The nurse continues to care for the client.
Click to highlight the findings that indicate improvement in the client's condition. To deselect a finding, click on the finding again.
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Assessment |
Findings |
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Nurses' Notes |
Client rates lower back pain a 0 on a scale from 0 to 10. No reports of vaginal discharge. Membranes intact No uterine contractions noted. FHR baseline 138, minimal variability. No further reports of burning with urination. |
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Laboratory Results |
WBC 12, 000/mm3 (5000 to 10000/mm3) Platelet count 188000/mm3 (150000 to 400000/mm3) |
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Vital Signs |
Temperature 37.1°C (98.7°F) Blood pressure 120/78 mmHg |
Client rates lower back pain a 0 on a scale from 0 to 10. No reports of vaginal discharge
Membranes intact
No uterine contractions noted
FHR baseline 138, minimal variability
No further reports of burning with urination
WBC 12, 000/mm3 (5000 to 10000/mm3)
Platelet count 188000/mm3 (150000 to 400000/mm3)
Temperature 37.1<strong>°</strong>C (98.7<strong>°</strong>F)
Blood pressure 120/78 mmHg
The Correct Answer is ["A","C","E","F","H","I"]
Nurses' Notes:
Client rates lower back pain a 0 on a scale from 0 to 10: Indicates pain resolution, suggesting improvement.
No reports of vaginal discharge: Suggests stabilization and no signs of labor progression.
No uterine contractions noted: Indicates that preterm labor is resolving.
No further reports of burning with urination: Suggests that the urinary tract infection (UTI) is improving.
Vital Signs:
Temperature 37.1°C (98.7°F): Fever has resolved, indicating response to antibiotics.
Blood pressure 120/78 mmHg: Remains stable within normal limits.
Laboratory Results:
WBC 12,000/mm³ (previously 16,000/mm³): Decreasing WBC count suggests resolution of infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Incorrect – While parental support may be helpful, obtaining permission or direct parental involvement is not always appropriate or necessary.
B. Incorrect – The adolescent’s concerns are financial, not necessarily mental health-related, so referring her to a mental health clinic is not the priority intervention.
C. Correct – Medicaid provides financial assistance for prenatal care, delivery, and postpartum care for low-income pregnant individuals.
D. Incorrect – Adoption is a personal choice, and the nurse should provide support and resources rather than advising the client on a specific course of action.
Correct Answer is A
Explanation
A. APs can remind clients to use the incentive spirometer as part of their role in promoting basic care and client independence.
B. Observing the position of the suspended weight is a nursing responsibility because improper traction can lead to complications.
C. Asking the client to describe their pain requires assessment, which is outside the scope of an AP’s role.
D. Checking the pedal pulse is an assessment task that requires nursing judgment and should not be delegated to an AP.
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