A nurse is assisting with the plan of care for a client who is Rh+, at 16 weeks of gestation, and scheduled for an amniocentesis. Which of the following actions should the nurse plan to take following the procedure?

Assist the client with positioning for an ultrasound.

Monitor the client for placental abruption.

Administer Rh.D immune globulin to the client.

Obtain an umbilical blood sample from the fetus.

Answer and Explanation

The Correct Answer is B

A. Assist the client with positioning for an ultrasound: Positioning for ultrasound is part of the preparation for amniocentesis, not a post-procedure intervention. After the procedure, the priority is monitoring the client for complications rather than repeating imaging unless clinically indicated.

B. Monitor the client for placental abruption: Amniocentesis carries a small risk of complications such as bleeding, cramping, or placental injury. Monitoring the client for signs of placental abruption, including vaginal bleeding, abdominal pain, and uterine tenderness, is an appropriate post-procedure action to ensure early detection and intervention.

C. Administer Rh.D immune globulin to the client: Administration of Rh.D immune globulin is indicated for Rh-negative clients to prevent isoimmunization. Since this client is Rh-positive, they do not require Rh immunoglobulin, so this action is not necessary.

D. Obtain an umbilical blood sample from the fetus: Umbilical blood sampling (cordocentesis) is a separate diagnostic procedure and is not part of routine amniocentesis. Post-procedure care focuses on maternal monitoring and fetal well-being rather than obtaining fetal blood immediately.

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Correct Answer is ["A","B","C"]

Explanation

A. Insulin lispro: Lispro is a rapid-acting insulin that can be mixed with intermediate-acting insulins such as NPH in the same syringe. When mixing, lispro is drawn into the syringe first to maintain its rapid-acting properties and prevent contamination of the intermediate insulin.

B. Insulin aspart: Aspart is another rapid-acting insulin compatible with intermediate-acting insulins like NPH for mixing. Proper technique involves drawing the rapid-acting insulin first, ensuring stable blood glucose control while reducing the number of injections.

C. Regular insulin: Regular insulin is short-acting and can be mixed with NPH insulin. This combination allows for both immediate and intermediate glycemic control, making it convenient for clients requiring multiple insulin actions in a single injection.

D. Insulin glargine: Glargine is a long-acting insulin that forms microprecipitates in subcutaneous tissue for steady absorption. It cannot be mixed with other insulins because mixing alters its pharmacokinetics and can compromise its peakless effect.

E. Insulin detemir: Detemir is also a long-acting insulin and must be administered separately. Mixing it with other insulins can change absorption rates and efficacy, making it unsafe to combine in the same syringe.

A. Discoloration at the postoperative site B. Urinary output 150 mL/hr C. Client report of pain at the incision site D. Blood pressure 78/38 mm Hg

Correct Answer is D

Explanation

A. Discoloration at the postoperative site: Mild bruising or ecchymosis around the incision is common after arthroscopy and generally expected. It does not usually indicate a complication requiring immediate reporting.

B. Urinary output 150 mL/hr: A urinary output of 150 mL/hr is above the minimum expected hourly output (typically 30 mL/hr) and suggests adequate renal perfusion. This finding does not require immediate notification.

C. Client report of pain at the incision site: Some pain at the incision site is expected postoperatively. While pain should be managed, reporting to the provider is not urgent unless it is uncontrolled or accompanied by other concerning signs.

D. Blood pressure 78/38 mm Hg: Hypotension at this level is significant and can indicate hypovolemia, bleeding, or shock. Immediate reporting to the provider is necessary to prevent organ hypoperfusion and initiate prompt interventions.

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A nurse is assisting with the plan of care for a client who is Rh+, at 16 weeks of gestation, and scheduled for an amniocentesis. Which of the following actions should the nurse plan to take following the procedure?

Nursing Test Bank

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