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Exhibits

The postpartum nurse reviews the nurses' notes to determine if the outcomes were successful.

Click to highlight the notes that demonstrate a positive outcome.

The client is admitted to the hospital after her membranes rupture at 38 weeks gestation. A vaginal examination is done. The nurse determines that the client is 3 cm dilated, 40% effaced, and the fetal head is at -1 station. The external monitor shows that contractions are occurring every 4 minutes and lasting 70 seconds, and the nurse palpates the quality as strong. Her fasting blood glucose (FSBG) is 86 (4.8 mmol/L). The client is transferred to the labor-delivery-recovery (LDR) suite. The client dilates quickly to 10 cm and feels a strong urge to push. The fetal heart rate is reassuring with a baseline of 145 and moderate variability The nurse briefly reviews pushing techniques with her and her husband and notifies the obstetrician of the client's progress. After three cycles of open-glottis pushing, the baby's head is crowning. The head is born easily over an intact perineum. The infant weighs 9 lbs. 9 oz (4.34 kgs) and has an Apgar of 7 at 1 minute, then 9 at 5 minutes.

Her fasting blood glucose (FSBG) is 86 (4.8 mmol/L)

The client dilates quickly to 10 cm and feels a strong urge to push

The fetal heart rate is reassuring with a baseline of 145 and moderate variability

After three cycles of open-glottis pushing, the baby's head is crowning

The head is born easily over an intact perineum

The infant weighs 9 lbs. 9 oz (4.34 kgs)

Apgar of 7 at 1 minute, then 9 at 5 minutes

Answer and Explanation

The Correct Answer is ["A","B","C","D","E","G"]

Rationale for Correct Findings:

The client dilates quickly to 10 cm and feels a strong urge to push: Rapid dilation and the strong urge to push indicate that the client is progressing effectively through labor, with no signs of obstruction or delays.
The fetal heart rate is reassuring with a baseline of 145 and moderate variability: A reassuring fetal heart rate with moderate variability is a good sign that the baby is not experiencing any distress during labor, indicating a healthy fetal condition.
The head is born easily over an intact perineum: The ease of the baby's head being born over an intact perineum suggests that the delivery is progressing smoothly, with minimal risk of perineal trauma.
Apgar of 7 at 1 minute, then 9 at 5 minutes: The Apgar scores of 7 at 1 minute and 9 at 5 minutes show a positive outcome in neonatal assessment, with a good recovery.
The fasting blood glucose (FSBG) is 86 (4.8 mmol/L): A fasting blood glucose of 86 mg/dL is within the normal range (74 to 106 mg/dL), indicating that the client’s blood glucose levels are well-controlled, which is a positive sign for managing her gestational diabetes.

Rationale for Negative Finding:

The infant weighs 9 lbs. 9 oz (4.34 kgs): Macrosomia (a term used for babies born weighing more than 4 kg) can be associated with gestational diabetes, which increases the likelihood of delivering a larger baby. Macrosomia may lead to potential complications such as shoulder dystocia or increased risk for cesarean delivery.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

A. Amiodarone: Amiodarone can cause pulmonary toxicity, but it is not a beta blocker and is less likely to cause acute bronchoconstriction. It should still be used cautiously in clients with lung disease, but it is not the priority to withhold based on current symptoms.

B. Propranolol: Propranolol is a non-selective beta blocker that can worsen bronchospasm in clients with COPD by blocking beta-2 receptors in the lungs. Given the client’s shortness of breath and COPD history, the nurse should consult the HCP before administering this drug.

C. Furosemide: Furosemide is a loop diuretic that helps reduce fluid overload and edema. It is appropriate in the presence of pitting edema and respiratory symptoms, as it may relieve symptoms related to right-sided heart failure commonly associated with advanced COPD.

D. Losartan: Losartan is an angiotensin receptor blocker (ARB) used to manage hypertension and reduce cardiac workload. It does not typically worsen pulmonary function and is not contraindicated in COPD patients presenting with shortness of breath or edema.

A. Tenderness. B. Pain. C. Musical and drumlike. D. Absent sounds.

Correct Answer is C

Explanation

A. Tenderness: Tenderness during percussion could indicate an underlying issue, such as inflammation or infection, and is not a normal finding.

B. Pain: Pain during percussion may suggest problems like organ inflammation or distension and is not considered normal.

C. Musical and drumlike: This finding is normal and is often indicative of the presence of air or gas in the intestines, which is a common finding in older adults, especially those with less efficient digestion.

D. Absent sounds: Absent sounds could indicate bowel obstruction or other serious issues and are not a normal finding. Normal percussive sounds should be heard.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse completes percussion of the abdomen on an older adult client. Which finding is considered normal for this client?

Correct Answer is C

Explanation

When performing suctioning for a client with a tracheostomy, which action should the nurse include?

After receiving report on an inpatient acute care unit, which client should the nurse assess first?

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