The nurse is completing a fundal assessment for her postpartum clients today. What will the nurse determine when assessing the fundus?

IV calculations: (rate-mL/h and gtt/min)

• IV rate calculations will be rounded to nearest whole number.

Adult calculations: the calculation will be rounded to the nearest tenth. Drug Calculation safety considerations:

• Examples:
  • 5 must be answered as 0.5
  • 5.0 must be answered as 5
• To promote safety, a zero must be placed to the left of the decimal point in answers that are less than one. No zero is allowed to the right of the decimal point in answers that are whole numbers.
• Labeling is not necessary

Available: see drug label above Ordered promethazine 12.5mg IM

How many mL of promethazine will the nurse administer?

The nurse is assisting a pregnant patient into bed after the patient reports a gush of fluid from the vagina. Which action will the nurse take first?

The nurse is caring for a client in labor receiving oxytocin. The client asks the nurse, "What is this medication for?" What is the best response by the nurse?

The nurse is discussing birth options with a pregnant client. The client previously had a cesarean birth with a classical incision at 26 weeks' gestation but desires a vaginal birth with this pregnancy. What is the best response by the nurse?

The nurse is caring for a client in labor. Which process will the nurse use to determine the duration of contractions?

The nurse is caring for a laboring client. The nurse observes that there are variable decelerations. What is the nurse's priority action?

The nurse is caring for a client during a vaginal exam by the provider. The provider informs the client that he will use the most common mechanical method to ripen her cervix prior to induction of labor. What is the method being used by the provider?

The nurse is caring for a client in labor. Which assessment finding will the nurse report to the charge nurse immediately?

The nurse is caring for a client in labor. Assessment findings: The fetal heart rate (FHR) baseline is 120 bpm The FHR begins slowing as the contraction starts, and is back to baseline at the end of the contraction There is moderate variability of the FHR Which periodic change will the nurse document in the electronic health record?

The nurse is caring for a multiparous client who has been in labor for 12 hours. The client had a spontaneous vaginal delivery 2 years ago. This was an unplanned pregnancy with someone she only knew briefly. Since finding out she was pregnant, she has been alone. Her pain is now 8/10 and she is becoming fearful that something is wrong since she has been in labor so long.

Contractions assessment:

• Contractions every 3-4 minutes
• Palpating moderate in intensity
• Lasting 45-60 seconds Cervical exam: .3 cm
• 90% effaced . -2 station
• Fetus is in a cephalic presentation.

Which component of labor is keeping the client from advancing in labor?