ATI RN
NCLEX Pediatric Respiratory Wong Nursing Questions Questions
Question 1 of 5
If nonsurgical treatment for subinvolution is ineffective, which surgical procedure is appropriate to correct the cause of this condition?
Correct Answer: D
Rationale: In the context of subinvolution of the uterus, where the uterus fails to return to its normal size after childbirth, if nonsurgical treatments such as medications or interventions like antibiotics or uterine massage are ineffective, a surgical procedure like dilation and curettage (D&C) may be necessary. D&C involves scraping the uterine lining to remove any retained placental tissue, clots, or debris that may be causing the subinvolution. This procedure helps promote proper involution of the uterus. Option A, hysterectomy, involves the removal of the uterus entirely and is not typically indicated for subinvolution unless there are severe complications. Option B, laparoscopy, is a minimally invasive procedure used for diagnostic purposes or to perform certain surgeries, but it is not the primary choice for addressing subinvolution. Option C, laparotomy, involves a larger abdominal incision and is usually reserved for more complex cases, not for subinvolution. Educationally, it is important for nursing students preparing for the NCLEX to understand the various treatment options for postpartum complications like subinvolution. Knowing when surgical interventions are necessary and the appropriate procedures for specific conditions is crucial for providing safe and effective care to postpartum patients. Understanding the rationale behind each treatment option helps nurses make informed decisions and advocate for their patients' health and well-being.
Question 2 of 5
Which patient data received during report should the nurse recognize as being at risk for postpartum complications?
Correct Answer: A
Rationale: Multiparity (five or more deliveries) is a risk factor for postpartum uterine atony and hemorrhage. A labor duration of 4 hours is not a risk factor because it is not a precipitate labor and birth (less than 3 hours), infant weight of 3800g is not a risk factor because the infant is not macrosomic, and epidural anesthesia is not a risk factor because it does not affect uterine contractions.
Question 3 of 5
The nurse notes that the fundus of a postpartum patient is boggy, shifted to the left of the midline, and 2 cm above the umbilicus. What is the nurse's priority action?
Correct Answer: A
Rationale: The nurse's priority action when the fundus is not firm is to massage it until it becomes firm and to express any clots that may have accumulated. This helps the uterus contract effectively. Other actions such as assisting the patient to void, increasing oxytocin infusion, or bringing in a straight catheter tray are not the immediate priority in this situation.
Question 4 of 5
A newborn is admitted to the special care nursery with hypothermia. Which complication should the nurse monitor for closely?
Correct Answer: B
Rationale: Hypothermia can lead to metabolic acidosis in newborns. Cold stress increases oxygen demands and metabolism of glucose in the absence of sufficient oxygen can result in increased production of acids, leading to metabolic acidosis. Monitoring for metabolic acidosis is crucial in this scenario to prevent life-threatening complications. The other options, such as hyperglycemia, respiratory acidosis, and vasodilation of peripheral blood vessels, do not directly relate to the complication of hypothermia.
Question 5 of 5
Inspection of a newborn's head following birth reveals a hard ridged area and significant molding. The anterior and posterior fontanels show no sign of depression. Delivery history indicates that the mother was pushing for over 3 hours and had epidural anesthesia. A vacuum extraction was necessary. Based on this information the nurse would
Correct Answer: C
Rationale: The nurse should suspect craniosynostosis (premature closing of sutures) and therefore should contact the pediatric provider immediately. The physical findings do not align with a strenuous birth process, and monitoring is not the appropriate initial action. It is important to note the presence of fontanels, but the immediate action should be to seek medical intervention.