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Patient Data

Exhibits

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The client is admitted to the hospital after her membranes rupture at 38 weeks gestation. A vaginal examination is done. The nurse determines that the client is 3 cm dilated, 40% effaced, and the fetal head is at -1 station. The external monitor snows that contractions are occurring every 4 minutes and lasting 70 seconds, and the nurse palpates the quality as strong. Her fasting blood glucose (FSBG) is 86 (4.8 mmol/L).

The client is transferred to the labor- delivery-recovery (LDR) suite. The client dilates quickly to 10 cm and feels a strong urge to push. The fetal heart rate is reassuring with a baseline of 145 and moderate variability. The nurse briefly reviews pushing techniques with her and her husband and notifies the obstetrician of the client's progress. After three cycles of open-glottis pushing, the baby's head is crowning. The head is born easily over an intact perineum. The infant weighs 9 lbs. 9 oz (4.34 kgs) and has an Apgar of 7 at 1 minute, then 9 at 5 minutes.

client is 3 cm dilated, 40% effaced, and the fetal head is at -1 station

contractions are occurring every 4 minutes and lasting 70 seconds

fasting blood glucose (FSBG) is 86 (4.8 mmol/L)

client dilates quickly to 10 cm and feels a strong urge to push

fetal heart rate is reassuring with a baseline of 145 and moderate variability

Apgar of 7 at 1 minute, then 9 at 5 minutes

After three cycles of open-glottis pushing, the baby's head is crowning

infant weighs 9 lbs. 9 oz

membranes rupture at 38 weeks gestation

Answer and Explanation

The Correct Answer is ["A","B","C","D","E","F"]

This blood glucose level is within the normal range, indicating that the client’s blood sugar is well-controlled at this point.

The client is 3 cm dilated, 40% effaced, with contractions every 4 minutes lasting 70 seconds and strong in quality. These are signs of active labor progressing appropriately.

The fetal heart rate is reassuring with a baseline of 145 beats per minute and moderate variability. This indicates good fetal well-being and adequate oxygenation.

The client quickly dilates to 10 cm and experiences a strong urge to push, suggesting efficient progress through labor.

The baby is born with an intact perineum, weighs 9 lbs. 9 oz (4.34 kg), and has excellent Apgar scores of 7 at 1 minute and 9 at 5 minutes. These scores indicate that the infant is in good condition and adapting well to extrauterine life.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

A. While impaired comfort is a concern, the priority is to address potential neurovascular compromise.

B. Impaired skin integrity is a concern but not the most immediate issue given the symptoms described.

C. Risk for infection is important but secondary to the acute concern of neurovascular function.

D. Risk for peripheral neurovascular dysfunction is the highest priority as it indicates potential compartment syndrome or other serious complications requiring urgent intervention.

A. Serum sodium level. B. Platelet count. C. Hematocrit. D. Neutrophil count.

Correct Answer is D

Explanation

A. Serum sodium level is not directly related to the presence of infection or the client's ability to fight infection.

B. Platelet count is important for assessing bleeding risk but is not directly related to infection.

C. Hematocrit levels are related to the client's blood volume and anemia status but do not directly indicate infection.

D. Neutrophil count is crucial for assessing the client’s immune response and ability to fight infection. An elevated neutrophil count could indicate an ongoing infection, while a low count could suggest an immunocompromised state.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Twelve hours after experiencing a traumatic closed fracture of the lower left tibia, a client reports pain, tingling, and diminished toe movement in the left foot. Which nursing problem has the highest priority based on this information?

Correct Answer is D

Explanation

While changing a client's postoperative dressing, the nurse observes purulent drainage at the site. Before reporting this finding to the healthcare provider, the nurse should note which of the client's laboratory values?

Correct Answer is D

Explanation

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