During the second stage of labor, the fetal head has just been born and the nurse observes the immediate retraction of the head against the perineum.
What action should the nurse anticipate performing to assist the healthcare provider?

A client at 38-weeks gestation reports experiencing severe abdominal pain.
Upon palpation, the nurse notes that the abdomen is rigid.
How should the nurse document the findings?

A client at 28-weeks gestation whose hemoglobin level is 10.7 g/dL (107 g/L) and hematocrit is 32.3% (0.323 volume fraction), tells the nurse that she eats plenty of green vegetables.
When the client asks the nurse how the pregnancy might affect the laboratory findings, which information should the nurse provide?

Assessment findings of a 4-hour-old newborn include: axillary temperature of 96.8° F (35.8° C), heart rate of 150 beats/minute with a soft murmur, irregular respiratory rate at 64 breaths/minute, jitteriness, hypotonic, and weak cry.
Based on these findings, which action should the nurse implement?

The nurse is instructing the parent of a 10-year-old child newly diagnosed with type 1 diabetes mellitus (DM) on how to administer subcutaneous insulin injections.

The parent expresses a fear of needles and is unable to perform the procedure.

What intervention should the nurse implement?

A client who experienced a severe postpartum hemorrhage following the vaginal birth of twins is transferred to the postpartum unit.
The nurse knows that assessment for which complication is the highest priority for this client?

A 17-year-old student arrives at the emergency department (ED) complaining of severe abdominal pain and cramping that has worsened since the morning.

Her mother suspects a urinary tract infection due to her daughter’s frequent and urgent urination, or possibly appendicitis.

What signs would indicate that a healthy psychosocial adaptation is taking place? Select all that apply.

A 3-year-old male was brought into the emergency room this morning with a sudden onset of “fast and noisy breathing”. According to his parents, he had sneezing and a runny nose last week but seemed to have recovered.

The child lives with 2 older, school-age siblings, his parents, and 3 dogs.

He was born at 37 weeks’ gestation.

The parents deny smoking, but his grandmother cares for him in the afternoons and smokes outside when she is at the house.

He has no significant medical history.

He has received all vaccines except for those due at 3 years.

Upon exam, the child is… Which two items must the nurse ensure are available before attempting to place the intravenous line?

A father observing his newborn’s admission to the nursery notices that eye ointment is applied to the infant’s eyes.

He asks the nurse about the purpose of the ointment.

What would be the correct response from the nurse regarding the purpose of the ointment?

The nurse finds that an infant admitted for surgical repair of an inguinal hernia voids a urinary stream from the ventral surface of the penis.
What action should the nurse take?