A nurse is teaching a client who is at 41 weeks of gestation about a nonstress test. Which of the following information should the nurse include in the teaching?

"You should massage one of your nipples to stimulate contractions of your uterus."

"You will have a Doppler transducer applied to your abdomen during the test.

"You should avoid eating or drinking for 4 hours before the test."

"You will need blood work before and after the test."

Answer and Explanation

The Correct Answer is B

A. "You should massage one of your nipples to stimulate contractions of your uterus.": Nipple stimulation is used to induce contractions during a contraction stress test, not a nonstress test. For a nonstress test, the goal is to assess fetal heart rate in response to fetal movements without inducing contractions.

B. "You will have a Doppler transducer applied to your abdomen during the test.": A nonstress test involves placing a Doppler transducer on the maternal abdomen to monitor fetal heart rate and a tocodynamometer to detect uterine activity. The test is noninvasive and monitors fetal heart rate accelerations in response to movement.

C. "You should avoid eating or drinking for 4 hours before the test.": Fasting is not required for a nonstress test. In fact, some providers encourage eating beforehand to promote fetal activity, which helps obtain accurate heart rate accelerations.

D. "You will need blood work before and after the test.": Blood work is not required for a nonstress test. The test relies solely on external monitoring of the fetal heart rate and maternal contractions, making it noninvasive and straightforward.

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Correct Answer is A

Explanation

A. Assess for bladder distention: A full bladder can prevent the uterus from contracting effectively, leading to a boggy fundus and increased risk of postpartum hemorrhage. Assessing and addressing bladder distention is the priority because it directly impacts uterine tone and hemorrhage prevention.

B. Apply supplemental oxygen via nonrebreather mask: Oxygen may be necessary if the client shows signs of hypoxia or shock, but it does not address the primary cause of a boggy uterus. The priority is to correct the underlying issue affecting uterine contraction.

C. Administer intramuscular methylergonovine: Methylergonovine is used to promote uterine contraction, but pharmacologic intervention should follow initial assessment to identify reversible causes such as bladder distention. Administering medication without assessment could overlook a correctable mechanical issue.

D. Analyze coagulation studies: Coagulation studies are important if bleeding persists or coagulopathy is suspected, but they are not the immediate priority in a client with a boggy fundus shortly after birth. Immediate interventions to promote uterine contraction take precedence.

A. The client takes 2 short naps during the day. B. The client engages in quiet activities in their room. C. The client slept 5 hr the previous night. D. The client appears to listen to unseen others. E. The client consumes 8 oz of high-calorie fluids each hour.

Correct Answer is ["A","B","C","E"]

Explanation

A. The client takes 2 short naps during the day: The ability to rest indicates decreased hyperactivity and improved regulation of sleep-wake cycles, reflecting early stabilization of manic symptoms.

B. The client engages in quiet activities in their room: Participation in calm, structured activities demonstrates reduced agitation and impulsivity, suggesting improvement in mood stability and ability to focus.

C. The client slept 5 hr the previous night: Improved sleep duration is a positive sign, as insomnia and decreased need for sleep are hallmark symptoms of mania. Achieving rest indicates partial symptom resolution.

D. The client appears to listen to unseen others: Continued auditory hallucinations indicate persistent psychotic features and do not represent improvement. These symptoms require ongoing monitoring and treatment.

E. The client consumes 8 oz of high-calorie fluids each hour: Adequate fluid and calorie intake reflects improved self-care and nutrition, which are often compromised during acute manic episodes. This is a positive indicator of functional recovery.

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A nurse is teaching a client who is at 41 weeks of gestation about a nonstress test. Which of the following information should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

A nurse is monitoring a client following a cesarean birth 6 hr ago who received an IV bolus oxytocin immediately after birth but continues to have a boggy fundus. Which of the following should the nurse identify as the priority intervention?

Correct Answer is A

Explanation

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Correct Answer is ["A","B","C","E"]

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