Burns
A patient presents with red, painful skin and no blisters after spending a day at the beach. What type of burn does the nurse suspect?
Superficial (first-degree)
The nurse’s first action when noticing excessive vaginal bleeding after delivery is to:
Massage the fundus firmly
The nurse is caring for a patient in active labor who suddenly reports “something tore” and severe abdominal pain. What should the nurse suspect?
Uterine rupture
What is the first step in neonatal resuscitation after birth?
Warm, dry, and stimulate the newborn
The nurse explains to a patient that antibiotics are effective in treating what type of infections?
Bacterial infections
Which 2 findings indicate possible inhalation injury?
Hoarse voice and singed nasal hairs
Which medication is routinely administered to prevent or treat uterine atony?
Oxytocin (Pitocin)
Which finding is most characteristic of uterine rupture during labor?
Fetal heart rate decelerations
The proper compression-to-breath ratio in neonatal resuscitation is:
3 compressions to 1 breath
Which of the following should the nurse teach a patient prescribed antibiotics?
“Take the full course of medication even if you feel better.”
The nurse is assessing a client with electrical burns. Which complication should the nurse anticipate?
Cardiac dysrhythmias
The nurse administers methylergonovine (Methergine). Which condition must be checked before giving this drug?
Blood pressure
Which maternal vital sign change is an early indicator of uterine rupture?
Increased heart rate and falling blood pressure
What is the preferred site for pulse and heart rate assessment during resuscitation?
Umbilical stump or base of cord
The nurse knows that penicillin is most likely to cause which adverse reaction?
Allergic reaction
A burn patient is admitted with soot around the mouth and coughing up black sputum. What is the priority nursing action?
Assess airway and prepare for intubation
Which assessment finding suggests uterine atony?
Soft, boggy uterus
The nurse suspects uterine rupture in a patient who had a previous cesarean section and is now attempting vaginal birth (VBAC). What is the priority nursing action?
Prepare the patient for emergency C-section
Which medication may be administered if the heart rate remains <60 bpm after ventilation and compressions?
Epinephrine
When administering vancomycin, the nurse should monitor for which serious reaction?
Red man syndrome
A patient weighs 70 kg and has burns covering 40% TBSA. According to the Parkland formula (4 mL × kg × %TBSA), how much fluid should be given in the first 24 hours?
4 × 70 × 40 = 11,200 mL
When the uterus fails to contract and the patient loses consciousness, what is the priority nursing action?
Call for help
Which complication is the nurse most concerned about following uterine rupture?
Hypovolemic shock
What is the preferred route for epinephrine administration during neonatal resuscitation?
Umbilical vein
The nurse is preparing to administer antibiotics on a septic patient. Before giving the first dose, the nurse should:
Check if a culture and sensitivity (C&S) was obtained prior to the start of the antibiotics.