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
Explanation
A. Clients should avoid lifting heavy objects (generally more than 5 pounds) following retinal detachment repair, as this increases intraocular pressure and could disrupt the reattachment of the retina.
B. Taking a stool softener daily helps prevent straining during bowel movements, which can increase intraocular pressure and risk retinal re-detachment. Preventing Valsalva maneuvers is a key postoperative teaching point.
C. Reading does not significantly increase intraocular pressure and can generally be resumed once the client is comfortable, unless the provider instructs otherwise. Avoiding reading is not necessary for retinal healing.
D. Bending at the waist increases pressure in the eye, which could compromise surgical outcomes. Clients should instead bend at the knees or ask for assistance.
Correct Answer is C
Explanation
A. A postoperative orthopedic client is at risk but is typically turned regularly and receives postoperative care.
B. A client post-myocardial infarction may have decreased activity but usually remains aware and continent, lowering the risk.
C. Incontinence increases moisture and skin maceration, while immobility and cognitive impairment from dementia reduce repositioning ability — both key factors in pressure injury development.
D. A T-tube affects bile drainage, not skin integrity, unless mobility is severely restricted.
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