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The nurse is reviewing the use of uterine tocolytics, such as indomethacin (Indocin). Which statement best describes the indication for these drugs?
- A. Prevention of preterm labor in the 15th week of pregnancy
- B. Prevention of preterm labor in the 22nd week of pregnancy
- C. Stimulation of contractions in prolonged labor
- D. Stimulation of ovulation as part of infertility treatments
Correct Answer: B
Rationale: Tocolytics like indomethacin are used to prevent preterm labor between 20 and 37 weeks, such as at 22 weeks, by relaxing uterine smooth muscle. They do not stimulate contractions or ovulation.
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The nurse is administering oxytocin. Which situation is an indication for the use of oxytocin?
- A. Decreased fetal heart rate and movements
- B. Stimulation of contractions during labor
- C. Cervical ripening near term in pregnant patients
- D. To reverse premature onset of labor
Correct Answer: B
Rationale: Oxytocin is used to stimulate uterine contractions during labor to induce or augment labor. It is also used for cervical ripening, but not to reverse preterm labor or address fetal distress.
A patient who is taking the bisphosphonate alendronate has been instructed to lie flat in bed for 2 days after having ophthalmic surgery. Which intervention is appropriate at this time?
- A. She will continue to take the alendronate with water.
- B. She cannot take the alendronate until she can sit up for 30 minutes.
- C. She can take the medication with breakfast.
- D. She will stop taking the medication 72 hours before her surgery.
Correct Answer: B
Rationale: Alendronate requires the patient to remain upright for 30 minutes post-dose to prevent esophageal damage. Lying flat post-surgery necessitates withholding the drug until the patient can sit up.
A patient is receiving oxytocin to induce labor. During administration of this medication, the nurse will also implement which action?
- A. Giving magnesium sulfate along with the oxytocin
- B. Administering the medication in an intravenous (IV) bolus
- C. Administering the medication with an IV infusion pump
- D. Monitoring fetal heart rate and maternal vital signs every 2 hours
Correct Answer: C
Rationale: Oxytocin is administered via an IV infusion pump to ensure controlled delivery and prevent overdose. Magnesium sulfate is not co-administered, bolus administration is unsafe, and monitoring should be continuous, not every 2 hours.
The nurse is providing teaching for a patient who is to receive progestin therapy. Which statement is correct to include in the teaching session?
- A. If you miss a dose, double-up on the next dose.
- B. There's no need to be concerned about breast lumps or bumps that occur.
- C. Be sure to report any weight gain of 5 pounds or more per week.
- D. Take the medication on an empty stomach to enhance absorption.
Correct Answer: C
Rationale: Significant weight gain (5 pounds or more per week) during progestin therapy may indicate fluid retention or other adverse effects, requiring medical evaluation. Doubling doses, ignoring breast lumps, or taking on an empty stomach are incorrect.
The nurse is providing patient education for a patient taking an oral contraceptive. Which drugs may cause interactions with oral contraceptives? (Select all that apply.)
- A. Cephalexin
- B. Guaifenesin
- C. Warfarin
- D. Ibuprofen
- E. Theophylline
Correct Answer: A,C,E
Rationale: Cephalexin, warfarin, and theophylline can interact with oral contraceptives, reducing their efficacy or altering drug levels. Antibiotics like cephalosporins may decrease contraceptive effectiveness, and contraceptives can affect warfarin and theophylline metabolism.