31. A nurse is preparing to perform Leopold maneuvers on a client who is at 36 weeks of gestation. Identify the sequence of actions the nurse should take. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps)
Position the client supine with knees flexed and place a small rolled towel under one of their hips.
Palpate the fetal part positioned in the fundus.
Instruct the client to empty their bladder.
Palpate the fetal parts along both sides of the uterus.
Palpate the fetal part positioned above the symphysis pubis.
The Correct Answer is C,A,B,D,E
C. Instruct the client to empty their bladder.
A. Position the client supine with knees flexed and place a small rolled towel under one of their hips.
B. Palpate the fetal part positioned in the fundus.
D. Palpate the fetal parts along both sides of the uterus.
E. Palpate the fetal part positioned above the symphysis pubis.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. Thick, white vaginal discharge is not characteristic of trichomoniasis. Trichomoniasis typically presents with a frothy, yellow-green, or grayish vaginal discharge.
B. Vulva lesions are not commonly associated with trichomoniasis. The primary symptom is vaginal discharge.
C. While urinary frequency can occur in some cases of trichomoniasis due to irritation of the urinary tract, it is not as specific a finding as the characteristic malodorous discharge.
D. Malodorous discharge is a hallmark symptom of trichomoniasis. The discharge is often described as having a foul or fishy odor and may be accompanied by itching and irritation of the genital area.
Correct Answer is C
Explanation
Rationale:
A. Using a 21-gauge needle may be too large for a newborn, increasing the risk of discomfort and tissue damage.
B. Inserting the needle at a 45° angle may not be appropriate for intramuscular injections in newborns. The preferred angle is typically 90°.
C. Administering the injection into the vastus lateralis muscle is the recommended site for hepatitis B vaccination in newborns. This site is located on the anterior lateral aspect of the thigh and provides good muscle mass for injection.
D. Vigorously massaging the site following the injection is not recommended as it may increase discomfort and tissue trauma. Instead, gentle pressure can be applied to the site to help reduce discomfort.
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