The practical nurse (PN) is assigned to assist in the care of a client at 34-weeks gestation with premature rupture of membranes (PROM). Four hours after admission, the PN recognizes an increasing trend in the maternal heart rate. Which action should the PN take?
Follow contact precautions when providing care.
Insert a urinary catheter to monitor hourly output.
Encourage the client to push with the next contraction.
Initiate oxygen via face mask at 8 to 10 L/min.
The Correct Answer is D
An increasing trend in maternal heart rate is a sign of fetal distress, which can be a serious complication of PROM. One of the primary interventions for fetal distress is to increase oxygen delivery to the fetus. The practical nurse should initiate oxygen via face mask at 8 to 10 L/min to improve fetal oxygenation.
Contact precautions may be necessary for certain conditions, but they are not indicated for an increasing maternal heart rate.
Inserting a urinary catheter may be appropriate for monitoring output, but it is not the first priority in this situation.
Encouraging the client to push is not appropriate because the client is not in active labor and pushing can cause further complications.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The PN should provide the information that it may be helpful to **try withholding fluids after supper and before bedtime**. Bedwetting is common and often runs in families. It can be upsetting, but most children and young people will grow out of it³. It’s not unusual for kids to wet the bed at night. Known formally as pediatric enuresis, uncontrolled nighttime urination affects as many as 5% to 10% of 7-year-olds in the United States.
Correct Answer is A
Explanation
Providing a structured daily routine is the most effective intervention for managing the symptoms of ADHD. Children with ADHD benefit from routines that include consistent times for meals, homework, play, and bedtime. This provides structure and predictability, which can help to decrease anxiety and improve the child's ability to focus.
Consulting with a licensed kinesiologist (B) or instituting a regimen of mega-vitamins (C) have not been found to be effective interventions for managing the symptoms of ADHD.
Eliminating dietary simple sugars (D) has also not been found to be an effective intervention for managing the symptoms of ADHD.
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