The nurse is monitoring a client who is 3 hours postpartum. On assessment, the nurse notes a temperature of 102.4°F.
Which action should the nurse prioritize?
Continue to monitor for another hour.
Administer an antipyretic.
Assist the client in ambulation.
Notify the RN; she will notify the provider.
The Correct Answer is D
A postpartum fever is defined as a temperature greater than 100.4 degrees F (38.0 degrees C) on at least two occasions.
These fevers cannot be ignored as they can represent serious infections. The first task is to identify the source.
Choice A is not correct because continuing to monitor for another hour may delay necessary treatment.
Choice B is not correct because administering an antipyretic may only treat the symptom and not address the underlying cause of the fever.
Choice C is not correct because assisting the client in ambulation does not address the underlying cause of the fever.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Radiographs are vital to the diagnosis of Legg-Calve-Perthes disease.
Initial X-rays might look normal because it can take one to two months after symptoms begin for the changes associated with Legg-Calve-Perthes disease to become evident on X-rays.
The doctor will likely recommend several X-rays over time, to track the progression of the disease.
Bone biopsy is not a diagnostic procedure for Legg-Calve-Perthes disease.
MRI can visualize bone damage caused by Legg-Calve-Perthes disease more clearly than X-rays can but are not always necessary.
Genetic testing is not a diagnostic procedure for Legg-Calve-Perthes disease.
Correct Answer is A
Explanation
Staphylococcus aureus is the most common cause of acute osteomyelitis.
Osteomyelitis is an infection of the bone that can be caused by a variety of microorganisms, including bacteria, fungi, and mycobacteria.
Staphylococcus aureus is present in more than 50% of patients with osteomyelitis that results from contiguous spread from adjacent infected tissue or open wounds.
Choice B is not an answer because Pseudomonas aeruginosa is a less common cause of osteomyelitis and is more commonly seen in injection drug users.
Choice C is not an answer because Streptococcus B is not a common cause of osteomyelitis.
Choice D is not an answer because Escherichia coli is not a common cause of osteomyelitis.
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