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 D
Explanation
True labor contractions continue and become stronger over time.
Choice A is incorrect because true labor contractions are usually regular and become longer over time.
Choice B is incorrect because true labor contractions are usually not relieved by walking.
Choice C is incorrect because, during true labor, the cervix dilates to allow for the baby to pass through the birth canal.
Correct Answer is A
Explanation
The umbilical vein carries oxygen-rich blood to the fetus from the placenta.
The umbilical vein is an important part of fetal circulation and carries oxygenated blood from the placenta into the growing fetus.
Choice B is incorrect because the two umbilical arteries carry deoxygenated blood from the fetus to the placenta23.
Choice C is incorrect because there are not two umbilical veins, but only one12.
Choice D is incorrect because it is not the one umbilical artery that carries oxygen-rich blood to the fetus from the placenta, but rather the one umbilical vein14.
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