A nurse has just received change-of-shift report about four clients who are postpartum.
Which of the following clients should the nurse plan to see first?
A client whose labor lasted for 6 hours.
A client who received magnesium sulfate during labor.
A client who has a history of oligohydramnios.
A client whose newborn is having difficulty latching-on.
The Correct Answer is B
Choice A rationale
A client whose labor lasted for 6 hours is not necessarily a priority unless other complications are present. Duration of labor alone does not indicate an urgent need for immediate attention postpartum.
Choice B rationale
A client who received magnesium sulfate during labor should be seen first due to the potential for serious side effects such as respiratory depression, hypotonia in the newborn, and maternal complications. Magnesium sulfate is used to prevent seizures in clients with preeclampsia and requires close monitoring.
Choice C rationale
A client with a history of oligohydramnios needs monitoring, but this condition alone does not take precedence over the immediate postpartum risks associated with magnesium sulfate.
Choice D rationale
A client whose newborn is having difficulty latching-on needs support and assistance with breastfeeding. While important, this issue is not as urgent as monitoring the effects of magnesium sulfate in the client described in Choice B.
Free Nursing Test Bank
- Free Pharmacology Quiz 1
- Free Medical-Surgical Quiz 2
- Free Fundamentals Quiz 3
- Free Maternal-Newborn Quiz 4
- Free Anatomy and Physiology Quiz 5
- Free Obstetrics and Pediatrics Quiz 6
- Free Fluid and Electrolytes Quiz 7
- Free Community Health Quiz 8
- Free Promoting Health across the Lifespan Quiz 9
- Free Multidimensional Care Quiz 10
View Related questions
Correct Answer is B
Explanation
Choice A rationale
1/2 cup (4 oz) orange juice provides about 55 micrograms of folate. While it is a good source of vitamin C and other nutrients, it does not contain as much folate compared to leafy greens.
Choice B rationale
1 cup cooked spinach contains approximately 263 micrograms of folate, making it one of the richest sources of this essential vitamin. Folate is crucial for DNA synthesis and cell division, especially during pregnancy.
Choice C rationale
1 large egg contains about 24 micrograms of folate. Although eggs offer several nutrients like protein and vitamins, their folate content is relatively low compared to green vegetables.
Choice D rationale
1 cup pasta has around 102 micrograms of folate, assuming it is enriched pasta. While it contributes to daily folate intake, it does not compare to the high levels found in spinach.
Correct Answer is B
Explanation
Choice A rationale
Elevating the client's legs is incorrect as an initial intervention. It is more important to address the potential cause of the late decelerations first.
Choice B rationale
Turning the client onto their side is correct. This intervention can improve blood flow to the fetus and reduce the pressure on the vena cava, potentially alleviating late decelerations.
Choice C rationale
Palpating the client's uterus is not the first action. It is essential to address maternal positioning and oxygenation issues first.
Choice D rationale
Increasing the client's IV fluid infusion rate may help, but it is not the initial action. Positioning changes can have an immediate effect on fetal oxygenation.