A charge nurse is creating assignments for the next shift for several nurses and one of the nurses is pregnant. Which of the following clients should the charge nurse assign to a nurse who is not pregnant?

A client who has alcoholic pancreatitis

A client who has latent tuberculosis

A client who is recovering from shingles

A client who has HIV

Answer and Explanation

The Correct Answer is C

Rationale:

A. A client who has alcoholic pancreatitis: Alcoholic pancreatitis does not pose a risk of teratogenicity or infectious transmission to a pregnant nurse. Standard precautions are sufficient, making this assignment safe for a pregnant nurse.

B. A client who has latent tuberculosis: Latent TB is not contagious, as the bacteria are inactive and the client cannot transmit the infection. A pregnant nurse can safely care for this client with standard precautions without increased risk.

C. A client who is recovering from shingles: Shingles (herpes zoster) is caused by reactivation of the varicella-zoster virus and can be transmitted via direct contact with lesions. Pregnant nurses who have not had chickenpox or the varicella vaccine are at risk for serious complications, so this client should be assigned to a non-pregnant nurse.

D. A client who has HIV: HIV is transmitted through blood and body fluids, and standard precautions effectively protect healthcare workers. There is no contraindication for a pregnant nurse to care for a client with HIV using proper infection control measures.

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Correct Answer is ["A","F","G","H","I","J"]

Explanation

Rationale for correct choices

• Temperature 38.2° C (100.8° F). An elevated temperature in a postpartum client may indicate infection, especially in the context of prolonged rupture of membranes and cesarean delivery. Prompt follow-up is required to identify the source and initiate treatment to prevent progression to sepsis.

• WBC count 33,000/mm³. A markedly elevated WBC suggests an active inflammatory or infectious process. In postpartum clients, leukocytosis can signal endometritis, mastitis, or surgical site infection, necessitating immediate assessment and intervention.

• Client reports feeling unwell. A general feeling of being ill or "not right" in a postpartum client with fever is a significant subjective finding often preceding more objective signs of infection/sepsis.

• Uterus firm at 1 cm above the umbillous and tender to palpation. Uterine tenderness combined with fever and foul-smelling lochia is a cardinal sign of endometritis (infection of the uterine lining), the most common postpartum infection, especially after Cesarean section.

• Moderate amount of dark brown, foul-smelling lochia. Foul-smelling lochia is a hallmark of uterine infection such as endometritis. Combined with fever and leukocytosis, this finding warrants urgent evaluation, monitoring, and possible initiation of antibiotics.

• Breasts firm, heavy, and warm with nipple discomfort. These signs are consistent with mastitis, particularly in a breastfeeding client. Early recognition and treatment with supportive measures or antibiotics prevent worsening infection and systemic involvement.

• Fundus boggy but firmed with massage. A boggy fundus indicates uterine atony, which can lead to postpartum hemorrhage. Immediate attention is required to prevent excessive blood loss and maintain hemodynamic stability.

Rationale for incorrect choices

• Vital signs: Heart rate while slightly elevated can be physiologic due to postpartum recovery, mild fever, or pain. Respiratory rate is within normal limits for adults; does not indicate acute compromise. Blood pressure is within normal postpartum range and does not signal hemodynamic instability at this time. Oxygen saturation is normal, indicating adequate oxygenation.

• Surgical incision well approximated with slight edema, no redness or drainage: Mild edema at the incision site is expected and not indicative of infection at this time. Regular monitoring is appropriate.

• No bowel movement since birth, hypoactive bowel sounds: Delayed bowel movements and hypoactive sounds are common postpartum, especially after cesarean section. Monitoring and supportive care are sufficient unless other symptoms develop.

A. Metoclopramide B. Dantrolene C. Midazolam D. Ketorolac

Correct Answer is C

Explanation

Rationale:

A. Metoclopramide: Metoclopramide is an antiemetic and prokinetic agent used to treat nausea and gastroparesis. It is not classified as a controlled substance because it does not have potential for abuse or dependence.

B. Dantrolene: Dantrolene is a muscle relaxant used to treat spasticity and malignant hyperthermia. It is not a controlled substance as it has low potential for abuse or addiction.

C. Midazolam: Midazolam is a benzodiazepine used for sedation, anesthesia, and seizure management. Benzodiazepines are classified as controlled substances due to their potential for dependence, abuse, and misuse, making midazolam a controlled drug.

D. Ketorolac: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) used for short-term pain management. It is not a controlled substance because it has minimal risk for abuse or dependence.

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A charge nurse is creating assignments for the next shift for several nurses and one of the nurses is pregnant. Which of the following clients should the charge nurse assign to a nurse who is not pregnant?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","F","G","H","I","J"]

Explanation

A nurse is caring for a client who is taking multiple medications. Which of the following medications should the nurse identify as a controlled substance?

Correct Answer is C

Explanation

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