Nokea
A post-term neonate diagnosed with persistent pulmonary hypertension is prescribed intravenous tolazoline (Priscoline). While administering this drug, the nurse should monitor the neonate for?
- A. Feeding behaviors.
- B. Temperature.
- C. Skin color.
- D. Blood pressure.
Correct Answer: D
Rationale: Tolazoline is a vasodilator, and monitoring blood pressure is critical due to the risk of hypotension.
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While the nurse is preparing to assist the primiparous client to the bathroom to void 6 hours after a vaginal delivery under epidural anesthesia, the client says that she feels dizzy when sitting up on the side of the bed. The nurse explains that this is most likely caused by which of the following?
- A. Effects of the anesthetic during labor.
- B. Hemorrhage during the delivery process.
- C. Effects of analgesics used during labor.
- D. Decreased blood volume in the vascular system.
Correct Answer: A
Rationale: Dizziness when sitting up is likely due to residual effects of epidural anesthesia, which can cause orthostatic hypotension.
The nurse is completing discharge instructions with a new mother and is concerned about her safety. Which statement by the client indicates the client needs further instructions?
- A. I will need to be checked out by the doctor in a week.
- B. I need to wear a sports bra for a few days so I don't get milk.
- C. I can get pregnant now if I don't use birth control.
- D. I may feel sad for a few days but should be OK within a few days.
Correct Answer: B
Rationale: Wearing a sports bra does not prevent milk production; this statement indicates a misunderstanding of lactation suppression.
The nurse is caring for a primiparous client and her neonate immediately after delivery. The neonate was born at 41 weeks' gestation and weighs 4,082 g (9 lb). Assessing for signs and symptoms of which of the following conditions should be a priority in the neonate?
- A. Anemia.
- B. Hypoglycemia.
- C. Delayed meconium.
- D. Elevated bilirubin.
Correct Answer: B
Rationale: Large-for-gestational-age neonates (e.g., 4,082 g) are at risk for hypoglycemia due to increased metabolic demand and potential maternal diabetes. Hypoglycemia screening is a priority. Anemia, delayed meconium, or hyperbilirubinemia are less immediate.
A client has just had a cesarean section for a prolapsed cord. In reviewing the client's history, which of the following factors places a client at risk for cord prolapse? Select all that apply.
- A. -2 station.
- B. Low birth weight infant.
- C. Rupture of membranes.
- D. Breech presentation.
- E. Prior abortion.
- F. Low lying placenta.
Correct Answer: A,B,C,D,F
Rationale: These factors increase the risk of cord prolapse.
At which of the following locations would the nurse expect to palpate the fundus of a primiparous client immediately after delivery of a neonate?
- A. Halfway between the umbilicus and the symphysis.
- B. At the level of the umbilicus.
- C. Just below the level of the umbilicus.
- D. Above the level of the umbilicus.
Correct Answer: B
Rationale: Immediately after delivery, the fundus is typically at the level of the umbilicus due to the uterus beginning to involute.