Nokea
A nurse is administering an uterotonic medication to a birthing person who has just delivered the placenta. Which uterotonic medication is commonly used to prevent postpartum hemorrhage and promote uterine contractions?
- A. oxytocin (Pitocin)
- B. fentanyl (Sublimaze)
- C. epinephrine (Adrenaline)
- D. lorazepam (Ativan)
Correct Answer: A
Rationale: The correct answer is A: oxytocin (Pitocin). Oxytocin is commonly used postpartum to prevent hemorrhage and promote uterine contractions due to its ability to stimulate uterine muscle contractions. Oxytocin plays a crucial role in the physiological process of labor and delivery by helping the uterus contract and reduce bleeding. Fentanyl (B), epinephrine (C), and lorazepam (D) are not uterotonic medications and do not have the same effects on the uterus as oxytocin. Fentanyl is an opioid analgesic, epinephrine is a vasoconstrictor, and lorazepam is a sedative, none of which are indicated for preventing postpartum hemorrhage or promoting uterine contractions.
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A client is 15 weeks pregnant. She calls the obstetric office to request a medication for a headache. The nurse answers the telephone. Which of the following is the nurse’s best response?
- A. Because the organ systems in the baby are developing right now, it is risky to take medicine.
- B. You can take any of the over-the-counter medications because they are all safe in pregnancy.
- C. The physician will prescribe a category 'X' medication for you.
- D. You can take acetaminophen because it is a category 'B' medicine.
Correct Answer: D
Rationale: Acetaminophen is a category 'B' medication, which is considered safe during pregnancy. Other over-the-counter medications may not be safe, and category 'X' medications are contraindicated.
A woman whose prenatal weight was 105 lb weighs 109 lb at her 12-week visit. Which of the following comments by the nurse is appropriate at this time?
- A. We expect you to gain about 1 lb per week, so your weight is a little low at this time.
- B. Most women gain no weight during the first trimester, so I would suggest you eat fewer desserts for the next few weeks.
- C. You entered the pregnancy well underweight, so we should check your diet to make sure you are getting the nutrients you need.
- D. Your weight gain is exactly what we would expect it to be at this time.
Correct Answer: D
Rationale: A weight gain of 3 to 5 lb is expected during the first trimester. The client's weight gain is within the normal range.
The nurse is caring for a pregnant patient at 36 weeks gestation who reports sudden, severe headache and blurred vision. What is the nurse's priority action?
- A. Administer pain medication as prescribed to relieve the headache.
- B. Monitor the patient's blood pressure and check for signs of preeclampsia.
- C. Encourage the patient to rest and drink plenty of fluids.
- D. Schedule a follow-up appointment with the healthcare provider for further evaluation.
Correct Answer: B
Rationale: The correct answer is B because sudden severe headache and blurred vision in a pregnant patient at 36 weeks gestation are potential signs of preeclampsia, a serious condition that can lead to complications for both the mother and the baby. Monitoring the patient's blood pressure and checking for signs of preeclampsia is crucial for early detection and timely intervention. Administering pain medication (choice A) may mask symptoms and delay appropriate treatment. Encouraging rest and fluids (choice C) may not address the underlying cause of the symptoms. Scheduling a follow-up appointment (choice D) may delay necessary immediate actions to address potential preeclampsia.
A patient in labor is requesting an epidural but has a history of a previous back surgery. What is the most important assessment before proceeding with the epidural?
- A. History of spinal surgery or deformity
- B. Fetal heart rate
- C. Perform a vaginal exam to assess for fetal position
- D. Administer Pitocin
Correct Answer: C
Rationale: The correct answer is C: Perform a vaginal exam to assess for fetal position. This is important because the position of the fetus can affect the safety and efficacy of administering an epidural in a patient with a history of back surgery. If the fetus is in a breech position or in any other position that could complicate the epidural placement, alternative pain management options may need to be considered.
A: History of spinal surgery or deformity is important but assessing the fetal position takes precedence in this scenario.
B: Fetal heart rate monitoring is essential during labor but not the most important assessment before proceeding with the epidural in this case.
D: Administering Pitocin is unrelated to the assessment needed before proceeding with the epidural.
A 20-year-old client states that the at-home pregnancy test that she took this morning was positive. Which of the following comments by the nurse is appropriate at this time?
- A. Congratulations, you and your family must be so happy.
- B. Have you told the baby’s father yet?
- C. How do you feel about the results?
- D. Please tell me when your last menstrual period was.
Correct Answer: C
Rationale: It is important to assess the client's emotional response to the pregnancy test result before providing further guidance or congratulations.