Which assessment finding should the nurse expect when palpating the fundus immediately after delivery?

Soft and not palpable.

Above the umbilicus.

At or below the umbilicus.

To the left or right of the umbilicus.

Answer and Explanation

The Correct Answer is C

A. Soft and not palpable: Immediately after delivery, the fundus should be firm and palpable. A soft, non-palpable fundus may indicate uterine atony, which is a serious condition that could lead to hemorrhage and requires immediate intervention.

B. Above the umbilicus: Immediately after delivery, the fundus is typically at or just below the umbilicus. If it is above the umbilicus, it could indicate uterine distension, a retained placenta, or excessive bleeding that needs to be addressed.

C. At or below the umbilicus: The fundus is expected to be firm and palpable at or just below the umbilicus immediately after delivery. This position reflects normal uterine contraction as the uterus begins to return to its pre-pregnancy size.

D. To the left or right of the umbilicus: The fundus should be midline after delivery. A deviation to the left or right may suggest a full bladder or uterine displacement, which can interfere with uterine contraction and increase the risk of bleeding.

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Correct Answer is B

Explanation

A. Notify the healthcare provider: There's no immediate need to notify the healthcare provider as the client is still in early labor, and pain relief can be managed with non-pharmacological methods.

B. Instruct the client to use deep breathing during a contraction: Non-pharmacological techniques, like deep breathing, should be used first to manage pain, allowing time for the medication effects to take place.

C. Discontinue the oxytocin infusion: The oxytocin infusion is still appropriate as labor is progressing, and there are no signs of complications.

D. Medicate the client with an additional 1 mg of butorphanol tartrate IV push: The client has already been medicated recently, so additional doses could lead to excessive sedation. Waiting for current medication effects is safer.

A. Wear loose fitting clothing without a bra for the procedure. B. Avoid using vaginal medications, lubricants, or contraceptives 2 days prior to the test. C. Refrain from wearing deodorant and lotions under the arms the day of the exam. D. Schedule the mammogram during the menstrual cycle.

Correct Answer is C

Explanation

A. Wear loose fitting clothing without a bra for the procedure: While loose-fitting clothing may be comfortable, the focus should be on avoiding substances like deodorant and lotions that could interfere with the mammogram. Wearing a bra is not specifically restricted.

B. Avoid using vaginal medications, lubricants, or contraceptives 2 days prior to the test: This instruction is not relevant to preparing for a mammogram, as these factors are more related to gynecological exams, not breast imaging.

C. Refrain from wearing deodorant and lotions under the arms the day of the exam: Deodorants, powders, or lotions can contain substances that may appear on the mammogram, potentially interfering with the accuracy of the images. Clients should avoid applying them on the day of the procedure.

D. Schedule the mammogram during the menstrual cycle: The timing of the mammogram in relation to the menstrual cycle is not crucial, although some women may find that their breasts are less tender during certain phases of their cycle. The focus should be on the other instructions for preparation.

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Body System	Nurses Notes and Flow Sheet
Respiratory	Respirations 16 breaths/minute Oxygen saturation of 89% Several deep breaths
Integumentary	Episiotomy intact with no redness Pad is saturated with blood 18 gauge IV to left forearm
Circulatory	Heart rate 96 beats/minute Blood pressure 90/62 mm Hg IV infusing at 125 mL/hr
Genital/Urinary	Boggy fundus 1 cm above umbilicus Fundus rotated to the right Voided 200 mL of clear yellow urine

Which assessment finding should the nurse expect when palpating the fundus immediately after delivery?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The healthcare provider (HCP) prescribes a diagnostic mammogram for a client who has detected a lump in the breast. Which instructions should the nurse provide the client to prepare for the procedure?

Correct Answer is C

Explanation

Exhibits The nurse reviews the client data. Complete the diagram by dragging from the choices area to specify what is occurring with the fetus, two actions the nurse should take to address the condition, and two parameters the nurse should monitor to assess progress.

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