A client who delivered vaginally 18-hours ago develops a slight fever. The delivery record shows spontaneous rupture of membranes (SROM) for 36 hours prior to delivery and labor lasting 24 hours. An epidural was placed during labor, and the client experienced a third-degree perineal laceration.

The practical nurse (PN) should recognize which information poses the greatest risk for developing postpartum endometritis?

Epidural anesthesia.

SROM for 36 hours.

Third-degree perineal laceration.

Labor lasting for 24 hours.

Answer and Explanation

The Correct Answer is B

The information that poses the greatest risk for developing postpartum endometritis in this situation is that the client experienced spontaneous rupture of membranes (SROM) for 36 hours prior to delivery. SROM for an extended period of time increases the risk of infection, including postpartum endometritis, which is an infection of the uterus. The practical nurse (PN) should recognize this risk factor and monitor the client closely for signs of infection. The other information listed may also be important to consider, but SROM for 36 hours poses the greatest risk for developing postpartum endometritis in this situation.

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Correct Answer is D

Explanation

An increasing trend in maternal heart rate is a sign of fetal distress, which can be a serious complication of PROM. One of the primary interventions for fetal distress is to increase oxygen delivery to the fetus. The practical nurse should initiate oxygen via face mask at 8 to 10 L/min to improve fetal oxygenation.

Contact precautions may be necessary for certain conditions, but they are not indicated for an increasing maternal heart rate.

Inserting a urinary catheter may be appropriate for monitoring output, but it is not the first priority in this situation.

Encouraging the client to push is not appropriate because the client is not in active labor and pushing can cause further complications.

A. Listen attentively to the client's expression of anger, then support the family's wish that the client be hospitalized. B. Tell the client that monitoring and medication management during detoxification is best provided in the hospital. C. Explain to the client that his family cares about him and wants him to be hospitalized during detoxification. D. Use a mater-of-fact manner to inform the client that hospitalization is necessary during detoxification.

Correct Answer is B

Explanation

Detoxification can be a difficult and potentially dangerous process, and it's important for the client to receive proper monitoring and medication management during this time. The hospital is equipped to provide this level of care and support. The practical nurse should explain this to the client and emphasize the importance of receiving proper care during detoxification.

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Naxlex Comprehensive Predictor Exams

The practical nurse (PN) is assigned to assist in the care of a client at 34-weeks gestation with premature rupture of membranes (PROM). Four hours after admission, the PN recognizes an increasing trend in the maternal heart rate. Which action should the PN take?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

A client at 8-weeks gestation presents to the office with a report of vaginal bleeding for the last 12 hours without cramping. Which action should the practical nurse (PN) take?

A male client with paranoia has been admitted to the mental health unit, and upon arrival, he immediately goes to the corner of the room and sits quietly without communicating. In approaching the client, what intervention should the practical nurse (PN) implement first?

A client with a major depressive disorder is admitted to the inpatient psychiatric unit. Which intervention should the practical nurse (PN) use to demonstrate support of the client?

A postpartum client who delivered vaginally 6-hours ago and had a second-degree perineal laceration reports feeling increased pain and pressure in her vaginal area. Which intervention should the practical nurse (PN) implement?

A postpartum client who is Rh-negative refuses to receive Rho(D) immune globulin after the delivery of an infant who is Rh-positive. Which information should the practical nurse (PN) provide this client?

Following the prenatal clinic's screening protocol, the practical nurse (PN) is preparing laboratory prescriptions for clients who are scheduled to be seen today. Which screening test should be scheduled for a client who is gravida 4 para 3 at 16-weeks gestation?

Another person tells the practical nurse (PN) that her 7-year-old child frequently wets the bed at night. Which information should the PN provide?