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Questions 149

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Question 1 of 5

The client is admitted to the postpartum unit with an order to continue the infusion of Pitocin. The nurse is aware that Pitocin is working if the fundus is:

Correct Answer: B

Rationale: A firm and midline fundus indicates effective uterine contraction, showing Pitocin is working to prevent postpartum hemorrhage.

Question 2 of 5

A client is receiving hospice and palliative care, including analgesia and other comfort measures. Which of the following indicates the client is undergoing life review? Select all that apply.

Correct Answer: A,C

Rationale: Looking at photos (
A) and reminiscing about parenting (
C) indicate life review, reflecting on past experiences. Other statements (B, D, E) relate to pain or end-of-life wishes.

Question 3 of 5

A 9-year-old is admitted with suspected rheumatic fever. Which finding is suggestive of Sydenham's chorea?

Correct Answer: A

Rationale: Sydenham's chorea, a manifestation of rheumatic fever, is characterized by irregular, involuntary movements and facial grimacing.

Question 4 of 5

The nurse is working with a nursing student to administer an enema solution to a client. The client states she feels painful cramping. The nurse should intervene by

Correct Answer: C

Rationale: Painful cramping during an enema suggests too-rapid administration. Clamping briefly and slowing the rate reduces discomfort.

Question 5 of 5

The nurse is caring for a client 7 days post-burn injury with 60% body surface area involved. The nursing care of this client would primarily focus on:

Correct Answer: A

Rationale: At 7 days post-burn, infection is a major risk due to open wounds and immunosuppression, making meticulous infection control the primary focus.

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