Question

A nurse is caring for a full term client in labor who is prescribed continuous fetal monitoring. On examination. the nurse determines the client's membranes are intact. Which of the following assessment methods should the nurse implement?

Answer 1

Correct Answers:

External ultrasound transducer monitor

Rationale :

🔷 With intact membranes, the safest and appropriate method for continuous fetal monitoring is an external ultrasound transducer, which does not require internal access.

🔷 External monitoring uses an ultrasound device placed on the maternal abdomen to continuously track the fetal heart rate (FHR) without breaking the membranes.

🔷 This method reduces risk of infection, fetal scalp trauma, and maternal tissue injury because it is noninvasive.

🔷 It is the standard first-line option for continuous monitoring when the fetus can be detected externally and the client’s membranes are intact.

🔷 It also allows ongoing assessment of fetal well-being (baseline, variability, accelerations, decelerations) while maintaining maternal-fetal safety.

Internal fetal scalp electrode

🔷A fetal scalp electrode requires ruptured membranes and sufficient cervical dilation so the electrode can contact the fetal presenting part.

🔷With intact membranes, it cannot be applied safely and increases risk of complications if attempted.

Transvaginal fetal Doppler probe

🔷A transvaginal Doppler is not used for continuous intrapartum monitoring in labor as a standard fetal monitoring method.

🔷Continuous monitoring is typically achieved by external ultrasound or internal electrode when membranes are ruptured.

DeLee-Hillis fetoscope

🔷A fetoscope provides intermittent auscultation, not continuous electronic fetal monitoring.

🔷It is also more user-dependent and does not provide continuous tracing needed for prescribed continuous monitoring.

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Answer 2

Correct Answers

Moderate lochia rubra [ Unrelated to diagnosis ]
WBC count 35.000/mm [ Sign of potential worsening condition ]
Purulent nipple discharge [ Sign of potential worsening condition ]
Temperature 38.4° C (101.1) [ Sign of potential worsening condition ]
High 12 g/d [ Unrelated to diagnosis ]
Client reports decreased level of pain [ Sign of potential improvement ]

Rationale :

WBC count 35,000/mm³ — Worsening

🔷 A rising WBC count suggests the body is mounting a stronger inflammatory response, which often means the infection is not controlled.

🔷 In effective mastitis treatment, the WBC should begin to trend downward within the first 24–48 hours as bacterial load decreases.

🔷 Increasing WBC from an already elevated level indicates possible progression of infection, poor antibiotic coverage, or inadequate breast drainage.

🔷 Severe leukocytosis raises concern for complications such as breast abscess or systemic spread of infection.

🔷 This finding requires immediate follow-up because persistent infection can escalate to sepsis, especially postpartum when the body is recovering from surgery and physiologic stress.

Purulent nipple discharge — Worsening

🔷 Purulent drainage (pus-like fluid) reflects active bacterial infection and a higher burden of organisms in the affected area.

🔷 Mastitis typically presents with pain, erythema, warmth, and possibly milk-streaked drainage, but pus suggests more advanced infection.

🔷 This finding increases suspicion for a localized collection such as a breast abscess, especially if symptoms persist despite therapy.

🔷 Abscess formation can prevent antibiotics from fully resolving the infection because pus-filled pockets often require drainage for cure.

🔷 Purulent discharge also raises risk of worsening systemic illness and indicates the need for provider notification, possible ultrasound, and treatment adjustment.

Temperature 38.4°C (101.1°F) — Worsening

🔷 A persistent fever above 38°C after 24 hours suggests the body is still experiencing systemic infection rather than resolving inflammation.

🔷 With appropriate antibiotics and effective breast emptying, temperature should typically improve within 24–48 hours.

🔷 Continued fever can indicate inadequate antibiotic effect, poor milk drainage, or progression to complications like abscess.

🔷 Fever is a key systemic warning sign because it reflects immune activation throughout the body, not just localized breast inflammation.

🔷 In a postpartum client (especially post-cesarean), ongoing fever also requires immediate assessment because infection can worsen rapidly and must be evaluated for broader causes if not improving.

Client reports decreased level of pain — Improving

🔷 A decrease in pain suggests reduced inflammation and tissue swelling in the affected breast.

🔷 As mastitis improves, the breast becomes less tender due to decreasing ductal obstruction and less pressure within inflamed tissue.

🔷 Symptom relief is often an early improvement marker, especially when paired with better comfort during feeding or pumping.

🔷 Even if labs are not fully normalized, improved pain can show partial effectiveness of interventions like antibiotics, warm compresses, and continued milk removal.

🔷 This finding supports improvement but must be interpreted with caution if fever or WBC remains elevated, because pain can decrease temporarily while infection still persists.

Moderate lochia rubra — Unrelated

🔷 Lochia rubra is a normal postpartum finding and represents uterine shedding of blood and tissue during early involution.

🔷 At 3–4 days postpartum, moderate rubra is expected and does not directly indicate breast infection improvement or decline.

🔷 Lochia is assessed for postpartum bleeding and uterine recovery, not for mastitis severity.

🔷 This finding becomes concerning only if it is excessive, foul-smelling, or persists unusually, which would suggest uterine infection or hemorrhage rather than mastitis.

Hgb 12 g/dL — Unrelated

🔷 A hemoglobin of 12 g/dL is within expected range for many postpartum clients and reflects oxygen-carrying capacity, not infection severity.

🔷 Hemoglobin trends relate more to blood loss, hydration, and recovery from cesarean delivery rather than mastitis progression.

🔷 Mastitis is primarily evaluated through symptoms (pain, warmth, erythema), fever, and WBC trends, not Hgb.

🔷 A normal hemoglobin does not rule out worsening infection and does not confirm improvement.

🔷 This value is helpful for general postpartum status but is not a key diagnostic marker for breast infection response.

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Answer 3

Correct Highlights :

Irritability
Axillary temperature
Respiratory rate
Apical heart rate

Rationale :

Neurologic: Irritability

🔷 Irritability in a newborn—especially with prolonged rupture of membranes—can be an early sign of neonatal infection/sepsis.

🔷 It reflects possible CNS irritation, systemic illness, or metabolic stress that requires prompt evaluation.

🔷 This symptom becomes more concerning when paired with abnormal labs like WBC 40,000/mm³ and CRP 2.5 mg/dL.

🔷 Newborns can deteriorate quickly, so behavioral changes are treated as early warning signs.

🔷 Reporting supports rapid assessment and timely initiation of testing or treatment (e.g., cultures, antibiotics).

Axillary Temperature: 36.2°C (97.2°F)

🔷 A temperature of 36.2°C is low for a newborn and can indicate cold stress or sepsis.

🔷 Newborns often show infection as hypothermia rather than fever, making this particularly important.

🔷 Cold stress increases oxygen consumption and can worsen respiratory distress and metabolic stability.

🔷 With the additional risk factor of prolonged rupture of membranes, this temperature requires provider notification.

🔷 Prompt intervention helps prevent complications like hypoglycemia, acidosis, and worsening respiratory effort.

Cardiopulmonary: Respiratory Rate 80/min

🔷 A respiratory rate of 80/min is tachypnea (normal newborn RR ≈ 30–60/min).

🔷 Tachypnea indicates respiratory distress and can be associated with infection, aspiration, or transitional problems.

🔷 When RR is this high, the newborn may have difficulty coordinating feeding and breathing, increasing risk of aspiration.

🔷 This finding is especially urgent when combined with expiratory grunting, which signals increased work of breathing.

🔷 The provider must evaluate quickly to prevent progression to respiratory failure or worsening hypoxemia.

Apical Heart Rate: 158/min

🔷 A heart rate of 158/min is at the upper end of normal for a newborn but becomes concerning with concurrent signs of stress.

🔷 Tachycardia may reflect respiratory distress, infection, or cold stress, all of which are present in this scenario.

🔷 When paired with tachypnea and hypothermia, it suggests systemic compensation and possible clinical deterioration.

🔷 Provider evaluation is needed to determine whether this is transitional or part of a worsening condition like sepsis.

🔷 Early reporting supports timely interventions to stabilize oxygenation and temperature, which often improves heart rate.

Gastrointestinal: Abdomen hard and distended

🔷 A hard, distended abdomen in a newborn is abnormal and can indicate bowel obstruction, necrotizing enterocolitis (NEC), or severe GI pathology.

🔷 Distention suggests impaired motility or inflammation, which can progress rapidly to perforation or sepsis.

🔷 This finding is especially concerning when paired with systemic signs like tachypnea and abnormal inflammatory labs.

🔷 A firm abdomen can also compromise breathing by limiting diaphragmatic expansion, worsening respiratory distress.

🔷 Immediate provider notification is needed for possible imaging, bowel rest, and urgent intervention.

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Answer 4

Correct Answers:

Apply sequential compression devices prior to the procedure.

Rationale :

🔷 Applying sequential compression devices (SCDs) before a cesarean helps prevent venous thromboembolism (VTE), a major postoperative risk due to pregnancy-related hypercoagulability and surgical immobility.

🔷 Cesarean birth increases clot risk because surgery causes vascular injury, reduced mobility, and venous stasis—SCDs directly reduce stasis in the legs.

🔷 Using SCDs preoperatively ensures protection starts before immobility and continues through the immediate perioperative period.

🔷 This intervention is a standard surgical safety measure and supports maternal outcomes by lowering risk of DVT and pulmonary embolism.

🔷 Including SCDs in the plan reflects priority prevention of a potentially life-threatening complication without interfering with fetal status or surgical workflow.

Initiate oxytocin via continuous IV infusion prior to the procedure.

🔷Oxytocin is typically used after delivery to promote uterine contraction and reduce postpartum hemorrhage, not routinely before incision.

🔷Starting it preoperatively is not a standard cesarean preparation step.

Perform a surgical timeout while the client is in the preoperative holding area.

🔷A surgical timeout is done immediately before incision in the operating room with the full surgical team present to verify the correct client, procedure, and site.

🔷Doing it in pre-op holding does not meet the safety purpose of the final shared verification.

Insert an indwelling urinary catheter immediately following the procedure.

🔷For cesarean birth, the urinary catheter is typically inserted before surgery to keep the bladder decompressed and reduce risk of injury.

🔷Placing it after the procedure misses the intraoperative safety benefit.

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Answer 5

Correct Answers:

“I should position my baby's car seat at a 45° angle in the car."

Rationale :

🔷 A rear-facing infant seat should be installed at about a 45° angle to keep the infant’s airway open and reduce risk of head slump and airway obstruction.

🔷 This angle supports the infant’s large occiput and weak neck control, preventing the chin from dropping toward the chest.

🔷 Correct recline improves breathing and decreases risk of desaturation, especially in newborns and small infants.

🔷 Many infant seats include angle indicators; teaching the 45° guideline helps guardians verify correct installation.

🔷 This statement reflects proper understanding of safe positioning, which is essential for injury prevention and respiratory safety during travel.

“I should place the harness snugly in a slot above my baby's shoulders."

🔷For a rear-facing seat, the harness straps should be at or below the infant’s shoulders to keep the baby secured properly.

🔷Straps above the shoulders can increase risk of the infant sliding upward during a crash.

“I should position the retainer clip at the top of my baby's abdomen."

🔷The retainer (chest) clip should be at armpit level, centered on the chest, to hold straps in the correct position.

🔷Placing it on the abdomen increases risk of poor restraint positioning and injury.

“I should place the car seat rear-facing until my baby is 12 months old."

🔷Best practice is to keep the seat rear-facing as long as possible until the child reaches the maximum height/weight limits of the seat, which is often beyond 12 months.

🔷 Stopping at 12 months is too early for optimal protection.

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Answer 6

Correct Answers:

Swaddle the newborn with flexed extremities.
Maintain a low stimulation environment.
Weigh the newborn daily.

Rationale :

Swaddle the newborn with flexed extremities

🔷 Swaddling with flexed extremities helps reduce the newborn’s tremors, hypertonicity, and exaggerated startle (Moro) reflex, which are common in NAS.

🔷 Flexed positioning mimics the contained intrauterine posture, which promotes self-regulation and decreases neurologic overstimulation.

🔷 This intervention helps lower energy expenditure caused by constant movement and irritability, supporting better physiologic stability.

🔷 Swaddling also supports improved sleep, which is crucial because this newborn has minimal sleep and a continuous high-pitched cry.

🔷 Comfort strategies like swaddling are first-line nonpharmacologic management that can reduce symptom severity and improve feeding tolerance.

Maintain a low stimulation environment

🔷 A low stimulation environment reduces sensory input that worsens NAS symptoms such as high-pitched crying, tremors, and irritability.

🔷 Decreasing noise, bright lights, frequent handling, and clustered care helps stabilize the newborn’s neurologic system.

🔷 Overstimulation increases autonomic stress responses, which can raise heart rate, respiratory rate, and temperature, all of which are already elevated.

🔷 A calm setting promotes longer sleep periods and reduces excessive crying, improving overall recovery and comfort.

🔷 This intervention is a key part of NAS supportive care and can reduce the need for pharmacologic treatment by minimizing symptom triggers.

Weigh the newborn daily

🔷 Newborns with NAS often have poor feeding coordination, uncoordinated suck/swallow, and high energy expenditure from tremors and crying.

🔷 These factors increase risk for inadequate caloric intake and weight loss, making daily weight monitoring essential.

🔷 Tracking weight helps evaluate effectiveness of interventions and detects early signs of dehydration or failure to thrive.

🔷 Frequent assessment supports timely nutrition adjustments, such as higher-calorie feedings or feeding support strategies.

🔷 Daily weights provide an objective measure of clinical progress and safety in a newborn experiencing withdrawal symptoms.

Plan to administer naloxone.

🔷Naloxone can trigger acute, severe withdrawal in newborns exposed to opioids, which can be dangerous.

🔷NAS is managed with supportive care and sometimes opioids like morphine, not naloxone.

Instruct the parent to avoid breastfeeding.

🔷Breastfeeding is often encouraged if the mother is in a supervised treatment program and has no contraindications (e.g., HIV, illicit drug use).

🔷Breastfeeding can actually reduce NAS severity by providing comfort and small consistent opioid exposure through milk in methadone-managed mothers.

Instruct the parent to avoid eye contact with the newborn during feeding.

🔷Eye contact supports bonding and soothing, and avoiding it is not therapeutic.

🔷NAS care promotes calm, consistent caregiver interaction, not detachment.

Perform Ballard newborn screening each shift.

🔷The Ballard score is used to estimate gestational age, not to monitor NAS severity.

🔷NAS monitoring uses structured withdrawal scoring tools (e.g., Finnegan), not Ballard assessments every shift.

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Answer 7

Correct Answers

BP 180/100 mm Hg [ Indication of Worsening Condition ]
FHR 80/min with absent variability [ Indication of Worsening Condition ]
Client reports sharp, stabbing abdominal pain [ Indication of Worsening Condition ]
PT 12 seconds [ Unrelated to Diagnosis ]
Moderate maternal bleeding [ Indication of Worsening Condition ]
Client reports ringing in ears [ Indication of Worsening Condition ]

Rationale :

BP 180/100 mm Hg — Worsening

🔷 Although lower than the prior 210/105, a BP of 180/100 mm Hg remains severely elevated and dangerous in HELLP syndrome.

🔷 Severe hypertension sustains risk for cerebral hemorrhage, placental abruption, and maternal stroke.

🔷 In HELLP, BP improvement must trend to <160/110 to be considered stabilizing; this value does not meet that threshold.

🔷 Persistent severe BP indicates ongoing endothelial injury and vasospasm.

🔷 This requires urgent antihypertensive management and continuous monitoring—thus signaling worsening/unstable status, not improvement.

FHR 80/min with absent variability — Worsening

🔷 A fetal heart rate of 80/min is bradycardia, indicating acute fetal compromise.

🔷 Absent variability reflects impaired fetal oxygenation and possible acid-base imbalance.

🔷 In HELLP, placental perfusion is often reduced due to vasospasm, directly affecting fetal status.

🔷 This tracing represents a Category III pattern and is an obstetric emergency.

🔷 Immediate provider notification and potential urgent delivery are required, confirming worsening condition.

Client reports sharp, stabbing abdominal pain — Worsening

🔷 Sharp, stabbing abdominal pain in HELLP suggests worsening hepatic involvement.

🔷 This raises concern for hepatic hematoma, liver capsule distention, or impending rupture.

🔷 Pain that changes in quality or intensity is a red flag for rapid disease progression.

🔷 HELLP can deteriorate suddenly, and severe abdominal pain is a classic warning sign.

🔷 This symptom mandates immediate escalation of care, marking worsening status.

Moderate maternal bleeding — Worsening

🔷 HELLP is associated with thrombocytopenia and coagulopathy, increasing bleeding risk.

🔷 Moderate bleeding suggests possible disseminated intravascular coagulation (DIC) or placental abruption.

🔷 Ongoing bleeding indicates impaired clot formation due to low platelets and prolonged PT.

🔷 This finding signals loss of hemostatic control and potential for rapid hemorrhage.

🔷 Therefore, this represents clinical deterioration requiring urgent intervention.

Client reports ringing in ears — Worsening

🔷 Tinnitus is a neurologic symptom linked to severe hypertension and cerebral vasospasm.

🔷 In preeclampsia/HELLP, tinnitus may precede seizure or intracranial bleeding.

🔷 The client has a history of tinnitus, but its presence during acute severe hypertension is significant.

🔷 Neurologic symptoms indicate worsening cerebral involvement.

🔷 This finding requires immediate provider notification and seizure precautions.

PT 12 seconds — Unrelated

🔷 A PT of 12 seconds falls within normal limits and does not indicate active coagulopathy progression.

🔷 While coagulation status is important in HELLP, this specific value does not explain acute changes at this moment.

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Answer 8

Correct Answers:

“I will expect my baby’s umbilical cord to fall off in a couple of weeks."

Rationale :

🔷 The umbilical cord stump normally dries, shrivels, and separates within about 1 to 2 weeks, so “a couple of weeks” reflects accurate understanding.

🔷 Keeping the cord clean and dry supports natural separation and reduces infection risk.

🔷 Parents should watch for redness, foul odor, purulent drainage, or bleeding, which would suggest infection and require follow-up.

🔷 This statement shows the parent understands normal newborn expectations and can identify abnormal changes.

🔷 Correct expectations reduce unnecessary worry and help the caregiver maintain appropriate cord care routines.

“I will compress the bulb syringe after I place it in my baby's mouth.”

🔷The bulb should be compressed before insertion so suction is created when released.

🔷Also, suction the mouth before the nose to reduce aspiration risk.

“I will place my baby on their side to sleep.”

🔷Safe sleep is supine (on the back) to reduce risk of SIDS.

🔷Side-lying is unstable and increases the chance the infant rolls prone.

“I will give my baby a tub bath once daily.”

🔷Tub baths should be avoided until the cord stump falls off; sponge baths are recommended.

🔷Daily tub bathing can also dry newborn skin unnecessarily.

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Answer 9

Correct Answers:

The fetus had 20 seconds of sustained breathing movements in 30 min.

Rationale :

🔷 In a biophysical profile, fetal well-being includes fetal breathing movements of at least 30 seconds (some sources accept shorter bursts depending on facility criteria), but sustained breathing activity still supports reassuring fetal status compared with nonreactive testing or low fluid.

🔷 Breathing movements indicate an intact central nervous system and adequate oxygenation.

🔷 BPP assesses fetal breathing, movement, tone, amniotic fluid, and NST, with normal findings suggesting adequate placental function.

🔷 Compared to the other choices, this is the only one that reflects a reassuring physiologic behavior rather than compromise.

🔷 A nonreactive NST and severely low AFI are strong indicators of potential fetal compromise, making fetal breathing the best indicator of well-being among the options.

The fetus had four limb movements in 30 min.

🔷BPP typically expects three or more gross body movements, but limb-only movement wording is less clearly aligned with standard scoring compared with sustained breathing.

🔷 The stronger indicator in these options is the presence of sustained breathing activity.

Nonreactive nonstress test

🔷 A nonreactive NST suggests inadequate accelerations and can indicate fetal sleep cycle or compromise.

🔷 It is not a reassuring indicator without further evaluation.

Amniotic fluid index of 1 cm

🔷 An AFI of 1 cm indicates severe oligohydramnios, which can reflect placental insufficiency.

🔷 This is a concerning finding requiring prompt provider evaluation.

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Answer 10

Correct Answers:

History of uterine atony
Labor induction with oxytocin
Vacuum-assisted delivery

Rationale :

History of uterine atony

🔷 Uterine atony is the most common cause of postpartum hemorrhage because the uterus fails to contract and compress blood vessels.

🔷 A prior history increases recurrence risk due to underlying uterine tone issues.

🔷 Without firm contraction, placental site vessels remain open and bleeding can become rapid.

🔷 Recognizing this risk prompts proactive measures such as uterine tone assessments and readiness for uterotonics.

🔷 Early identification supports prevention and rapid response to heavy bleeding.

Labor induction with oxytocin

🔷 Prolonged or high-dose oxytocin can desensitize uterine receptors, increasing risk of uterine fatigue and atony after delivery.

🔷 When the uterus is exhausted, it may not clamp down effectively, increasing hemorrhage risk.

🔷 This is why uterine tone monitoring and postpartum fundal checks are critical.

🔷 Oxytocin exposure is a recognized risk factor for postpartum uterine relaxation.

🔷 The nurse should anticipate possible need for additional uterotonics and close monitoring.

Vacuum-assisted delivery

🔷 Operative vaginal births increase risk for postpartum hemorrhage due to genital tract trauma (lacerations, hematomas).

🔷 Trauma can cause persistent bleeding even when the uterus is firm.

🔷 Vacuum delivery may also be associated with prolonged labor and uterine fatigue.

🔷 This method requires careful assessment for concealed bleeding and perineal injury.

🔷 Early recognition supports rapid intervention and prevention of severe blood loss.

History of human papillomavirus

🔷HPV history does not directly affect uterine tone or postpartum bleeding control.

🔷It is unrelated to the primary causes of postpartum hemorrhage.

Newborn weight 2.948 kg (6 lb 8 oz)

🔷This is a normal birth weight and does not overstretch the uterus.

🔷Large infants (macrosomia) increase atony risk, but this weight does not.

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Findings 24 hr later	Unrelated to diagnosis	Sign of potential improvement	Sign of potential worsening condition
Moderate lochia rubra
WBC count 35.000/mm
Purulent nipple discharge
Temperature 38.4° C (101.1)
High 12 g/d
Client reports decreased level of pain

Findings 15 min Later	Unrelated to Diagnosis	Indication of Improving Condition	Indication of Worsening Condition
BP 180/100 mm Hg
FHR 80/min with absent variability
Client reports sharp, stabbing abdominal pain
PT 12 seconds
Moderate maternal bleeding
Client reports ringing in ears

QLexNursing

1 :
A nurse is caring for a full term client in labor who is prescribed continuous fetal monitoring. On examination. the nurse determines the client's membranes are intact. Which of the following assessment methods should the nurse implement?

2 :
A nurse is caring for a client who is postpartum and has mastitis.

Correct Answers

3 :
A nurse is caring for a newborn.

Correct Highlights :

4 :
A nurse is planning care for a client who is scheduled for a cesarean birth. Which of the following interventions should the nurse include in the plan of care?

5 :
A nurse is providing discharge teaching to a new guardian about car seat safety. Which of the following statements by the guardian indicates an understanding of the teaching?

6 :
A nurse is caring for a newborn who is 5 days old.

Answer Options

7 :
A nurse is caring for a client who is at 28 weeks of gestation and has been diagnosed with HELLP syndrome.

Correct Answers

8 :
A nurse is providing discharge teaching to a new mother about newborn care. Which of the following statements by the client indicates an understanding of the teaching?

9 :
A nurse is reviewing the results of a biophysical profile for a client who is at 37 weeks of gestation. Which of the following findings indicates fetal well-being?

10 :
A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)

QLexNursing

1 : A nurse is caring for a full term client in labor who is prescribed continuous fetal monitoring. On examination. the nurse determines the client's membranes are intact. Which of the following assessment methods should the nurse implement?

2 : A nurse is caring for a client who is postpartum and has mastitis.

Correct Answers

3 : A nurse is caring for a newborn.

Correct Highlights :

4 : A nurse is planning care for a client who is scheduled for a cesarean birth. Which of the following interventions should the nurse include in the plan of care?

5 : A nurse is providing discharge teaching to a new guardian about car seat safety. Which of the following statements by the guardian indicates an understanding of the teaching?

6 : A nurse is caring for a newborn who is 5 days old.

Answer Options

7 : A nurse is caring for a client who is at 28 weeks of gestation and has been diagnosed with HELLP syndrome.

Correct Answers

8 : A nurse is providing discharge teaching to a new mother about newborn care. Which of the following statements by the client indicates an understanding of the teaching?

9 : A nurse is reviewing the results of a biophysical profile for a client who is at 37 weeks of gestation. Which of the following findings indicates fetal well-being?

10 : A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)

1 :
A nurse is caring for a full term client in labor who is prescribed continuous fetal monitoring. On examination. the nurse determines the client's membranes are intact. Which of the following assessment methods should the nurse implement?

2 :
A nurse is caring for a client who is postpartum and has mastitis.

3 :
A nurse is caring for a newborn.

4 :
A nurse is planning care for a client who is scheduled for a cesarean birth. Which of the following interventions should the nurse include in the plan of care?

5 :
A nurse is providing discharge teaching to a new guardian about car seat safety. Which of the following statements by the guardian indicates an understanding of the teaching?

6 :
A nurse is caring for a newborn who is 5 days old.

7 :
A nurse is caring for a client who is at 28 weeks of gestation and has been diagnosed with HELLP syndrome.

8 :
A nurse is providing discharge teaching to a new mother about newborn care. Which of the following statements by the client indicates an understanding of the teaching?

9 :
A nurse is reviewing the results of a biophysical profile for a client who is at 37 weeks of gestation. Which of the following findings indicates fetal well-being?

10 :
A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings place the client at risk for postpartum hemorrhage? (Select all that apply.)