Correct Answer: A

Rationale: Encouraging the client to log-roll when turning prevents twisting of the spine, maintaining alignment and reducing strain on the surgical site after a lumbar laminectomy.
Choice B is incorrect because a prone position is uncomfortable and not recommended post-laminectomy; a side-lying or semi-Fowler's position is preferred.
Choice C is incorrect because a heating pad is not typically used, as it may increase swelling; cold packs are often applied initially.
Choice D is incorrect because ambulation is usually encouraged on the first postoperative day, not delayed to the second, unless contraindicated.

Correct Answer: C

Rationale:
Choice A is wrong because checking a STAT cardiac troponin is not the first priority. Cardiac troponin is a biomarker that indicates myocardial injury, but it may not rise until several hours after the onset of chest pain.
Therefore, it is not useful for immediate diagnosis or treatment of acute coronary syndrome.
Choice B is wrong because requesting a prescription for a beta-blocker is not the first priority. Beta-blockers are medications that can lower blood pressure and heart rate, and reduce the oxygen demand of the heart. They can prevent or reduce the recurrence of chest pain and complications of acute coronary syndrome, but they are not indicated for immediate relief of chest pain. Nitroglycerin is a vasodilator that can relieve chest pain caused by myocardial ischemia. The nurse should administer it as soon as possible to improve blood flow to the heart and reduce the risk of myocardial infarction. The nurse should also monitor the client's blood pressure and heart rate after giving nitroglycerin, as it can cause hypotension and reflex tachycardia.
Choice D is wrong because administering oxygen is not the first priority. Oxygen therapy can increase the oxygen supply to the heart and reduce ischemia, but it is not necessary for all clients with chest pain. Oxygen therapy should be based on the client's oxygen saturation level and clinical condition. If the client's oxygen saturation is normal or high, oxygen therapy may not be beneficial and may even be harmful.

Correct Answer: A

Rationale: Lochia serosa (pinkish-brown discharge) on day 1 postpartum is abnormal and should be reported, as lochia is typically rubra (bright red) for the first 3-4 days; serosa usually appears around day 4-10, and early serosa may indicate retained placental fragments or infection.
Choice B is wrong because a firm fundus 2 cm below the umbilicus is a normal finding, indicating appropriate uterine involution.
Choice C is wrong because mild perineal discomfort during ambulation is expected, especially after a vaginal delivery, and does not require immediate reporting unless severe or accompanied by other symptoms.
Choice D is wrong because breast tenderness when breastfeeding is common in the early days as milk comes in and does not typically require reporting unless severe or associated with signs of mastitis.

Correct Answer: A

Rationale: A respiratory rate of 10/min is below the normal range (12-20/min) and indicates potential magnesium sulfate toxicity, which can lead to respiratory depression or arrest. This finding should be reported immediately to the provider, and the infusion may need to be stopped.
Choice B is wrong because a blood pressure of 150/90 mm Hg, while elevated, is not unexpected in preeclampsia and does not indicate immediate toxicity; it should be monitored, but it is not the priority.
Choice C is wrong because a urine output of 40 mL/hr is within the acceptable range (at least 30 mL/hr) for a client receiving magnesium sulfate and does not indicate renal compromise.
Choice D is wrong because deep tendon reflexes of 2+ are normal and do not suggest magnesium toxicity, which would present with absent or diminished reflexes.

Correct Answer: D

Rationale:
Choice A is wrong because the blood sample is not drawn from the baby's inner elbow, but from the heel.
Choice B is wrong because the baby does not need to drink water prior to the test, as this could dilute the blood sample and affect the results.
Choice C is wrong because the test does not need to be repeated when the baby is 2 months old, unless there is a positive or inconclusive result from the first test. Newborn genetic screening is important for early detection and intervention. This test should be performed after your baby is 24 hours old. This is because newborn genetic screening is a set of laboratory tests that detect a set of known genetic diseases that can affect a child's long-term health or survival. The test is performed on a blood sample obtained from a heel prick when the baby is two or three days old. Performing the test after 24 hours ensures that the baby has had enough time to metabolize certain substances that could interfere with the accuracy of the test.