A nurse has just received change-of-shift report about four clients who are postpartum. Which of the following clients should the nurse plan to see first?
A client whose newborn is having difficulty latching-on
A client who received magnesium sulfate during labor
A client who has a history of oligohydramnios
A client whose labor lasted for 6 hr
The Correct Answer is B
A. A client whose newborn is having difficulty latching-on should be addressed, but this issue is not an immediate postpartum emergency. It is important but does not require urgent intervention compared to potential complications from magnesium sulfate.
B. A client who received magnesium sulfate during labor should be seen first because magnesium sulfate can cause significant side effects like respiratory depression, decreased reflexes, and altered mental status. These effects require close monitoring to prevent severe complications.
C. A client who has a history of oligohydramnios requires monitoring but this history does not necessarily indicate an immediate postpartum issue requiring urgent assessment at this time.
D. A client whose labor lasted for 6 hr does not have an immediate concern solely based on labor duration. While it is relevant, it does not indicate an urgent need for assessment compared to the effects of magnesium sulfate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Decreased muscle tone is not a typical manifestation of neonatal abstinence syndrome. Symptoms of neonatal abstinence syndrome usually include increased muscle tone and irritability.
B. An exaggerated Moro reflex is a sign of neonatal abstinence syndrome. This reflex can be more pronounced in infants experiencing withdrawal from substances.
C. A weak cry is not characteristic of neonatal abstinence syndrome. Infants with this syndrome may have a high-pitched, excessive, or persistent cry.
D. Neonates with abstinence syndrome are difficult to console. They may have persistent crying and be hard to calm, which contrasts with the ability to console easily.
Correct Answer is C
Explanation
A. One cup of pasta contains some folate, but it is not the best source for increasing folate intake during pregnancy. Pasta provides carbohydrates but is not as rich in folate compared to leafy greens.
B. One large egg contains a moderate amount of folate but is not the highest source of folate compared to other foods. Eggs provide several nutrients, but for folate, there are better food options.
C. One cup of cooked spinach is a highly recommended food for increasing folate intake. Spinach is rich in folate, which is essential for fetal development, including preventing neural tube defects.
D. Half a cup of orange juice provides a decent amount of folate but is not as high in folate as one cup of cooked spinach. While orange juice can contribute to folate intake, it does not match the folate content of leafy greens like spinach.
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