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. Begin prescribed intravenous antibiotic administration. While IV antibiotics are essential for treating bacterial infections such as epiglottitis, securing the airway is the priority in this child with severe respiratory distress. Antibiotic therapy should be initiated after airway stabilization to prevent further deterioration.
B. Schedule the child for a STAT magnetic resonance imaging (MRI) of the neck. An MRI is not appropriate in an emergency airway situation, as it requires the child to remain still and may delay critical interventions. A clinical diagnosis of epiglottitis is based on symptoms, and confirmation is typically done with lateral neck X-rays only if the airway is stable.
C. Obtain bedside trays for intubation or tracheotomy by the healthcare provider. The child’s symptoms—high fever, drooling, anxiety, and a tripod sitting position—are classic signs of epiglottitis, a life-threatening condition caused by Haemophilus influenzae type B (Hib). Immediate airway management is critical, as swelling of the epiglottis can rapidly lead to complete airway obstruction. Equipment for emergency intubation or tracheotomy must be readily available.
D. Provide a nebulizer treatment with bronchodilators. Nebulized bronchodilators are used for conditions like asthma or croup but are ineffective in epiglottitis, which is caused by inflammation and swelling of the supraglottic structures. Administering nebulized treatments may further distress the child and increase the risk of airway obstruction.

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

Explanation

Plugged duct: A plugged duct occurs when milk is not effectively drained from the breast, leading to milk stasis and inflammation. If untreated, it can progress to mastitis, an infection caused by bacterial overgrowth in stagnant milk. The client's history of missing a feeding while shopping increases the likelihood of milk stasis, making a plugged duct the most likely cause of mastitis.
Breast abscess: A breast abscess is a collection of pus that forms when mastitis is left untreated or does not respond to antibiotics. Unlike mastitis, an abscess is typically fluctuant (soft and fluid-filled), extremely tender, and may require drainage. Since the client’s mastitis symptoms have just begun, an abscess is unlikely at this stage.
Engorgement : Breast engorgement occurs when the breasts overfill with milk, causing swelling and discomfort. While engorgement can increase the risk of mastitis, it is not an infection itself and does not directly cause mastitis unless milk stasis leads to bacterial overgrowth. Engorgement is bilateral, whereas mastitis is usually unilateral with localized redness, warmth, and fever.
Nipple trauma with cracked skin: Cracked nipples can allow bacteria to enter the breast, increasing the risk of infection. However, mastitis is primarily caused by milk stasis, not just nipple trauma. In this client, there is no mention of nipple cracks or bleeding, making this a less likely cause.
Firm, red, warm area on the right breast: A firm, red, warm, and tender area on the breast is a hallmark symptom of mastitis, indicating localized inflammation and infection. The presence of systemic symptoms (fever, chills, fatigue) further supports mastitis rather than another breast condition.
Pus draining from the nipple: Pus or fluctuance (fluid-filled swelling) suggests a breast abscess, not mastitis. While untreated mastitis can lead to an abscess, this client’s symptoms do not indicate a severe or advanced infection requiring drainage.
Generalized swelling of the entire breast: Severe engorgement can cause generalized swelling, but mastitis typically presents as a localized, inflamed area rather than affecting the entire breast. Engorgement also does not cause fever or systemic illness, which are present in mastitis.
Pain that worsens with cold compresses: Cold compresses reduce inflammation and discomfort in mastitis. If cold worsens pain, it may suggest Raynaud’s phenomenon of the nipple, which is not related to mastitis. Mastitis pain is relieved with warmth, massage, and frequent breastfeeding.

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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 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?

Correct Answer is C

Explanation

Exhibits Choose the most likely options for the information missing from the statement by selecting from the list of options provided. The nurse knows that the mastitis in this scenario is most likely caused bydropdown, as evidenced bydropdown

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

Explanation

Which is the most important assessment for the nurse to conduct following the administration of epidural anesthesia to a client who is at 40-weeks gestation?

Exhibits Which description(s) by the client should help confirm that the mastitis has been resolved and breastfeeding/breast health is well maintained? Select all that apply.

A client who is 37 weeks gestation comes to the women's health clinic reporting an excruciating headache. On examination, the nurse determines the client has an elevated blood pressure. Which action should the nurse implement next?

Upon completion of a 14-day antibiotic treatment for bacterial meningitis in an infant, the nurse prepares the family for discharge. Which information should the nurse include?

The mother of a 4-month-old baby girl asks the nurse when should she introduce solid foods to her infant. The mother states, "My mother says I should put rice cereal in the baby's bottle now. The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior?

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.

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.