A nurse is caring for the client.

Select the 5 findings that indicate the client's condition has improved.

WBC count

Heart rate

Fundal height

Temperature

Hgb

Lochia

Answer and Explanation

Correct Answer : A,B,C,D,F

A. WBC count: The client’s WBC count decreased from 33,000/mm³ to 10,000/mm³, returning to the expected postpartum reference range. This decline indicates resolution of the infectious or inflammatory process, consistent with effective antibiotic therapy for postpartum infection such as endometritis.

B. Heart rate: The heart rate decreased from tachycardic values (104–110/min) to 78/min, which is within normal limits. Resolution of tachycardia suggests improvement in systemic stress, infection, and overall hemodynamic stability.

C. Fundal height: The fundus progressed from being above the umbilicus to 4 cm below the umbilicus, demonstrating appropriate uterine involution. This finding reflects improved uterine tone and reduced risk of postpartum hemorrhage or ongoing uterine infection.

D. Temperature: The client’s temperature normalized from febrile readings (38.2–38.6°C) to 37.1°C. Resolution of fever is a key indicator of infection control and clinical improvement following antimicrobial treatment.

E. Hgb: Hemoglobin decreased from 11.1 g/dL to 10 g/dL, which does not indicate improvement. This trend suggests ongoing physiologic postpartum blood loss or dilution and does not reflect recovery.

F. Lochia: Lochia changed from dark brown with foul odor to a small amount of brownish-red lochia without odor. This improvement indicates resolution of uterine infection and normalization of postpartum uterine discharge.

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Correct Answer is A

Explanation

A. Weigh the client before and after the procedure: Monitoring the client’s weight before and after paracentesis provides an objective measure of the volume of fluid removed. This helps evaluate the effectiveness of the procedure and assess for complications such as fluid shifts or hypotension.

B. Administer a low-volume hypertonic enema the night before the procedure: Bowel cleansing is not required for paracentesis, as the procedure targets the peritoneal cavity, not the gastrointestinal tract. Administering an enema could cause unnecessary discomfort without benefit.

C. Ensure the client has a full bladder just prior to the procedure: A full bladder increases the risk of puncture during paracentesis. Clients are typically advised to void before the procedure to minimize the risk of bladder injury.

D. Place the client in a side-lying position for the procedure: Paracentesis is usually performed with the client in a sitting position, leaning slightly forward, or in a supine position with the head of the bed elevated. Side-lying positioning does not provide optimal access to the fluid-filled peritoneal cavity.

A. Obtain a provider order for vaginal/anal culture. B. Obtain a provider prescription for antibiotics. C. Obtain a provider prescription for ibuprofen 600 mg every 6 hr for mild to moderate pain. D. Obtain a provider prescription for phenazopyridine. E. Obtain a provider order for a urine culture.

Correct Answer is ["B","D","E"]

Explanation

A. Obtain a provider order for vaginal/anal culture: A vaginal or anal culture is not indicated at this time because the client’s symptoms—dysuria, urinary frequency, and positive leukocyte esterase—are consistent with a urinary tract infection rather than a sexually transmitted infection or perianal infection.

B. Obtain a provider prescription for antibiotics: The client demonstrates signs of a urinary tract infection, including dysuria, positive leukocyte esterase, elevated WBC count, and cloudy urine. Prompt initiation of antibiotics is important in pregnancy to prevent complications such as pyelonephritis and preterm labor.

C. Obtain a provider prescription for ibuprofen 600 mg every 6 hr for mild to moderate pain: Ibuprofen is generally avoided during the third trimester because it can cause premature closure of the fetal ductus arteriosus and oligohydramnios. Alternative analgesics that are safe in pregnancy should be used instead.

D. Obtain a provider prescription for phenazopyridine: Phenazopyridine is a urinary analgesic that can help relieve dysuria and urinary discomfort while the client awaits antibiotic therapy. It does not treat the infection itself but improves client comfort.

E. Obtain a provider order for a urine culture: A urine culture is indicated to confirm the presence of infection and identify the causative organism. This ensures that antibiotic therapy can be tailored appropriately, which is especially important in pregnancy to reduce maternal and fetal complications.

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A nurse is caring for the client. Select the 5 findings that indicate the client's condition has improved.

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Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who is to undergo paracentesis for removal of ascitic fluid. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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Correct Answer is ["B","D","E"]

Explanation

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A nurse is caring for the client. Select the 5 findings that indicate the client's condition has improved.

A nurse is caring for the client.

Select the 5 findings that indicate the client's condition has improved.