The practical nurse (PN) determines that a client who is one day postpartum has a moderate amount of lochia rubra and the uterus is firm, dextroverted, and three fingerbreadths above the umbilicus. Which should be the PN's initial action?

Provide a stool softener for constipation.

Assess the bladder for distension.

Check the hemoglobin to determine uterine hemorrhage.

Massage the uterus to decrease atony.

Answer and Explanation

The Correct Answer is B

Correct Answer: B.
A.   Providing a stool softener for constipation might be necessary postpartum but isn't the initial action indicated by the client's current status.
B.   Assessing the bladder for distension is crucial because a distended bladder can displace the uterus and impede its ability to contract properly, leading to uterine atony and increased bleeding.
C.   Checking the hemoglobin to determine uterine hemorrhage is important but might not be the initial step needed based on the client's condition.
D.   Massaging the uterus to decrease atony is a potential intervention, but assessing for bladder distension takes priority in this scenario to prevent uterine displacement.

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Correct Answer is ["B","C"]

Explanation

A. The wound is not inflamed, but rather discharging excessively. The PN should document the amount and color of the drainage, the size and location of the wound, and any signs of infection or complications.
B. The dressing needs to be changed as soon as possible to prevent infection and further blood loss. The charge nurse can also assess the need for additional interventions, such as suturing, hemostasis, or transfusion.
C. Compressing the device creates a vacuum that helps drain the fluid from the wound. The PN should squeeze the device until it is about half full, then close the tab securely.
D. Clamping the tubing can cause a backup of fluid in the wound, which can increase the risk of infection and impair healing. The PN should never clamp the tubing unless instructed by the provider.
E. Removing the device can cause more bleeding and disrupt the healing process. The PN should only remove the device when ordered by the provider or when it is no longer needed.

A. Checks the medical record for the correct signed consent form prior to the examination. B. Explains the examination and ask the client to sign the consent form. C. Explains to a family member and obtain their signature on the consent form. D. Asks if the client understands the exam and why the consent form must be signed. E. Asks if the client understands the exam and why the consent form must be signed.

Correct Answer is A

Explanation

A. Checks the medical record for the correct signed consent form prior to the examination. - Verifying that the correct consent form is signed and present in the medical record before the invasive examination is crucial to ensure the procedure is performed with proper authorization.
B. Explains the examination and asks the client to sign the consent form. - While it's important to explain the examination, obtaining consent typically involves the healthcare provider or a designated professional.
C. Explains to a family member and obtains their signature on the consent form. - Consent generally needs to be obtained directly from the client or their legally authorized representative, not just a family member.
D. Asks if the client understands the exam and why the consent form must be signed. - While educating the client about the procedure and the purpose of consent is important, it doesn't cover the formal process of obtaining and verifying the consent form.

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The practical nurse (PN) determines that a client who is one day postpartum has a moderate amount of lochia rubra and the uterus is firm, dextroverted, and three fingerbreadths above the umbilicus. Which should be the PN's initial action?

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) observes a client's initial postoperative dressing and drain as seen in the picture. Which follow-up actions should the PN implement? (Select all that apply.)

Correct Answer is ["B","C"]

Explanation

Prior to an invasive examination of a hospitalized client, a consent form should be obtained. Which action best describes the responsibility of the practical nurse (PN)?

Correct Answer is A

Explanation

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