A nurse is assessing a client who is in active labor. Which of the following findings should the nurse report to the provider?
Contractions lasting 80 seconds
Early decelerations in the FHR
FHR baseline 170/min
Temperature 37.4° C (99.3° F)
The Correct Answer is C
A. Contractions lasting 80 seconds, while prolonged, may occur in active labor and do not necessarily indicate a complication requiring immediate provider notification.
B. Early decelerations in the fetal heart rate are typically benign and are not typically concerning unless they are persistent or associated with other signs of fetal distress.
C. An FHR baseline of 170/min is above the normal range and may indicate fetal distress or other complications requiring further evaluation and possible intervention, necessitating prompt provider notification.
D. A temperature of 37.4°C (99.3°F) is within the normal range and does not typically require immediate provider notification unless accompanied by other concerning symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B,C,A,D
Explanation
The nurse should first review the skill level and qualifications of each AP then communicate appropriate tasks to the APs with specific expectations, then monitor progress of task completion with each AP; and lastly evaluate the APs' performance of each task. This sequence ensures that tasks are delegated appropriately and that the APs' performance is monitored and evaluated.
Correct Answer is D
Explanation
A. Potatoes do not contain significant levels of tyramine and are generally safe to consume with MAOIs.
B. Grapefruit does not contain significant levels of tyramine and are generally safe to consume with MAOIs.
C. Eggs do not contain significant levels of tyramine and are generally safe to consume with MAOIs.
D. MAOIs (Monoamine Oxidase Inhibitors) require dietary restrictions to avoid tyramine, which is found in high levels in aged cheeses. High tyramine intake while on MAOIs can lead to hypertensive crises.

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