Nokea
When teaching about electrical fire prevention at a community health fair, which of the following information should be included?
- A. Use three-pronged grounded plugs.
- B. Cover extension cords with a rug.
- C. Check for tingling sensations around the cord to ensure electricity is working.
- D. Remove the plug from the socket by pulling the plug, not the cord.
Correct Answer: A
Rationale: The correct answer is to use three-pronged grounded plugs because they are safer and reduce the risk of electrical fires. Option B is incorrect as covering extension cords with a rug can pose a fire hazard. Option C is incorrect; tingling sensations around a cord indicate an electrical issue, not proper functioning. Option D is unsafe; plugs should be removed from the socket by pulling the plug, not the cord, to prevent damage and reduce the risk of electrical hazards.
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A client who is at 38 weeks gestation, is in active labor, and has ruptured membranes is being cared for by a nurse. What action should the nurse take?
- A. Insert an indwelling urinary catheter
- B. Apply fetal heart rate monitor
- C. Initiate fundal massage
- D. Initiate an oxytocin IV infusion
Correct Answer: B
Rationale: When caring for a client in active labor with ruptured membranes, the priority action for the nurse is to apply a fetal heart rate monitor. This helps monitor the well-being of the fetus during labor and delivery, enabling timely interventions if any fetal distress is detected. Inserting an indwelling urinary catheter may be required in some cases, but it is not the priority in the given scenario. Fundal massage is typically done after delivery to help the uterus contract and prevent postpartum hemorrhage. Initiating an oxytocin IV infusion may be indicated to augment labor, but it is not the initial action needed in this situation.
A client is to receive a transfusion of packed RBCs. Which of the following actions should the nurse take?
- A. Prime IV tubing with 0.9% sodium chloride
- B. Use a 24-gauge IV catheter
- C. Obtain filterless IV tubing
- D. Place blood in the warmer for 1 hr
Correct Answer: A
Rationale: Prior to administering a blood transfusion, it is essential to prime the IV tubing with 0.9% sodium chloride to prevent hemolysis of the blood cells. Using a smaller gauge IV catheter (e.g., 20 or 22 gauge) is recommended for blood transfusions to prevent hemolysis. Filterless IV tubing is contraindicated for blood transfusions as it does not have a filter to trap potential blood clots or debris. Warming blood is unnecessary and could lead to the development of bacteria in the blood product. Therefore, the correct action for the nurse to take is to prime the IV tubing with 0.9% sodium chloride.
When caring for a client who speaks a language different from their own, what action should the nurse take?
- A. Request an interpreter of a different sex from the client.
- B. Request a family member or friend to interpret information for the client.
- C. Direct attention toward the interpreter when speaking to the client.
- D. Review the facility policy about the use of an interpreter.
Correct Answer: D
Rationale: When caring for a client who speaks a different language, it is essential for the nurse to review the facility policy about the use of an interpreter. Using a professional interpreter ensures accurate communication and protects the client's confidentiality. Requesting an interpreter of a specific sex or relying on family members or friends can lead to miscommunication or breaches of confidentiality. Directing attention towards the interpreter helps facilitate communication but does not address the need for a professional interpreter as per facility policy.
A client in labor is receiving oxytocin. Which of the following findings indicates that the nurse should increase the rate of infusion?
- A. Urine output of 20 ml/hr.
- B. Montevideo units constantly at 300 mm Hg.
- C. FHR pattern showing absent variability.
- D. Contractions occurring every 5 minutes and lasting 30 seconds.
Correct Answer: B
Rationale: Montevideo units measure the strength and frequency of contractions during labor. A consistent Montevideo units reading of 300 mm Hg or higher is indicative of effective uterine contractions. In this scenario, an increase in the rate of oxytocin infusion may be warranted to further augment contractions and promote progress in labor. The other options, such as low urine output, absent variability in fetal heart rate, and short contractions, do not directly correlate with the need for an increase in oxytocin infusion rate.
A charge nurse is recommending postpartum client discharge following a local disaster. Which of the following should the nurse recommend for discharge?
- A. A 42-year-old client who has preeclampsia and a BP of 166/110 mm Hg
- B. A 15-year-old client who delivered via emergency cesarean birth 1 day ago
- C. A client who received 2 units of packed RBCs 6 hr ago for a postpartum hemorrhage
- D. A client who delivered precipitously 36 hr ago and has a second-degree perineal laceration
Correct Answer: D
Rationale: The most appropriate client to recommend for discharge following a local disaster in the postpartum unit is the one who delivered precipitously 36 hours ago and has a second-degree perineal laceration. This client's condition is stable enough for discharge, and the timing and extent of the perineal laceration are within expectations for a safe discharge. Clients with conditions such as preeclampsia, recent emergency cesarean birth, or recent administration of packed RBCs for postpartum hemorrhage require further monitoring and care before being considered for discharge.