The practical nurse (PN) is assigned to assist in the care of a client at 34-weeks gestation with premature rupture of membranes (PROM). Four hours after admission, the PN recognizes an increasing trend in the maternal heart rate. Which action should the PN take?

Follow contact precautions when providing care.

Insert a urinary catheter to monitor hourly output.

Encourage the client to push with the next contraction.

Initiate oxygen via face mask at 8 to 10 L/min.

Answer and Explanation

The Correct Answer is D

An increasing trend in maternal heart rate is a sign of fetal distress, which can be a serious complication of PROM. One of the primary interventions for fetal distress is to increase oxygen delivery to the fetus. The practical nurse should initiate oxygen via face mask at 8 to 10 L/min to improve fetal oxygenation.

Contact precautions may be necessary for certain conditions, but they are not indicated for an increasing maternal heart rate.

Inserting a urinary catheter may be appropriate for monitoring output, but it is not the first priority in this situation.

Encouraging the client to push is not appropriate because the client is not in active labor and pushing can cause further complications.

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Correct Answer is A

Explanation

Flaring of the nares, or widening of the nostrils, is a sign of respiratory distress in infants. It indicates that the child is working harder to breathe. This finding should alert the practical nurse (PN) that the child with bronchiolitis is in acute respiratory distress.

A resting respiratory rate of 35 breaths/minute (B) is within the normal range for a 3-month-old infant. Bilateral bronchial breath sounds (C) and diaphragmatic respirations (D) are not specific signs of acute respiratory distress in infants.

A. Take an enema the morning of the procedure. B. Empty your urinary bladder prior to the procedure. C. Refrain from sexual intercourse for 48 hours prior to the procedure. D. Shower with an antibacterial soap the night before the procedure.

Correct Answer is B

Explanation

Amniocentesis is a prenatal test that can diagnose genetic disorders and other health issues in a fetus. A provider uses a needle to remove a small amount of amniotic ﬂuid from inside your uterus, and then a lab tests the sample for specific conditions². It is important to empty your urinary bladder prior to the procedure ².

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The practical nurse (PN) is assigned to assist in the care of a client at 34-weeks gestation with premature rupture of membranes (PROM). Four hours after admission, the PN recognizes an increasing trend in the maternal heart rate. Which action should the PN take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 3-month-old with bronchiolitis is brought to the clinic experiencing irritability and poor oral intake. Which finding should alert the practical nurse (PN) that the child is in acute respiratory distress?

Correct Answer is A

Explanation

The practical nurse (PN) is preparing a client at 22-weeks gestation for an amniocentesis. Which instruction should the PN give to this client?

Correct Answer is B

Explanation

A client with a major depressive disorder is admitted to the inpatient psychiatric unit. Which intervention should the practical nurse (PN) use to demonstrate support of the client?

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