A nurse is caring for a female client, age 36, in the postpartum unit following a scheduled cesarean birth 12 hours ago.

Complete the following sentence by using the lists of options.
The client is at greatest risk for developing

as evidenced by the client’s

.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

The client is at greatest risk for developing Endometritis as evidenced by the client’s Lochia characteristics.

Rationale for correct answers:
Endometritis is a postpartum uterine infection commonly occurring after cesarean birth due to ascending bacterial contamination. The client’s foul-smelling lochia is a hallmark sign, indicating infection of the uterine lining. Normally, lochia is odorless and changes from red to serous and then to white over weeks postpartum. The elevated WBC count (18,000/mm³; normal 5,000–15,000/mm³) supports infection but is nonspecific. The firm uterine tone reduces likelihood of postpartum hemorrhage. Urinalysis positive for bacteria suggests UTI but does not explain uterine signs. Hence, lochia changes are the most direct indicator of endometritis.

Rationale for incorrect Response 1 answers:
Postpartum hemorrhage typically involves heavy bleeding, uterine atony, or a rapidly dropping hematocrit, none of which is reported here. Urinary tract infection is suggested by urinalysis but does not account for uterine tenderness or foul lochia. Deep vein thrombosis would present with limb swelling, pain, and possible fever but no uterine or lochia changes.

Rationale for incorrect Response 2 answers:
Urinalysis positive for bacteria points to UTI but not uterine infection. Elevated WBC count indicates infection or inflammation but lacks specificity for endometritis versus other infections. Uterine tone is firm here, making hemorrhage or uterine atony unlikely and less relevant to infection diagnosis.

Take home points:

Endometritis often presents postpartum with foul-smelling lochia and elevated WBC.
Foul-smelling lochia is a critical clinical sign distinguishing endometritis from other postpartum complications.
Positive urinalysis suggests UTI, a separate postpartum infection that requires differentiation.
Uterine tone helps rule out hemorrhage and guides diagnosis of infection versus atony.

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Correct Answer is ["A","B","D","E"]

Explanation

Choice A rationale: Calcium gluconate is the antidote for magnesium sulfate toxicity, often used in labor inductions complicated by preeclampsia or gestational hypertension. Having it readily available ensures prompt treatment of symptoms like respiratory depression or cardiac arrhythmias caused by magnesium overdose. This safety measure is critical because oxytocin use can increase uterine contractions and magnesium sulfate use requires close monitoring to prevent toxicity.

Choice B rationale: Obtaining the client’s heart rate prior to initiating oxytocin is essential to establish a baseline and monitor for tachycardia or bradycardia, which may affect maternal and fetal safety. Oxytocin can cause cardiovascular changes, including hypertension or arrhythmias, especially in clients with gestational hypertension. Continuous maternal cardiac assessment helps detect adverse effects early and adjust treatment accordingly.

Choice C rationale: Evaluating platelet count before induction is important in clients with gestational hypertension due to the risk of HELLP syndrome, which involves thrombocytopenia. Normal platelet levels range from 150,000 to 400,000/mm³; low levels increase bleeding risk during labor and delivery. Knowing platelet status guides safe management decisions, including anesthesia options and readiness for potential hemorrhagic complications.

Choice D rationale: Assessing for aspirin sensitivity is crucial because aspirin is often used in pregnancy for preeclampsia prevention. Aspirin hypersensitivity can lead to allergic reactions or exacerbation of asthma. Since the client has gestational hypertension, determining aspirin tolerance before administering medications is necessary to prevent adverse drug reactions and ensure safe pharmacologic management.

Choice E rationale: Reviewing the client’s history for heart disease documentation is vital as gestational hypertension increases cardiovascular risk. Preexisting heart conditions can complicate labor induction and oxytocin administration due to possible cardiac overload or arrhythmias. A comprehensive cardiac history ensures appropriate monitoring and interventions to prevent maternal and fetal complications during labor.

A. "This test will check your baby's lung maturity.”. B. "This test will check your baby's blood type.”. C. "This test will check your baby's liver development.”. D. "This test will check your baby for genetic disorders.”.

Correct Answer is A

Explanation

Choice A rationale

The lecithin/sphingomyelin (L/S) ratio test is a crucial assessment of fetal lung maturity. Lecithin and sphingomyelin are phospholipids that are components of surfactant, a substance vital for reducing surface tension in the alveoli and preventing lung collapse at birth. A ratio of 2: or greater generally indicates adequate lung maturity.

Choice B rationale

The L/S ratio test does not assess the baby's blood type. Fetal blood typing is determined through other methods, such as cordocentesis or maternal blood tests for fetal DNA, if clinically indicated. The L/S ratio specifically evaluates the quantity and ratio of pulmonary surfactants.

Choice C rationale

This test does not check the baby's liver development. Fetal liver development is assessed through different parameters, such as ultrasound visualization of liver size, blood flow characteristics, and specific liver enzyme levels if a concern exists. The L/S ratio is solely focused on pulmonary maturity.

Choice D rationale

The L/S ratio test is not used to check for genetic disorders. Genetic disorders are identified through chromosomal analysis, DNA sequencing, or biochemical tests performed on amniotic fluid cells obtained during amniocentesis, or through chorionic villus sampling. The L/S ratio is a physiological marker of lung readiness.

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A nurse is caring for a female client, age 36, in the postpartum unit following a scheduled cesarean birth 12 hours ago. Complete the following sentence by using the lists of options. The client is at greatest risk for developing __________ as evidenced by the client’s __________.

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Naxlex Comprehensive Predictor Exams

A nurse is admitting a female client, age 34, who is at 38 weeks of gestation to the labor and delivery unit for induction of labor. Which of the following actions should the nurse take prior to implementing the provider’s prescriptions?

Correct Answer is ["A","B","D","E"]

Explanation

A nurse is teaching a client who is scheduled for an amniocentesis about the purpose of a lecithin/sphingomyelin ratio test. Which of the following statements should the nurse make?

Correct Answer is A

Explanation

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A nurse is caring for a female client, age 36, in the postpartum unit following a scheduled cesarean birth 12 hours ago.

Complete the following sentence by using the lists of options.
The client is at greatest risk for developing

as evidenced by the client’s

.