Nokea
Pregnant client with hypertension.
For each of the following potential antihypertensive medications, indicate whether it is recommended or not recommended for use in a pregnant client.
- A. Methyldopa.
- B. Lisinopril.
- C. Labetalol.
- D. Losartan.
- E. Hydralazine.
Correct Answer: A,C,E
Rationale: Methyldopa (A) is safe and effective for pregnancy-induced hypertension. Labetalol (C) is recommended for hypertensive crises with a favorable safety profile. Hydralazine (E) is safe for severe hypertensive emergencies. Lisinopril (B) and Losartan (D) are contraindicated due to teratogenic risks.
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Following this type of birth, the nurse should monitor the client for hemorrhage and monitor the newborn for facial nerve palsy. What additional care should the nurse consider?
- A. Administering prophylactic antibiotics to prevent infection.
- B. Assessing for signs of jaundice in the newborn.
- C. Monitoring the client's vital signs for stability.
- D. Educating the client on breastfeeding techniques.
Correct Answer: B
Rationale: Jaundice assessment is critical for newborns with facial bruising or cephalohematoma, as bilirubin levels may rise due to blood breakdown in the localized hematoma.
Client experiencing preterm labor with a new prescription for terbutaline.
A nurse is caring for a client who is experiencing preterm labor and has a new prescription for terbutaline. Which of the following findings is a contraindication for administration of this medication?
- A. Heart disease.
- B. Cervical dilation of 2 cm.
- C. Gestational age of 34 weeks.
- D. Allergy to penicillin.
Correct Answer: A
Rationale: Terbutaline is contraindicated in heart disease because it can cause tachycardia and arrhythmias, worsening cardiac conditions. Cardiovascular side effects result from its beta-adrenergic agonist action.
Client with a prescription for ibuprofen to treat postpartum cramping.
A nurse is caring for a client who has a prescription for ibuprofen to treat postpartum cramping. Which of the following questions should the nurse ask prior to administering the medication?
- A. Are you taking over-the-counter medications?
- B. Do you have a history of gastric problems?
- C. What kind of contraception will you be using?
- D. Are you being treated for high blood pressure?
Correct Answer: A
Rationale: Ibuprofen can interact with various over-the-counter medications, including anticoagulants and corticosteroids, which may increase risks of side effects like gastrointestinal bleeding or reduced efficacy, necessitating careful assessment of concurrent drug use.
Client at 31 weeks of gestation.
A nurse is assessing a client who is at 31 weeks of gestation. Which of the following findings should the nurse identify as an indication of a potential prenatal complication?
- A. Periodic tingling of fingers.
- B. Absence of clonus.
- C. Leg cramps.
- D. Blurred vision.
Correct Answer: D
Rationale: Blurred vision may result from severe preeclampsia or elevated blood pressure, signifying potential end-organ damage. It requires immediate medical evaluation to prevent progression to eclampsia.
Four postpartum clients: 1 day ago needs Rh(D) immune globulin, 3 days ago reports breast fullness, 12 hours ago reports increased urinary output, 8 hours ago saturating a perineal pad every hour.
A nurse on a postpartum unit is receiving change-of-shift report for four clients. Which of the following clients should the nurse see first?
- A. A client who gave birth 1 day ago and needs Rh(D) immune globulin.
- B. A client who gave birth 3 days ago and reports breast fullness.
- C. A client who gave birth 12 hours ago and reports an increase in urinary output.
- D. A client who gave birth 8 hours ago and is saturating a perineal pad every hour.
Correct Answer: D
Rationale: Saturating a perineal pad every hour 8 hours postpartum indicates heavy vaginal bleeding, potentially signifying postpartum hemorrhage, a life-threatening condition requiring immediate evaluation and intervention.