Nokea
The nurse is preparing to administer oxytocin IV to a client after the delivery of her infant. Which outcome should the nurse expect from the administration of oxytocin?
- A. Return of the uterus to prepregnancy size.
- B. Expulsion of the placenta.
- C. Activation of the let down reflex.
- D. Stimulation of uterine contractions.
Correct Answer: D
Rationale: Oxytocin stimulates uterine contractions to reduce postpartum bleeding by compressing blood vessels.
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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.
Based on the FLACC score and the client's developmental level, mark which nurse actions would be appropriate, and which would not be appropriate.
- A. Ask the healthcare provider to prescribe a nonsteroidal anti-inflammatory drug (NSAID)
- B. Have one of the parents hold the baby
- C. Perform guided imagery
- D. Consult a child life specialist
- E. Encourage the baby's mother to breastfeed the baby
- F. Wait 1 hour, reassess, and give medication if the FLACC score remains elevated
- G. Request a prescription for an opioid
Correct Answer: B,D,G
Rationale: NSAIDs, parental holding, child life consultation, and opioids (if severe) are appropriate. Guided imagery is too advanced, breastfeeding is contraindicated (NPO), and delaying treatment is inappropriate.
Upon completion of a 14-day antibiotic treatment for bacterial meningitis in an infant, the nurse prepares the family for discharge. Which information should the nurse include?
- A. Administer antipyretic medication on a continuous basis.
- B. Continue strict monitoring of daily wet diapers for 1 week.
- C. Have the antibiotic trough level drawn within 3 days.
- D. Monitor the infant for response to auditory stimuli.
Correct Answer: D
Rationale: Monitoring auditory responses detects hearing loss, a common meningitis complication, requiring follow-up screening.
A child who weighs 25 kg receives a prescription for isoniazid 10 mg/kg/day by mouth once a day. The bottle is labeled 'Isoniazid Oral Solution, USP 50 mg per 5 mL.' How many mL should the nurse administer?
- A. 25 mL
Correct Answer: A
Rationale: For a 25 kg child, the dose is 250 mg/day (25 kg × 10 mg/kg). With a concentration of 50 mg/5 mL (10 mg/mL), the volume is 250 mg ÷ 10 mg/mL = 25 mL.
A 7-year-old child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's mother, the recent occurrence of which illness is most significant?
- A. Influenza.
- B. Chickenpox.
- C. Mumps.
- D. Sore throat.
Correct Answer: D
Rationale: A recent untreated Group A Streptococcus sore throat is the primary risk factor for acute rheumatic fever, triggering an autoimmune response.
The nurse is providing preconception counseling. Which supplement should the nurse recommend to help prevent the occurrence of anencephaly?
- A. Folic acid.
- B. Iron.
- C. Vitamin D.
- D. Calcium.
Correct Answer: A
Rationale: Folic acid (400-800 mcg daily) prevents neural tube defects like anencephaly by supporting neural tube closure.