A nurse is planning care prior to an amniocentesis for a client who is at 22 weeks of gestation. Which of the following actions should the nurse include in the plan of care?

Instruct the client to be NPO for six hours prior to the procedure

Instruct the client to maintain a full bladder for the procedure

Monitor the fetal heart rate prior to the procedure.

Place the client in Trendelenburg position during the procedure

Answer and Explanation

The Correct Answer is C

Rationale:

A. Instruct the client to be NPO for six hours prior to the procedure: Amniocentesis is typically done under local anesthesia and does not require sedation or general anesthesia, so there is no need for the client to be NPO beforehand.

B. Instruct the client to maintain a full bladder for the procedure: A full bladder is required during early pregnancy to help lift the uterus for better visualization. However, at 22 weeks gestation, the uterus is already an abdominal organ, and a full bladder is not necessary.

C. Monitor the fetal heart rate prior to the procedure: Monitoring the fetal heart rate before an amniocentesis is essential to establish a baseline and ensure fetal well-being. It also aids in identifying any immediate changes following the procedure.

D. Place the client in Trendelenburg position during the procedure: The Trendelenburg position is not appropriate for amniocentesis. The client is typically placed in a supine or slightly tilted position to allow proper access to the uterus and avoid vena cava compression.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Rationale:

A. Apply direct pressure to the wound with thick dressing material: Direct pressure is the first-line intervention for controlling active external bleeding. Applying firm pressure with thick, sterile dressing helps tamponade the bleeding vessel and minimizes blood loss while awaiting further treatment.

B. Apply a transparent dressing to the wound: Transparent dressings are used for minor wounds or IV sites, not for managing active bleeding. They do not provide the necessary compression to control hemorrhage from a deep or penetrating injury.

C. Irrigate the wound with sterile water: Wound irrigation is appropriate for cleaning minor wounds or after bleeding is controlled. Irrigating during active bleeding can delay hemostasis and increase blood loss.

D. Tie a tourniquet around the leg distal to the wound: A tourniquet, if necessary, must be placed proximal not distal to the bleeding site to effectively restrict arterial flow. Distal placement worsens bleeding and can compromise tissue perfusion unnecessarily.

A. Fentanyl B. Aspirin C. Hydrocodone D. Acetaminophen

Correct Answer is C

Explanation

Rationale:

A. Fentanyl: Fentanyl is a potent opioid typically reserved for severe, acute, or chronic pain such as in surgical or cancer-related conditions. It is not commonly used for moderate pain in stable orthopedic cases like a simple fracture.

B. Aspirin: Aspirin is a mild analgesic and anti-inflammatory. It may help with mild pain but is inadequate for moderate pain rated 7/10. Additionally, its antiplatelet effects can increase bleeding risk, especially post-trauma.

C. Hydrocodone: Hydrocodone is an opioid analgesic appropriate for managing moderate to severe pain, such as that caused by a fracture. It is commonly used in combination with acetaminophen and is suitable for a pain rating of 7/10.

D. Acetaminophen: Acetaminophen is effective for mild to moderate pain but may not provide sufficient relief for pain rated at 7/10. It is often used adjunctively but would not be the primary choice in this scenario.

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A nurse is planning care prior to an amniocentesis for a client who is at 22 weeks of gestation. Which of the following actions should the nurse include in the plan of care?

Nursing Test Bank

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