Free NCLEX-RN Exam Braindumps (page: 146)

Page 146 of 431

A pregnant client experiences a precipitous delivery. The nursing action during a precipitous delivery is to:

  1. Control the delivery by guiding expulsion of fetus
  2. Leave the room to call the physician
  3. Push against the perineum to stop delivery
  4. Cross client's legs tightly

Answer(s): A

Explanation:

(A) Controlling the rapid delivery will reduce the risk of fetal injury and perineal lacerations. (B) The nurse should always remain with a client experiencing a precipitous delivery. (C) Pushing against the perineum may cause fetal distress. (D) Crossing of legs may cause fetal distress and does not stop the delivery process.



A pregnant client experiences a precipitous delivery. The nursing action during a precipitous delivery is to:

  1. Control the delivery by guiding expulsion of fetus
  2. Leave the room to call the physician
  3. Push against the perineum to stop delivery
  4. Cross client's legs tightly

Answer(s): A

Explanation:

(A) Controlling the rapid delivery will reduce the risk of fetal injury and perineal lacerations. (B) The nurse should always remain with a client experiencing a precipitous delivery. (C) Pushing against the perineum may cause fetal distress. (D) Crossing of legs may cause fetal distress and does not stop the delivery process.



A premature infant needs supplemental O2 therapy. A nursing intervention that reduces the risk of retrolental fibroplasia is to:

  1. Maintain O2at <40%
  2. Maintain O2at>40%
  3. Give moist O2at>40%
  4. Maintain on 100% O2

Answer(s): A

Explanation:

(A) Retrolental fibroplasia is the result of prolonged exposure to high levels of O2in premature infants. Complications are hemorrhage and retinal detachment. (B, C, D) O2concentration is too high.



A premature infant needs supplemental O2 therapy. A nursing intervention that reduces the risk of retrolental fibroplasia is to:

  1. Maintain O2at <40%
  2. Maintain O2at>40%
  3. Give moist O2at>40%
  4. Maintain on 100% O2

Answer(s): A

Explanation:

(A) Retrolental fibroplasia is the result of prolonged exposure to high levels of O2in premature infants. Complications are hemorrhage and retinal detachment. (B, C, D) O2concentration is too high.



Page 146 of 431



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