Assessment findings of a 4-hour-old newborn include: axillary temperature of 96.8° F (35.8° C), heart rate of 150 beats/minute with a soft murmur, irregular respiratory rate at 64 breaths/minute, jitteriness, hypotonic, and weak cry.
Based on these findings, which action should the nurse implement?

A laboring client has a variable deceleration on the fetal monitor.
What is the first action that the nurse should take?

The nurse is reviewing a client’s chart.

Click to highlight areas of client history and physical below that increase the risk for postpartum hemorrhage.

Client was middle-aged and married.

She was in labor for 25 hours and forceps were used to assist with the delivery.

She was given an epidural for anesthesia that was effective.

The labor and delivery nurse reported that the client had a 4th degree laceration, and her pain was currently at a 4 on a 0 to 10 pain scale.

Her vital signs were stable, and she was catheterized for 500 mL of light-yellow urine just prior to delivery.

Her spouse was at the bedside for delivery.

The nurse is providing information to a parent of a six-month old about vaccinations.
Which statement made by the parent should the nurse recognize as understanding the information?

A client who experienced a severe postpartum hemorrhage following the vaginal birth of twins is transferred to the postpartum unit.
The nurse knows that assessment for which complication is the highest priority for this client?

A 17-year-old student arrives at the emergency department (ED) complaining of severe abdominal pain and cramping that has worsened since the morning.

Her mother suspects a urinary tract infection due to her daughter’s frequent and urgent urination, or possibly appendicitis.

What signs would indicate that a healthy psychosocial adaptation is taking place? Select all that apply.

A parent rushes their pre-school age child to the emergency department with an asthma exacerbation.
Which additional finding should alert the nurse that the child is in acute respiratory distress?

A client at 38-weeks gestation reports experiencing severe abdominal pain.
Upon palpation, the nurse notes that the abdomen is rigid.
How should the nurse document the findings?

A 3-year-old male was brought into the emergency room this morning with a sudden onset of “fast and noisy breathing”. According to his parents, he had sneezing and a runny nose last week but seemed to have recovered.
The child lives with 2 older, school-age siblings, his parents, and 3 dogs.
He was born at 37 weeks’ gestation.
The parents deny smoking, but his grandmother cares for him in the afternoons and smokes outside when she is at the house.
He has no significant medical history.
He has received all vaccines except for those due at 3 years.
Upon exam, the child is… Which two items must the nurse ensure are available before attempting to place the intravenous line?

The nurse is providing treatment education to the caregiver of a school-age child recently diagnosed with ADHD.
Which statement(s) made by the caregiver demonstrates an understanding?