Nokea
A laboring client with preeclampsia is prescribed magnesium sulfate 2 g/hour I.V. piggyback. The pharmacy sends the I.V. to the unit labeled magnesium sulfate 20 g/500 mL normal saline. To deliver the correct dose, the nurse should set the pump to deliver how many milliliters per hour?
Correct Answer: 50
Rationale: To calculate the correct dose: (2 g/hour * 500 mL) / 20 g = 50 mL/hour.
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The nurse is assessing a multigravida client at 12 weeks' gestation who has been admitted to the emergency department with sharp right-sided abdominal pain and vaginal spotting. Which of the following should the nurse obtain about the client's history? Select all that apply.
- A. History of sexually transmitted infections.
- B. Number of sexual partners.
- C. Last menstrual period.
- D. Cesarean section.
- E. IUD use.
- F. Contraceptive use.
Correct Answer: A,B,C,E,F
Rationale: These factors increase the risk of ectopic pregnancy.
A multigravid client in active labor has been diagnosed with class II heart disease and has had a prosthetic valve replacement. When developing the plan of care for this client, the nurse should anticipate that the physician most likely will order which of the following medications?
- A. Anticoagulants.
- B. Antibiotics.
- C. Diuretics.
- D. Folic acid supplements.
Correct Answer: B
Rationale: Prosthetic heart valves increase the risk of endocarditis during labor due to bacteremia. Prophylactic antibiotics are typically ordered. Anticoagulants may be adjusted, but antibiotics are prioritized during labor.
After teaching the parents of a neonate born with a cleft lip and cleft palate about appropriate feeding techniques, the nurse determines that the mother needs further instruction when the mother says which of the following?
- A. I should clean her mouth with soapy water after feeding.'
- B. I should feed her in an upright position.'
- C. I need to remember to burp her often.'
- D. I may need to use a special nipple for feeding.'
Correct Answer: A
Rationale: Cleaning the mouth with soapy water is inappropriate and could irritate the cleft, indicating a need for further instruction.
The nurse is caring for a 2-day-old neonate in the recovery room 30 minutes after surgical correction for the cardiac defect, transposition of the great vessels. Which of the following would alert the nurse to notify the physician?
- A. Oxygen saturation of 90%.
- B. Pale pink extremities.
- C. Warm, dry skin.
- D. Femoral pulse of 90 bpm.
Correct Answer: A
Rationale: An oxygen saturation of 90% is below the expected postoperative range and indicates potential hypoxemia, requiring physician notification.
The client is breast-feeding and asks the nurse about nutrition and diet. Which of the following statements by the client indicate understanding of dietary needs to promote successful breastfeeding? Select all that apply.
- A. I need to increase the number of meals I eat from three to five each day.
- B. I have to add about 500 more calories to my diet while I breast-feed.
- C. I need at least two servings of protein, like meat or eggs, with each meal.
- D. I need to double my fluids from my normal three to six glasses each day.
- E. I can eat more cheese and drink orange juice with calcium to increase my calcium intake.
Correct Answer: B,E
Rationale: An additional 500 calories and increased calcium intake are correct for breastfeeding; the other statements are inaccurate or excessive.