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A nurse is evaluating a postpartum client for potential endometritis.
Which of the following symptoms should the nurse identify as a need for further assessment?

Hematuria

Pelvic pain

Moderate amount of dark red lochia with a bloody odor

Localized area of breast tenderness

Answer and Explanation

The Correct Answer is B

Choice A rationale

Hematuria, or blood in the urine, is not typically a symptom of postpartum endometritis.

Choice B rationale

Pelvic pain is a common symptom of postpartum endometritis. It is often one of the first symptoms to appear, along with lower abdominal pain and uterine tenderness.

Choice C rationale

While a moderate amount of dark red lochia with a bloody odor can be a normal part of the postpartum period, it is not specifically indicative of endometritis.

Choice D rationale

Localized area of breast tenderness is not typically a symptom of postpartum endometritis.

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Correct Answer is B

Explanation

Choice A rationale

Quickening is the sensation of fetal movement by the pregnant woman. It usually occurs between 16 and 20 weeks of gestation.

Choice B rationale

Hegar’s sign is a probable sign of pregnancy that is characterized by the compressibility and softening of the cervical isthmus, which is the portion of the cervix between the uterus and the vaginal portion of the cervix. This sign typically presents between the fourth and sixth week of pregnancy. Therefore, if the nurse identifies a probable sign indicating the softening of the lower uterine segment, it is likely that the nurse has observed Hegar’s sign.

Choice C rationale

Braxton Hicks contractions are intermittent uterine contractions that occur during pregnancy. They are not a sign of labor and do not lead to cervical dilation or effacement. Therefore, they would not indicate the softening of the lower uterine segment.

Choice D rationale

Ballottement is a technique of palpating a floating structure by bouncing it and feeling it rebound. In the context of pregnancy, it refers to the movement of the fetus when the uterus is tapped during a pelvic examination. This does not indicate the softening of the lower uterine segment.

A. Administer the insulin 30 minutes after breakfast along with the patient’s other routine medications. B. Administer the insulin at 0700. C. Administer the insulin at 0730. D. Administer the insulin when the breakfast tray arrives.

Correct Answer is C

Explanation

Choice A rationale

Administering the insulin 30 minutes after breakfast is not recommended. Regular insulin should be administered before meals.

Choice B rationale

Administering the insulin at 0700 is not recommended. Regular insulin should be administered 30 to 45 minutes before a meal.

Choice C rationale

Administering the insulin at 0730 is recommended if breakfast is at 0800. Regular insulin should be administered 30 to 45 minutes before a meal. This is the correct answer.

Choice D rationale

Administering the insulin when the breakfast tray arrives is not recommended. Regular insulin should be administered 30 to 45 minutes before a meal.

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A nurse is evaluating a postpartum client for potential endometritis.Which of the following symptoms should the nurse identify as a need for further assessment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While assessing a pregnant primigravida client, the nurse identifies a probable sign indicating the softening of the lower uterine segment.Which of the following signs is the nurse likely to have observed?

Correct Answer is B

Explanation

A nurse is caring for a patient with diabetes and plans to administer regular insulin subcutaneously before breakfast at 0800.After checking the patient’s morning glucose level, what action should the nurse take?

Correct Answer is C

Explanation

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A nurse is evaluating a postpartum client for potential endometritis.
Which of the following symptoms should the nurse identify as a need for further assessment?