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

Encouraging the client to initiate daily rituals, such as practicing relaxation techniques, engaging in physical exercise, and spending time with friends and family, can be an eﬀective way to diminish anxiety. These activities can provide a sense of structure and routine that can help to manage stress and anxiety. Options A and C are not recommended because alcohol and caﬀeine can worsen sleeplessness and anxiety. Option B can be counterproductive and increase the client's anxiety level. Therefore, Option D is the best option to assist this client in diminishing his anxiety.

Therefore, options A, B, and C are not answers because they are not the best action to assist this client in diminishing his anxiety.

A. Check serum human chorionic gonadotropin. B. Verify the date of the last menstrual cycle. C. Repeat a urine pregnancy test. D. Inquire about the last occurrence of intercourse.

Correct Answer is A

Explanation

The first action the PN should take is to check the client's serum human chorionic gonadotropin (hCG) level. This hormone is produced by the placenta and can provide important information about the viability of the pregnancy.

Option B, verifying the date of the last menstrual cycle, can provide useful information about the gestational age of the pregnancy but is not the first priority.

Option C, repeating a urine pregnancy test, can confirm the presence of a pregnancy but does not provide information about its viability.

Option D, inquiring about the last occurrence of intercourse, is not relevant to addressing the client's immediate concern of vaginal bleeding.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A highly successful businessman presents to a mental health center complaining of sleeplessness and anxiety over his financial status. Which action should the practical nurse (PN) take to assist this client in diminishing his anxiety?

Correct Answer is D

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?

Correct Answer is A

Explanation

Epidural anesthesia is initiated for a primigravida at 40 weeks gestation who is in active labor. Which assessment has the greatest priority for the practical nurse to monitor during the administration of epidural anesthesia?

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 newborn infant with a tracheoesophageal repair is receiving gastrostomy (GT) feedings postoperatively. Which intervention should the practical nurse (PN) implement during the GT feedings?

An older client is admitted to the psychiatric unit for assessment of a recent onset of dementia. The practical nurse (PN) notes that in the evening this client often becomes restless, confused, and agitated. Which intervention should the PN implement?

The client tells the practical nurse (PN), "I have been applying triple antibiotic ointment to my athlete's foot for the past two days, but it still itches." How should the PN respond?

The practical nurse (PN) is assisting with the admission of a 12-month-old child with a history of frequent colds and growth failure. Testing is being planned for a possible diagnosis of cystic fibrosis (CF). Which information is most important for the PN to obtain?

During a well-baby clinic visit, a mother tells the practical nurse (PN) that her 12-month-old infant is not yet eating solid foods and drinks whole milk from a bottle. Based on these assessment findings, this infant is at the greatest risk for developing which condition?

The practical nurse (PN) is caring for a client who has been diagnosed with gestational diabetes mellitus. Which complication should the PN recognize as the greatest risk to the fetus if euglycemia is not maintained?