EPA regulates the use, disposal, and cleanup of asbestos, a known carcinogen and health hazard.

Choice C reason: This statement is not the best answer, as the Centers for Disease Control and Prevention (CDC) is not the primary agency responsible for regulating or enforcing environmental standards. The CDC is a public health agency that monitors and responds to disease outbreaks, conducts research, and provides health information.

Choice D reason: This statement is not the best answer, as the Department of Health and Human Services (HHS) is not the primary agency responsible for regulating or enforcing environmental standards. The HHS is a cabinet-level department that oversees various health and human services programs and agencies, such as the NIH, the CDC, and the Food and Drug Administration.