A term multigravida, who is receiving oxytocin IV for labor augmentation, is requesting pain medication. Review of the client's record indicates that she was medicated 30 minutes ago with butorphanol 2 mg and promethazine 25 mg IV push. Vaginal examination reveals that the client's cervical dilation is 3 cm, 10% eﬀaced, and at a 0 station. Which action should the practical nurse (PN) implement?

Coach the client to take slow, deep breaths during each contraction.

Report to the nurse that the client needs another dose of butorphanol.

Notify the healthcare provider.

Discontinue the oxytocin infusion.

Answer and Explanation

The Correct Answer is A

In this situation, the practical nurse (PN) should coach the client to take slow, deep breaths during each contraction. The client has already been medicated with butorphanol and promethazine for pain relief and it may not be appropriate to administer another dose at this time. Instead, the PN can provide non- pharmacological pain relief measures such as coaching the client to use breathing techniques to help manage the pain during contractions. The other actions listed may also be appropriate in some situations, but coaching the client to use breathing techniques is the most appropriate action in this situation.

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Correct Answer is B

Explanation

Acute leukemia can cause thrombocytopenia, which is a decrease in the number of platelets in the blood. Platelets are essential for blood clotting, and a low platelet count can result in heavy menstrual bleeding. Therefore, reviewing the client's platelet count is the priority in response to the client's statement. The other laboratory data may also be important to assess, but platelet count is the most relevant in this situation.

A. The child likes to wiggle the fingers on the hand of the aﬀected side. B. The child's radial pulse volume on the aﬀected arm is difficult to palpate. C. An accurate respiratory rate cannot be measured because of the child's crying. D. The parents of the child are requesting that the child receive an analgesic.

Correct Answer is B

Explanation

This could indicate reduced blood ﬂow to the aﬀected arm, which may be a sign of compartment syndrome. Compartment syndrome is a serious condition that requires immediate intervention by a registered nurse (RN). The other options may also require intervention, but they are not as urgent as the situation described in option B.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adolescent female client with acute leukemia reports that she is experiencing an unusually heavy menstrual ﬂow. Which laboratory data should the practical nurse (PN) review in response to this statement?

Correct Answer is B

Explanation

The practical nurse (PN) is monitoring a 5-year-old following a fracture of the ulna. For which situation should the PN seek immediate intervention by the registered nurse (RN)?

Correct Answer is B

Explanation

A newborn infant with a tracheoesophageal repair is receiving gastrostomy (GT) feedings postoperatively. Which intervention should the practical nurse (PN) implement during the GT feedings?

Which newborn assessment finding of 24-hour-old infant should the practical nurse (PN) report to the charge nurse immediately?

A child with cerebral palsy (CP) is taking baclofen, a relaxant. Which assessment finding indicates to the practical nurse (PN) that the drug is eﬀective?

A client on the mental health unit has been scowling and rapidly pacing up and down the hall for several minutes. Which behaviors are most important for the practical nurse (PN) to monitor?

A 3-week-old infant is admited to the pediatric unit with vomiting and dehydration. The mother describes the infant as having projectile vomiting after eating. She also tells the practical nurse (PN) that the baby is always hungry. Which finding warrants immediate intervention by the PN?

Epidural anesthesia is initiated for a primigravida at 40 weeks gestation who is in active labor. Which assessment has the greatest priority for the practical nurse to monitor during the administration of epidural anesthesia?

The practical nurse (PN) is assisting with the admission of a 12-month-old child with a history of frequent colds and growth failure. Testing is being planned for a possible diagnosis of cystic fibrosis (CF). Which information is most important for the PN to obtain?