Nokea
Carboprost (Hemabate) was injected into the uterus of a client to treat uterine atony during a cesarean section. In preparing to care for this client postpartum, the nurse should assess the client for which of the following common adverse effects of the medication?
- A. Vertigo and confusion.
- B. Nausea and diarrhea.
- C. Restlessness and increased vaginal bleeding.
- D. Headache and hypertension.
Correct Answer: B
Rationale: Carboprost commonly causes nausea and diarrhea as side effects.
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Three days after admission of a neonate delivered at 30 weeks' gestation, the neonatologist plans to assess the neonate for periventricular-intraventricular hemorrhage (PIVH). The nurse should plan to assist the neonatologist by preparing the neonate for which of the following?
- A. Computed tomography scan.
- B. Arterial blood specimen collection.
- C. Radiographs of the skull.
- D. Complete blood count specimen collection.
Correct Answer: A
Rationale: A computed tomography scan is used to assess for PIVH, as it visualizes bleeding in the brain.
While assessing the fundus of a multiparous client 36 hours after delivery of a term neonate, the nurse notes a separation of the abdominal muscles. What action should the nurse take based on this assessment?
- A. Notify the health care provider of the separation.
- B. Discuss with the client that no further action is needed.
- C. Demonstrate exercises involving head and shoulder lifting.
- D. Refer the client to a surgeon for surgical repair after 6 weeks postpartum.
Correct Answer: C
Rationale: Diastasis recti is managed with specific exercises like head and shoulder lifts to strengthen abdominal muscles.
In preparation for discharge, the nurse discusses sexual issues with a primiparous client who had a routine vaginal delivery with a midline episiotomy. The nurse should instruct the client that she can resume sexual intercourse:
- A. In 6 weeks when the episiotomy is completely healed.
- B. After a postpartum check by the health care provider.
- C. Whenever the client is feeling amorous and desirable.
- D. When lochia flow and episiotomy pain have stopped.
Correct Answer: D
Rationale: Resuming sexual intercourse is safe when lochia has stopped and episiotomy pain has resolved, indicating healing.
The nurse makes a home visit to a 3-day-old full-term neonate who weighed 3,912 grams (8 lb, 10 oz) at birth. Today the neonate, who is being bottle-fed, weighs 1,350 grams (7 lb, 14 oz).Which of the following instructions should the nurse give to the mother?
- A. Continue feeding every 3 to 4 hours since the weight loss is normal.
- B. Contact the physician if the weight loss continues over the next few days.
- C. Switch to a soy-based formula because the current one seems inadequate.
- D. Change to a higher-calorie formula to prevent further weight loss.
Correct Answer: A
Rationale: The weight loss from 3,912 g to 3,550 g (7 lb, 14 oz) is approximately 9%, which is within the normal range of up to 10% for newborns in the first few days. Continuing regular feedings is appropriate.
Which of the following nursing diagnoses would be the priority for a multigravid diabetic client at 38 weeks' gestation who is scheduled for labor induction with oxytocin (Pitocin)?
- A. Risk for deficient fluid volume related to oxytocin infusion.
- B. Pain related to prolonged labor and uterine ischemia.
- C. Fear related to possible need for cesarean delivery.
- D. Risk for injury, maternal or fetal, related to potential uterine hyperstimulation.
Correct Answer: D
Rationale: Oxytocin can cause uterine hyperstimulation, risking maternal or fetal injury (e.g., fetal hypoxia). This is the priority in a diabetic client due to increased fetal vulnerability. Fluid volume, pain, and fear are less immediate.