A client has just received an epidural block. She is laboring on her right side. The nurse notes that her blood pressure has dropped from 132/68 to 78/42 mm Hg. The nurse's first action would be to:

• A.Call the physician immediately and give dopamine IM
• B.Turn her on her left side and recheck her blood pressure in 5 minutes
• C.Administer oxytocin (Pitocin) immediately and increase the rate of IV fluids
• D.Increase the rate of IV fluids and start O2 by mask

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A 28-year-old multigravida has class II heart disease. At her prenatal visit at 34 weeks' gestation, all of the following observations are made. Which would require intervention?

• A.Weight gain of 2 kg in 4 weeks
• B.Blood pressure of 128/78
• C.Subjective data: shortness of breath after showering
• D.Ankle edema reported present in late afternoon and evenings

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A 24-year-old male client is admitted with a diagnosis of sickle cell anemia. The nurse discusses his disease with him and emphasizes the following information:

• A.He should monitor his sputum, stools, and urine for signs of bleeding.
• B.His daily diet should include a large amount of fluid.
• C.He should not be concerned about having to fly on a commuter airplane on a weekly basis.
• D.He should not worry about having children because this disease is passed on only by female carriers.

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A 6-year-old child returned to the surgical floor 20 hours ago after an appendectomy for a gangrenous appendix. His mother tells the nurse that he is becoming more restless and is anxious. Assessment findings indicate that the child has atelectasis. Appropriate nursing actions would include:

• A.Allowing the child to remain in the position of comfort, preferably semi-or high-Fowler position
• B.Administering analgesics as ordered
• C.Having the child turn, cough, and deep breathe every 1-2 hours
• D.Remaining with the child and keeping as calm and quiet as possible

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A client has been admitted to the labor and delivery unit in active labor. After assessing her, the RN notes that the client's fetus position is left occipital posterior. Which of the following statements best describes what this means to the labor process:

• A.Decreases the overall time of the labor process
• B.Prolongs the client's first stage of labor
• C.Decreases the time of the client's first stage of labor
• D.Prolongs the client's third stage of labor

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