A nurse is caring for a client who is in the early stages of labor and requests nonpharmacological interventions for pain. Which of the following actions should the nurse take?

Encourage the client to void often.

Assist the client in remaining awake between contractions.

Minimize the client's position changes.

Limit the amount of time the support person remains in the room.

Answer and Explanation

The Correct Answer is A

A)   Correct - Encouraging the client to void often is important, as a full bladder can increase discomfort and interfere with labor progress.
B)   Incorrect- Remaining awake between contractions might not directly address pain management strategies.
C)   Incorrect- Position changes can help with pain management, so minimizing them would not be appropriate.
D)   Incorrect- The presence of a support person is often encouraged during labor, and there is no need to limit their time in the room.

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Correct Answer is B

Explanation

A) Incorrect- An amniocentesis is not typically needed after a molar pregnancy since there is no viable fetus.
B) Correct - A molar pregnancy is a rare condition where abnormal tissue forms in the uterus instead of a normal embryo. It often requires medical follow-up and emotional support. Attending a support group is important for emotional and psychological healing after the experience of a molar pregnancy.
C) Incorrect- Chemotherapy might be necessary in certain cases of molar pregnancy, but immediate chemotherapy is not a general requirement.
D) Incorrect- Home palliative services are not typically needed for molar pregnancy recovery.

A. A client who has a reddened area on their right calf B. A client who reports painful uterine contractions during breastfeeding C. A client who has a urinary output of 125 mL in 4 hr D. A client who reports changing their perineal pad every 2 hr

Correct Answer is C

Explanation

A) Incorrect- A reddened area on the calf might indicate a potential blood clot (deep vein thrombosis), which is important to assess but may not be the highest priority.
B) Incorrect- Painful uterine contractions during breastfeeding can be a normal response due to oxytocin release during breastfeeding and might not require immediate reporting.
C) Correct - A urinary output of 125 mL in 4 hours is significantly low and could indicate inadequate fluid intake, potential urinary retention, or other issues that need prompt attention. It is a sign of impaired renal function. This could indicate dehydration, blood loss, infection, or kidney injury. The nurse should assess the client's fluid intake and output, vital signs, urine specific gravity, and serum electrolyte levels. The nurse should also monitor the client for signs of hypovolemia, such as tachycardia, hypotension, and decreased skin turgor.
D) Incorrect- Changing a perineal pad every 2 hours is within the normal range for postpartum bleeding and might not require immediate reporting.

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A nurse is caring for a client who is in the early stages of labor and requests nonpharmacological interventions for pain. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about outpatient resources for a client who is recovering from a molar pregnancy. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is B

Explanation

A nurse working on a postpartum unit is collecting data from four clients. Which of the following findings should the nurse report to the provider?

Correct Answer is C

Explanation

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