Nokea
The client is admitted to the postpartum unit with an order to continue the infusion of Pitocin. The nurse is aware that Pitocin is working if the fundus is:
- A. Deviated to the left.
- B. Firm and in the midline.
- C. Boggy.
- D. Two finger breadths below the umbilicus.
Correct Answer: B
Rationale: A firm and midline fundus indicates effective uterine contraction, showing Pitocin is working to prevent postpartum hemorrhage.
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The nurse plans on administering a medication using the Z-track intramuscular technique. The nurse knows the following steps are required during the procedure. Select all that apply.
- A. Draw 0.2-0.5 cc of air after aspirating the prescribed medication.
- B. Use the vastus lateralis muscle.
- C. Replace the needle used for medication withdrawal with a new one prior to injection.
- D. Insert the needle at 45-degree angle.
Correct Answer: A,C
Rationale: Z-track requires an air lock (A) to seal medication and a new needle (C) to prevent tracking. The needle is inserted at 90 degrees, not 45 (D), and various muscles can be used (B is not mandatory).
The physician has ordered a homocysteine blood level on a client. The nurse recognizes that the results will be increased in a client with a deficiency in:
- A. Vitamin B12
- B. Vitamin C
- C. Vitamin A
- D. Vitamin E
Correct Answer: A
Rationale: Homocysteine levels rise with vitamin B12 deficiency, as B12 is needed for homocysteine metabolism, unlike other vitamins listed.
The physician has ordered a serum aminophylline level for a client with chronic obstructive lung disease. The nurse knows that the therapeutic range for aminophylline is:
- A. 1-3 micrograms/mL
- B. 4-6 micrograms/mL
- C. 7-9 micrograms/mL
- D. 10-20 micrograms/mL
Correct Answer: D
Rationale: The therapeutic range for aminophylline is 10-20 micrograms/mL to effectively manage symptoms of chronic obstructive lung disease.
The nurse receives an order to administer 1,500 mL D5W IV over 12 hours. The drop factor is 15 drops/1 mL. The IV flow rate should be set at how many drops per minute? Round to the nearest whole number.
Correct Answer: 31
Rationale: Flow rate (drops/min) = (volume × drop factor) ÷ time. Calculation: (1,500 mL × 15 drops/mL) ÷ (12 × 60) = 22,500 ÷ 720 ≈ 31 drops/min.
The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?
- A. Macaroni and cheese
- B. Shrimp with rice
- C. Turkey breast
- D. Spaghetti with meat sauce
Correct Answer: C
Rationale: Turkey breast is lean and has the lowest saturated fat content compared to the other options, which contain higher-fat ingredients.