A charge nurse is recommending postpartum clients for discharge following a local disaster. Which of the following clients should the nurse recommend for discharge first?
A client who had an emergency cesarean birth 1 day ago
A client who had a precipitous birth 36 hr ago and has a second-degree perineal laceration
A client who has preeclampsia and a blood pressure of 166/110 mm Hg
A client who received 2 units of packed RBCs 6 hr ago for a postpartum hemorrhage
The Correct Answer is B
A. A client 1 day post-cesarean birth is still at risk for postoperative complications (e.g., infection, bleeding, pain, immobility). This client requires ongoing hospital monitoring.
B. A client who delivered vaginally 36 hours ago and has only a second-degree laceration is generally stable and can safely be discharged home with proper instructions for perineal care.
C. The client with preeclampsia and severe hypertension (166/110 mm Hg) is at high risk for seizures, stroke, and organ complications. This client must remain hospitalized for stabilization and management.
D. A client recently transfused after postpartum hemorrhage needs continued monitoring for recurrent bleeding and transfusion reactions. Discharging this client would be unsafe.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","E"]
Explanation
A. Clients with C. difficile require dedicated equipment (e.g., thermometers, stethoscopes) that is not shared to prevent cross-contamination.
B. C. difficile is transmitted via spores that contaminate surfaces and clothing; a gown is required for contact precautions.
C. Alcohol-based hand rubs are ineffective against C. difficile spores. Hands must be washed with soap and water.
D. An N95 respirator is required only for airborne precautions (e.g., tuberculosis), not C. difficile.
E. Gloves must be changed after contact with infectious material and between procedures to prevent spore transmission.
Correct Answer is B
Explanation
Rationale:
A. Amitriptyline, a tricyclic antidepressant (TCA), commonly causes orthostatic hypotension, not hypertension.
B. TCAs require 2 to 4 weeks to achieve therapeutic effect. Informing clients of this delay encourages adherence and sets realistic expectations.
C. Amitriptyline should be taken with or after meals to reduce gastric irritation.
D. St. John’s wort should not be used with TCAs due to risk of serotonin syndrome and potential drug interactions.
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