Nokea
The healthcare provider prescribes magnesium sulfate 6 grams IV to be infused over 20 minutes for client with preterm labor. The IV bag contains 'Magnesium sulfate 20 grams in dextrose 5% in water 500 mL.' How many mL/hour should the nurse set the infusion pump?
- A. 450 mL/hour
Correct Answer: A
Rationale: For 6 grams in 20 minutes, 150 mL (6 ÷ 0.04 g/mL) is needed. Infusion rate is 150 mL ÷ 20 min × 60 = 450 mL/hour.
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The nurse is caring for a primigravida client who delivered vaginally 48-hours ago. The client's laboratory results are: hemoglobin 12.5 g/dL (125 g/L), hematocrit 34% (0.34 volume fraction), hepatitis B surface antigen negative, rubella non-immune, group B Streptococcus positive. Which prescription should the nurse prepare to administer?
- A. Hepatitis B immunoglobulin.
- B. Rubella vaccination.
- C. Blood transfusion.
- D. Penicillin G potassium.
Correct Answer: B
Rationale: The client's rubella non-immune status requires postpartum vaccination to prevent future congenital defects. Normal hemoglobin/hematocrit, negative hepatitis B, and post-delivery GBS status do not warrant other interventions.
For best pain management, the nurse should give... of acetaminophen every 4 hours as scheduled.
- A. 3.3 mL
- B. 1.9 mL
- C. 5.0 mL
- D. 0.8 mL
Correct Answer: A
Rationale: For a 7 kg infant, 15 mg/kg = 105 mg. At 160 mg/5 mL, 105 mg requires 3.3 mL, providing effective pain relief without toxicity.
Which is the most important assessment for the nurse to conduct following the administration of epidural anesthesia to a client who is at 40-weeks gestation?
- A. Variability of fetal heart rate.
- B. Station of presenting part.
- C. Level of pain sensation.
- D. Maternal blood pressure.
Correct Answer: D
Rationale: Monitoring maternal blood pressure detects hypotension from epidural-induced vasodilation, preventing reduced placental perfusion.
A multiparous client with active herpes lesions is admitted to the unit with spontaneous rupture of membranes. Which action should the nurse take?
- A. Obtain blood cultures.
- B. Administer penicillin.
- C. Prepare for a cesarean section.
- D. Cover the lesion with a dressing.
Correct Answer: C
Rationale: Cesarean section prevents neonatal herpes transmission during delivery with active lesions.
History and Physical
Nurses' Notes
Orders
The client is a 4-month-old female with a history of gastroesophageal reflux (GERD). Client had fundoplication surgery and will be hospitalized for several days of recovery.
Which pain scales would be appropriate for this client? Select all that apply.
- A. FLACC Postoperative Pain Scale
- B. Riley Infant Pain Scale
- C. Poker Chip Tool
- D. Visual Analog Scale
- E. Numeric
- F. FACES
Correct Answer: A,B
Rationale: FLACC and Riley Infant Pain Scales assess behavioral cues in nonverbal infants, suitable for a 4-month-old post-surgery. Other scales require cognitive abilities beyond this age.