A nurse is caring for a client who had a vaginal delivery 1 day ago. The nurse determines that the client's fundus is firm, located 2 fingerbreadths above the umbilicus, and deviated to the left. Which of the following actions should the nurse take first?

Notify the provider.

Administer a prescribed analgesic

Assist the client to empty her bladder.

Monitor perineal pads for clots.

Answer and Explanation

The Correct Answer is C

A)   Incorrect- While notifying the provider might be necessary, addressing bladder distention takes precedence in this scenario.
B)   Incorrect- Administering an analgesic might be indicated for pain relief, but addressing bladder distention is the priority.
C)   Correct - Assisting the client to empty her bladder is the first action to take. A full bladder can prevent the uterus from contracting properly and can lead to excessive bleeding.
D)   Incorrect- Monitoring perineal pads for clots is important but not the first action to take when bladder distention is present.

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Correct Answer is A

Explanation

A) Correct - Newborn screening typically involves a heel stick using a lancet to collect a few drops of blood from the inner aspect of the newborn's heel.
B) Incorrect- Leaving the newborn's heel open to the air after the puncture is not necessary; a small bandage is typically applied.
C) Incorrect- An antiseptic is not typically applied after collecting the specimen, as it could interfere with the accuracy of the screening tests.
D) Incorrect- Warming the newborn's heel is not a standard step before collecting a specimen for newborn screening.

A. "Place your baby in the bassinet in your room by the bed when you use the bathroom." B. "Make sure anyone caring for or transporting your baby is wearing an identification badge." C. "Carry your baby in your arms when you go for a walk in the hallway." D. "If your baby's identification band slips off place it in the drawer of the bassinet

Correct Answer is B

Explanation

A) Incorrect- While placing the baby in the bassinet in the room is a good practice, it may not be sufficient to prevent abduction.
B) Correct - Ensuring that anyone caring for or transporting the baby is wearing an identification badge helps confirm their authorized status to handle the baby.
C) Incorrect- Carrying the baby in the arms is a safe practice, but it doesn't specifically address preventing abduction.
D) Incorrect- Placing the identification band in the bassinet drawer is not a recommended practice, as it can potentially lead to confusion or misidentification.

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A nurse is caring for a client who had a vaginal delivery 1 day ago. The nurse determines that the client's fundus is firm, located 2 fingerbreadths above the umbilicus, and deviated to the left. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to collect a specimen for newborn screening. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is reinforcing teaching about safety measures for preventing newborn abduction with a client who is postpartum. Which of the following statements should the nurse make?

Correct Answer is B

Explanation

A nurse in an antepartum clinic is reinforcing teaching with a client who is pregnant and has a new prescription for oral ferrous sulfate. Which of the following statements by the client indicates an understanding of the teaching?

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