Exhibits

For each assessment finding, click to indicate whether findings from this client's assessment are generally associated with mastitis, endometritis, or could be a sign of both conditions. Each row must have only one response option selected.

Pulse of 105 beats/minute

Feeling chilled, achy, and fatigued

Baby fed pumped breast milk

Pain rating of 4 on a 0 to 10 scale

Foul-smelling lochia rubra at 2 Weeks postpartum

Temperature of 101.2° F (38.4°C)

Answer and Explanation

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

Pulse of 105 beats/minute – Both mastitis and endometritis
Tachycardia (heart rate >100 bpm) is a systemic response to infection and inflammation, which can occur in both mastitis and endometritis. In mastitis, infection in the breast tissue triggers a systemic inflammatory response, while in endometritis, uterine infection can cause sepsis-related tachycardia.
Feeling chilled, achy, and fatigued – Both mastitis and endometritis
Both conditions can cause systemic flu-like symptoms, including chills, body aches, and fatigue, as the body mounts an immune response. Mastitis leads to generalized malaise due to localized infection and inflammation in the breast, while endometritis causes uterine infection, which can spread if untreated.
Baby fed pumped breast milk – Mastitis
Mastitis often develops due to milk stasis when the breasts are not fully emptied. The client was away from the baby for several hours while feeding pumped milk, which may have led to incomplete drainage of the breast, increasing the risk of bacterial overgrowth and mastitis.
Pain rating of 4 on a 0 to 10 scale – Mastitis
Pain in mastitis is usually localized to the affected breast, presenting as a red, firm, warm area. The uterine pain in endometritis is generally more cramp-like and associated with uterine tenderness, rather than a focal area of pain like in mastitis.
Foul-smelling lochia rubra at 2 weeks postpartum – Endometritis
Lochia should transition from rubra (red) to serosa (pink-brown) to alba (white/yellow) within 2 weeks postpartum. Foul-smelling, persistent lochia rubra is a hallmark sign of endometritis, indicating bacterial overgrowth in the uterus.
Temperature of 101.2° F (38.4°C) – Both mastitis and endometritis
Fever is a key symptom of both mastitis and endometritis as the body responds to infection. Mastitis causes localized breast infection with systemic symptoms, while endometritis results in uterine infection and systemic inflammatory response.

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Correct Answer is C

Explanation

A. Describe genetic testing protocols. Genetic testing is useful for identifying hereditary conditions, but it does not address the immediate health concerns of a pregnant client with opioid use disorder. Early prenatal care is more critical for monitoring fetal development and reducing complications associated with substance use.
B. Sign up for group therapy sessions. Group therapy can provide emotional support and coping strategies, but it is not the most immediate or essential step for ensuring a healthy pregnancy. While therapy is beneficial, comprehensive prenatal care should be prioritized to monitor fetal growth and manage opioid withdrawal safely.
C. Start a prenatal care plan as soon as possible. Early prenatal care is essential for monitoring the effects of methadone therapy on both the mother and fetus, ensuring appropriate fetal development, and managing potential complications such as neonatal abstinence syndrome (NAS). Prenatal visits will also provide guidance on nutrition, lifestyle modifications, and necessary medical interventions.
D. Discontinue the methadone right away. Abruptly stopping methadone can cause severe withdrawal symptoms in both the mother and fetus, increasing the risk of miscarriage, preterm labor, or stillbirth. Methadone maintenance therapy is the recommended treatment for opioid addiction during pregnancy, as it stabilizes maternal opioid levels and reduces harm to the fetus.

A. Encourage breastfeeding every 2 to 3 hours. B. Administer antibiotics for 7 to 10 days. C. Give zidovudine 6 to 12 hours after birth. D. Delay the initial bath for 1 to 2 days.

Correct Answer is C

Explanation

A. Encourage breastfeeding every 2 to 3 hours. Breastfeeding is contraindicated in HIV-positive mothers in regions where safe formula feeding is available, as HIV can be transmitted through breast milk. Instead, formula feeding is recommended to prevent vertical transmission of the virus.
B. Administer antibiotics for 7 to 10 days. Routine antibiotic prophylaxis is not necessary for newborns born to HIV-positive mothers. Instead, the focus is on antiretroviral therapy (ART) to reduce the risk of HIV transmission. Antibiotics would only be indicated if there is a confirmed or suspected infection.
C. Give zidovudine 6 to 12 hours after birth. Newborns of HIV-positive mothers should receive zidovudine (AZT) as post-exposure prophylaxis within the first 6 to 12 hours after birth to reduce the risk of perinatal HIV transmission. The duration of therapy depends on the infant’s risk level, with high-risk infants receiving combination antiretroviral therapy.
D. Delay the initial bath for 1 to 2 days. The newborn should be bathed as soon as their temperature is stable to remove maternal blood and amniotic fluid, which could contain the virus. Early bathing reduces the risk of viral exposure through mucous membranes or breaks in the skin.

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Exhibits For each assessment finding, click to indicate whether findings from this client's assessment are generally associated with mastitis, endometritis, or could be a sign of both conditions. Each row must have only one response option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is speaking with a client who is addicted to heroin and who just learned that she is pregnant. The client states, "I just started taking methadone. Is there anything else I can do to make sure my baby is healthy?" Which information should the nurse provide?

Correct Answer is C

Explanation

A newborn is delivered by cesarean section to a mother who is HIV-positive. The mother received antiretroviral therapy during pregnancy. Which intervention should the nurse implement?

Correct Answer is C

Explanation

An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?

The nurse is preparing to administer oxytocin IV to a client after the delivery of her infant. Which outcome should the nurse expect from the administration of oxytocin?

Exhibits Which other assessment data would the nurse want to collect before implementing pain management strategies? Select all that apply.

A mother brings her male preschooler to the clinic because he has had diarrhea, vomiting, and high fevers for the past three days. The child begins to cry and cling to his mother when the nurse enters the examination room. Which action should the nurse implement to get the child to cooperate?

Exhibits Which education by the nurse will help resolve the issue for the client? Select all that apply.

A multiparous client with active herpes lesions is admitted to the unit with spontaneous rupture of membranes. Which action should the nurse take?

Exhibits Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate. Each row must have one option selected.

A preschool-aged child who is experiencing respiratory distress is brought to the emergency department by the parents. The child is anxious, has a temperature of 102.8° F (39.3° C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse implement next?

Exhibits

For each assessment finding, click to indicate whether findings from this client's assessment are generally associated with mastitis, endometritis, or could be a sign of both conditions. Each row must have only one response option selected.