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A nurse is assisting in the care of a client who is in active labor and is to undergo an amniotomy. Which of the following actions should the nurse take? (Move the steps into the box, placing them in the order of performance. Use all the steps.)

Obtain a baseline reading of the FHR and contraction pattern.

Document the procedure in the electronic medical record.

Pass the sterile hook to the provider.

Position the client with a rolled towel under her hips

Check the fluid for color, odor, and consistency

Answer and Explanation

The Correct Answer is A,D,C,E,B

A. Obtain a baseline reading of the FHR and contraction pattern.
- Establishing a baseline of fetal heart rate (FHR) and contraction pattern is crucial to assess for any immediate changes following the amniotomy.
D. Position the client with a rolled towel under her hips.
- Positioning the client with a rolled towel under her hips helps to relieve pressure on the vena cava, improve uterine blood flow, and optimize fetal positioning.
C. Pass the sterile hook to the provider.
- The sterile hook is used to break the amniotic sac, and the nurse should pass it to the provider during the procedure.
E. Check the fluid for color, odor, and consistency.
- After the amniotomy, the nurse should assess the amniotic fluid for color (should be clear), odor (should be odorless), and consistency to check for any signs of meconium or infection.
B. Document the procedure in the electronic medical record.
- The nurse should document the amniotomy procedure and any findings (e.g., FHR changes, amniotic fluid assessment) in the medical record after the procedure has been completed.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. "Take the medication and then lay down for 30 min.": This is not recommended. Lying down after taking doxycycline can increase the risk of esophageal irritation and ulceration. It is best to remain upright for at least 30 minutes after taking the medication.

B. "Take the medication with an antacid.": This is incorrect. Antacids can interfere with the absorption of doxycycline and reduce its effectiveness. It is important to avoid antacids, calcium supplements, and iron supplements within 2 hours of taking doxycycline.

C. "Take the medication with calcium-fortified orange juice.": This is incorrect. Calcium can bind with doxycycline, reducing its absorption and effectiveness. It is best to avoid taking doxycycline with calcium-rich products like milk or fortified juices.

D. "Take the medication with crackers.": This is correct. Taking doxycycline with a small amount of food, like crackers, can help reduce gastrointestinal discomfort, such as nausea and vomiting. It is recommended to take doxycycline with food if nausea occurs, though not with dairy or antacids.

A. Oranges B. Potatoes C. Grapes D. Corn

Correct Answer is C

Explanation

A. Oranges is incorrect. Oranges are not a choking hazard as long as they are peeled and cut into small pieces for a toddler. The nurse should not include oranges in a list of choking hazards for toddlers.

B. Potatoes is incorrect. Potatoes themselves are not a choking hazard for toddlers, though whole or large pieces could pose a risk. The risk comes from how the food is prepared, not the food itself. If properly cooked and mashed or cut into small pieces, potatoes are safe.

C. Grapes is correct. Grapes are a common choking hazard for toddlers because they are small, round, and can easily block the airway if not properly cut into small pieces. The nurse should definitely include grapes in the pamphlet as a choking hazard.

D. Corn is incorrect. Corn kernels are not typically a choking hazard for toddlers unless they are served as whole kernels, which could pose a risk if not chewed properly. However, corn in the form of pureed corn or small pieces is safe for toddlers to eat.

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A nurse is assisting in the care of a client who is in active labor and is to undergo an amniotomy. Which of the following actions should the nurse take? (Move the steps into the box, placing them in the order of performance. Use all the steps.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a chlamydial infection and a new prescription for doxycycline. The client reports nausea and vomiting after starting the medication. Which of the following recommendations should the nurse make?

Correct Answer is D

Explanation

A community health nurse is assisting with the development of a pamphlet regarding choking hazards for toddlers. Which of the following foods should the nurse include?

Correct Answer is C

Explanation

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