Nokea
A nurse is caring for a client who is 12 hr postpartum and has a third-degree perineal laceration. The client reports not having a bowel movement for 4 days. Which of the following medications should the nurse administer?
- A. Bisacodyl 10 mg rectal suppository
- B. Magnesium hydroxide 30 mL PO
- C. Famotidine 20 mg PO
- D. Loperamide 4 mg PO
Correct Answer: A
Rationale: A rectal suppository like bisacodyl is appropriate for relieving constipation in a postpartum client with a perineal laceration, as it avoids straining. Loperamide is an antidiarrheal and not indicated here.
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What is the recommended method of administering vitamin K to a newborn who is at risk for bleeding?
- A. Intramuscular injection
- B. Oral administration
- C. Topical application
- D. Subcutaneous injection
Correct Answer: A
Rationale: The correct answer is A: Intramuscular injection. This method ensures rapid and complete absorption, providing immediate protection against bleeding in newborns. Oral administration may be ineffective due to immature gastrointestinal tract. Topical application may not achieve adequate absorption. Subcutaneous injection may lead to variable absorption rates, delaying the onset of vitamin K's protective effects. Thus, intramuscular injection is the most reliable and recommended method for newborns at risk for bleeding.
A nurse is preparing to administer an IM injection to a newborn. Which of the following sites should the nurse select?
- A. Vastus lateralis
- B. Dorsogluteal
- C. Deltoid
- D. Rectus femoris
Correct Answer: A
Rationale: The correct answer is A: Vastus lateralis. For newborns, the vastus lateralis muscle is the preferred site for intramuscular injections due to its larger muscle mass and reduced risk of injury to nerves and blood vessels. It is located on the thigh, making it easily accessible and safe for administration. The deltoid muscle (choice C) is not recommended for newborns due to insufficient muscle mass. The dorsogluteal site (choice B) is not recommended for infants due to the proximity to the sciatic nerve. The rectus femoris (choice D) is not typically used for IM injections in newborns.
A nurse is preparing to administer oxytocin to a client who is postpartum. Which of the following findings is an indication for the administration of the medication? (Select all that apply.)
- A. Flaccid uterus
- B. Cervical laceration
- C. Excess vaginal bleeding
- D. Increased afterbirth cramping
Correct Answer: A,C
Rationale: Oxytocin is administered postpartum to manage uterine atony (flaccid uterus) and control excessive bleeding, which are common indications for its use.
A nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will need to increase my insulin doses during the first trimester.
- B. I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or greater.
- C. I will continue taking my insulin if I experience nausea and vomiting.
- D. I will ensure that my bedtime snack is high in refined sugar.
Correct Answer: C
Rationale: Continuing to take insulin as prescribed, even when experiencing nausea and vomiting, is essential for maintaining blood glucose control during pregnancy.
Which of the following hormones is responsible for stimulating uterine contractions during labor?
- A. Progesterone
- B. Estrogen
- C. Prolactin
- D. Oxytocin
Correct Answer: D
Rationale: Oxytocin is the correct answer as it is the hormone responsible for stimulating uterine contractions during labor. Oxytocin is produced by the pituitary gland and plays a crucial role in initiating and sustaining labor contractions. It acts on the smooth muscle cells of the uterus, causing them to contract and aiding in the progression of labor. Progesterone and estrogen are involved in preparing the uterus for pregnancy but do not directly stimulate contractions. Prolactin is responsible for milk production, not uterine contractions. Therefore, D is the correct answer due to its specific role in labor contractions.