ATI RN
Pediatric Respiratory Nursing Questions Questions
Question 1 of 5
The nurse is providing care to a patient who delivered a 3525g infant 14 hours ago. The nurse palpates the fundus of the uterus as firm and at the umbilicus. What is the nurse's priority action related to this finding?
Correct Answer: D
Rationale: The location of the uterine fundus helps determine whether involution is progressing normally. Immediately after birth, the uterus is about the size of a large grapefruit or softball and weighs approximately 1000g (2.2 lb). The fundus can be palpated midway between the symphysis pubis and umbilicus in the midline of the abdomen. Within 12 hours, the fundus rises to approximately the level of the umbilicus. This finding is expected and can be followed with documentation. No further action is needed.
Question 2 of 5
A multiparous patient is admitted to the postpartum unit after a rapid labor and birth of a 4000g infant. Her fundus is boggy, lochia is heavy, and vital signs are unchanged. The nurse has the patient void and massages her fundus; however, the fundus remains difficult to find and the rubra lochia remains heavy. Which action should the nurse take next?
Correct Answer: C
Rationale: The correct answer is C because treatment of excessive bleeding requires collaboration with the healthcare provider, especially in cases of persistent heavy bleeding and boggy fundus. Choices A, B, and D are incorrect as they do not address the need for further medical intervention in this situation. It is crucial to involve the healthcare provider promptly to ensure appropriate management of the patient's condition.
Question 3 of 5
The patient who is being treated for endometritis is placed in the Fowler position because this position
Correct Answer: B
Rationale: The Fowler position aids in gravity drainage of lochia and infectious material, promoting healing and preventing complications. While comfort is important, the primary reason for this positioning is to facilitate drainage. Good hygiene practices help prevent the spread of infection to the urinary tract, but the Fowler position specifically aids in draining fluids from the reproductive organs.
Question 4 of 5
To determine an adverse response to carboprost tromethamine (Hemabate), the nurse should frequently assess
Correct Answer: D
Rationale: Carboprost tromethamine (Hemabate) can potentially cause pulmonary edema as an adverse effect. Therefore, frequent assessment of breath sounds is crucial to detect this complication. Monitoring temperature, lochial flow, and fundal height will not provide information about potential adverse effects of the medication.
Question 5 of 5
If a DVT (deep vein thrombosis) is suspected, the nurse should
Correct Answer: D
Rationale: The correct action if a DVT is suspected is to place the patient on bed rest with the affected leg elevated to decrease swelling and promote venous return. Performing a Homans sign, dorsiflexing the foot, and palpating the leg are contraindicated as they may dislodge the DVT and result in a pulmonary embolism.