A nurse is assisting in the care of a client who is in labor and whose membranes ruptured 6 hr ago. Which of the following is an appropriate nursing intervention for this client?

Monitor for infection.

Position the client supine.

Obtain consent for a cesarean birth.

Prepare for a forceps delivery.

Answer and Explanation

The Correct Answer is A

A)   Correct - Monitoring for infection is an appropriate nursing intervention for a client whose membranes have ruptured, as there is an increased risk of infection after the amniotic sac has ruptured for an extended period.
B)   Incorrect- Positioning the client supine is not generally recommended for a client in labor, especially if the client's membranes have ruptured.
C)   Incorrect- Obtaining consent for a cesarean birth is not indicated solely based on the information provided.
D)   Incorrect- Preparing for a forceps delivery is not indicated solely based on the information provided.

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Correct Answer is B

Explanation

A) Incorrect- Kegel exercises are helpful for strengthening pelvic floor muscles but may not directly alleviate afterpains.
B) Correct - Afterpains are uterine contractions that occur after childbirth and can be uncomfortable, especially during breastfeeding. Ibuprofen is often used to relieve this discomfort.
C) Incorrect- Applying a cool compress might provide some relief, but pain relief medications like ibuprofen are more effective for afterpains.
D) Incorrect- While a side-lying position can be comfortable for breastfeeding, it may not directly address the afterpains.

A. "Cleanse your perineum with povidone-iodine prior to collecting each urine specimen." B. "You should start the 24-hour collection with your first urination." C. "You should record the time on the collection container of any missed urine specimens." D. "Do not add a urine specimen to the collection container if it contains stool

Correct Answer is C

Explanation

A) Incorrect- Cleansing the perineum with povidone-iodine is not relevant to the collection process.
B) Incorrect- The 24-hour collection should start with the first-morning urination, not with any random urination.
C) Correct - Recording the time on the collection container for any missed urine specimens is important for accurate measurement.
D) Incorrect- Stool should not be added to the urine collection container, but this is not the most important point to emphasize in this teaching.

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A nurse is assisting in the care of a client who is in labor and whose membranes ruptured 6 hr ago. Which of the following is an appropriate nursing intervention for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who reports discomfort due to afterpains following breastfeeding. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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