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While waiting for the placenta to deliver during the third stage of labor, the nurse must assess the new mother's vital signs every 15 minutes.
What sign would indicate impending shock?.

Bradypnea and hypertension.

Tachycardia and a falling blood pressure.

Tachypnea and a widening pulse pressure.

Bradycardia and auscultation of fluid in the base of the lungs.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Bradypnea and hypertension are not typically signs of impending shock.

Choice B rationale:

Tachycardia and a falling blood pressure are classic signs of shock as the body tries to compensate for the decreased blood flow.

Choice C rationale:

Tachypnea and a widening pulse pressure can be signs of shock, but they are not as indicative as tachycardia and a falling blood pressure.

Choice D rationale:

Bradycardia and auscultation of fluid in the base of the lungs are not typically signs of impending shock.

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Correct Answer is D

Explanation

Choice A rationale:

This choice indicates 3 pregnancies, 1 term, 2 preterm, 2 living children, and 3 abortions. However, the client has had 4 pregnancies (twins, a son, and a miscarriage), so this choice is incorrect.

Choice B rationale:

This choice indicates 3 pregnancies, 2 term, 1 preterm, no living children, and 3 abortions. The client has 3 living children (twins and a son), so this choice is incorrect.

Choice C rationale:

This choice indicates 4 pregnancies, 1 term, 1 preterm, 1 living child, and 3 abortions. The client has 3 living children (twins and a son), so this choice is incorrect.

Choice D rationale:

This choice indicates 4 pregnancies, 2 term, 1 preterm, 3 living children, and 1 abortion. This correctly reflects the client’s obstetric history.

A. Offering fluids as indicated. B. Encouraging the woman to void. C. Assessing the uterine fundus. D. Assisting with perineal care. E. Assisting with perineal care.

Correct Answer is C

Explanation

Choice A rationale:

Offering fluids is important to prevent dehydration, but it’s not the priority during the fourth stage of labor.

Choice B rationale:

Encouraging the woman to void can help prevent urinary retention, but it’s not the priority.

Choice C rationale:

Assessing the uterine fundus is the priority during the fourth stage of labor. This is to ensure that the uterus is contracting and to prevent postpartum hemorrhage.

Choice D rationale:

Assisting with perineal care is important for comfort and hygiene, but it’s not the priority.

So, the correct answer is C, assessing the uterine fundus.

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While waiting for the placenta to deliver during the third stage of labor, the nurse must assess the new mother's vital signs every 15 minutes. What sign would indicate impending shock?.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Which action is a priority when caring for a woman during the fourth stage of labor?.

Correct Answer is C

Explanation

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While waiting for the placenta to deliver during the third stage of labor, the nurse must assess the new mother's vital signs every 15 minutes.
What sign would indicate impending shock?.