Click to indicate which interventions the nurse would include in the plan of care to support the expected outcomes of adequate epidural anesthesia on the mother and the fetus. Each column must have a least one response selected.

Administering bolus fluids

Side positioning

Urinary drainage

Assisting with pushing efforts

Administering IV fluids

Monitoring blood pressure

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"B"},"F":{"answers":"A,B"}}

Intervention	Fetus	Maternal
Administering bolus fluids	✔	✔
Side positioning	✔	✔
Urinary drainage		✔
Assisting with pushing efforts		✔
Administering IV fluids		✔
Monitoring blood pressure	✔	✔

• Administering bolus fluids: Increases maternal intravascular volume to reduce the risk of epidural-induced hypotension. Stable maternal blood pressure helps maintain adequate uteroplacental perfusion. This ensures continuous oxygen delivery to the fetus during labor.

• Side positioning: Prevents compression of the inferior vena cava by the gravid uterus. This improves venous return and cardiac output, enhancing blood flow to the placenta. Helps avoid supine hypotension syndrome, maintaining maternal blood pressure and fetal perfusion. Fetal oxygenation is better preserved in side-lying positions.

• Urinary drainage: Prevents bladder overdistention caused by sensory and motor blockade from epidural anesthesia. A full bladder can hinder fetal descent and prolong labor. Catheterization protects maternal comfort and labor progression.

• Assisting with pushing efforts: Supports the second stage of labor when the epidural limits maternal bearing-down ability. Coaching synchronizes maternal effort with contractions. This intervention improves efficiency of pushing and fetal descent.

• Administering IV fluids: Maintains adequate preload to prevent vasodilation-related hypotension after epidural administration. Consistent fluid support sustains maternal blood pressure and perfusion to uterine arteries during labor.

• Monitoring blood pressure: Detects early signs of hypotension, a common adverse effect of epidural anesthesia. Frequent readings guide prompt intervention to stabilize maternal hemodynamics. This protects both maternal safety and fetal well-being.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["12.5"]

Explanation

Calculate the total daily dose in milligrams:

Total daily dose (mg) = Prescribed dose (grams) x 1000 mg/gram

= 1.5 grams x 1000 mg/gram

= 1500 mg

Determine the number of doses per day:

Number of doses per day = 24 hours / Frequency of doses (hours)

= 24 hours / 8 hours/dose

= 3 doses/day

Calculate the dose to administer every 8 hours:

Dose per administration (mg) = Total daily dose (mg) / Number of doses per day

= 1500 mg / 3 doses

= 500 mg

Calculate the volume to administer per dose in mL:

Volume per dose (mL) = Desired dose (mg) / Available concentration (mg/mL)

= 500 mg / (200 mg / 5 mL)

= 500 mg / 40 mg/mL

= 12.5 mL

The nurse should administer 12.5 mL every 8 hours.

A. Client education about diagnosis and plan of care B. Effective coping with illness related anxiety C. Promotion of bowel routine D. Infection prevention related to illness E. Relief of acute pain F. Fluid volume management G. A review of diet progression postoperatively H. Prevention of deep vein thrombosis (DVT) related to immobility

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

Explanation

A. Client education about diagnosis and plan of care: Important for informed consent, cooperation, and reducing fear. The client is alert and oriented, so she should be provided with accurate information about appendicitis, surgical intervention, and next steps.

B. Effective coping with illness related anxiety: The client has a history of anxiety and reports feeling anxious during this episode. Addressing anxiety helps reduce sympathetic stimulation, supports emotional well-being, and improves overall cooperation with care.

C. Promotion of bowel routine: Not a current priority. The client’s bowel pattern is normal, and constipation is not contributing to the acute condition. Interventions should focus on the acute issue rather than chronic baseline management.

D. Infection prevention related to illness: Critical due to elevated WBC, fever, and confirmed appendicitis. Delayed or perforated appendicitis can lead to peritonitis or sepsis, so infection control is a top goal before and after surgery.

E. Relief of acute pain: A major priority as the client reports severe pain (9/10). Pain control improves comfort, reduces physiological stress responses, and is essential prior to surgical intervention.

F. Fluid volume management: The client has tachycardia, fever, and vomiting, placing her at risk for hypovolemia. The 1-liter lactated Ringer's bolus is essential to stabilize circulatory volume before anesthesia or surgery.

G. A review of diet progression postoperatively: Not a current focus in the ED. Nutritional education is typically addressed postoperatively when the client is recovering and cleared to resume oral intake.

H. Prevention of deep vein thrombosis (DVT) related to immobility: Important in longer-term or postoperative care, but not a priority during acute stabilization in the emergency setting before surgery.

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Click to indicate which interventions the nurse would include in the plan of care to support the expected outcomes of adequate epidural anesthesia on the mother and the fetus. Each column must have a least one response selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["12.5"]

Explanation

Patient Data The nurse is stabilizing the client and preparing her for surgery. Which goals should the nurse prioritize in the care plan for the client while in the emergency department? Select all that apply.

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

Explanation

Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

When changing the client's dressing for a vacuum-assisted closure (VAC) wound therapy system, the nurse observes foul, purulent drainage. Which intervention(s) should the nurse implement? Select all that apply.

Exhibits Select the 3 statements that the nurse should include when discussing caregiver stress with the client's daughter.

A client with pancreatitis reports severe epigastric pain, so the nurse administers a prescribed narcotic analgesic. Ten minutes later, the client insists on sitting up and leaning forward. Which intervention should the nurse implement?

Client data Complete the table by matching each client data to the appropriate goal of care

Which assessment technique provides the most useful data when the nurse is concerned about possible urinary retention?

The nurse is teaching a female client about preventive measures for urinary tract infections (UTI). Which information should the nurse include?