A nurse on a postpartum unit is caring for a client.

For each finding, click to specify if the finding is consistent with uterine atony or infection. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

High parity

Prolonged rupture of membranes

Polyhydramnios

Prenatal anemia

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"}}

Rationale:

• High parity: Multiple prior pregnancies overstretch the uterine muscle, reducing its ability to contract effectively after delivery. Decreased uterine tone interferes with compression of uterine blood vessels, increasing the risk of postpartum hemorrhage. This makes high parity a classic and well-established risk factor for uterine atony.

• Prolonged rupture of membranes: Rupture of membranes lasting longer than 18–24 hours allows ascending vaginal flora to enter the uterine cavity. This significantly increases the risk of postpartum uterine infection, including endometritis. The client’s 28-hour rupture combined with fever and foul-smelling lochia strongly supports infection.

• Polyhydramnios: Excessive amniotic fluid causes overdistention of the uterus, which can impair uterine muscle contraction after birth. Poor uterine contraction prevents effective involution and promotes uterine atony.

• Prenatal anemia: Anemia weakens the body’s immune response and reduces tissue oxygenation, increasing susceptibility to infection. Clients with anemia are at higher risk for postpartum infectious complications, especially after cesarean delivery. Anemia contributes to vulnerability rather than uterine tone issues.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. "Remove the patch for 8 hours every day to reduce the risk of tolerance.": Fentanyl patches should remain in place for the prescribed duration (usually 72 hours) to maintain consistent pain control. Intermittent removal is not recommended and can result in breakthrough pain.

B. "Avoid high-fiber foods while taking this medication.": High-fiber foods are not contraindicated with fentanyl. Clients should maintain a balanced diet, and fiber can help prevent opioid-induced constipation rather than being avoided.

C. "Avoid hot tubs while wearing the patch.": Heat increases transdermal absorption of fentanyl, which can lead to overdose and respiratory depression. Clients should avoid hot tubs, heating pads, and prolonged sun exposure on the patch site.

D. "Apply the patch to your forearm.": Fentanyl patches are typically applied to the chest, back, or upper arm, not specifically the forearm. Correct application sites are areas with minimal hair and intact skin to ensure proper absorption.

A. "This type of seizure can be mistaken for daydreaming." B. "This type of seizure lasts 30 to 60 seconds," C. "The child usually has an aura prior to onset." D. "This type of seizure has a gradual onset."

Correct Answer is A

Explanation

A. "This type of seizure can be mistaken for daydreaming.": Absence seizures are brief, sudden episodes of impaired consciousness, often with staring and subtle motor activity. Because these episodes are very short and the child resumes normal activity immediately, they can easily be misinterpreted as inattentiveness or daydreaming.

B. "This type of seizure lasts 30 to 60 seconds.": Absence seizures are typically very brief, usually lasting 5 to 10 seconds, rarely up to 15 seconds. A duration of 30 to 60 seconds is longer than expected and more characteristic of other seizure types.

C. "The child usually has an aura prior to onset.": Absence seizures do not usually have a preceding aura. Auras are more commonly associated with focal or partial seizures, not generalized absence seizures.

D. "This type of seizure has a gradual onset.": Absence seizures have a sudden onset and end abruptly. There is no gradual buildup of symptoms, which helps differentiate them from other neurological or behavioral events.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge teaching to a client who has cancer and a prescription for a fentanyl 25 mcg/hr transdermal patch. Which of the following instructions should the nurse include in the teaching?

Correct Answer is C

Explanation

A school nurse is teaching a parent about absence seizures. Which of the following information should the nurse include?

Correct Answer is A

Explanation

A nurse is preparing to administer a nasogastric (NG) tube feeding to a school-age child. Which of the following actions should the nurse plan to take?

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