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The patient who has received a dose of preservative-free morphine (Duramorph) is beginning to experience pruritus. Which medication is used to treat this?
- A. Low-dose naloxone infusion
- B. Diphenhydramine
- C. Dilaudid
- D. Sublimaze
Correct Answer: B
Rationale: The correct answer is B: Diphenhydramine. Pruritus is a common side effect of opioids like morphine. Diphenhydramine, an antihistamine, can help alleviate itching by blocking histamine receptors. Low-dose naloxone infusion (A) is used to reverse opioid overdose, not treat pruritus. Dilaudid (C) and Sublimaze (D) are also opioids and would not be effective in treating pruritus caused by morphine. Diphenhydramine is the most appropriate choice for addressing this specific symptom.
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A woman, 26-weeks’ gestation, calls the triage nurse stating, 'I’m really scared. I tried not to but I had an orgasm when we were making love. I just know that I will go into preterm labor now.'
- A. Lie down and drink a quart of water. If you feel any back pressure at all call me back right away.
- B. Although oxytocin was responsible for your orgasm it is very unlikely that it will stimulate preterm labor.
- C. I will inform the doctor for you. What I want you to do is to come to the hospital right now to be checked.
- D. The best thing for you to do right now is to take a warm shower and then do a fetal kick count assessment.
Correct Answer: B
Rationale: Oxytocin released during orgasm does not typically trigger preterm labor. Reassurance is appropriate unless there are other risk factors present.
A client is 15 weeks pregnant. She calls the obstetric office to request a medication for a headache. The nurse answers the telephone. Which of the following is the nurse’s best response?
- A. Because the organ systems in the baby are developing right now, it is risky to take medicine.
- B. You can take any of the over-the-counter medications because they are all safe in pregnancy.
- C. The physician will prescribe a category 'X' medication for you.
- D. You can take acetaminophen because it is a category 'B' medicine.
Correct Answer: D
Rationale: Acetaminophen is a category 'B' medication, which is considered safe during pregnancy. Other over-the-counter medications may not be safe, and category 'X' medications are contraindicated.
A nurse is caring for a pregnant patient who is at 24 weeks gestation and reports difficulty breathing, especially when lying flat. Which action should the nurse take first?
- A. Assess the patient's respiratory rate and oxygen saturation.
- B. Encourage the patient to rest and limit physical activity.
- C. Administer oxygen and prepare the patient for delivery.
- D. Ask the patient to lie on her left side and monitor for improvement.
Correct Answer: A
Rationale: Step 1: Assessing the patient's respiratory rate and oxygen saturation is essential to determine the severity of the breathing difficulty.
Step 2: It helps in identifying potential respiratory issues or complications that may require immediate intervention.
Step 3: This data will guide the nurse in making informed decisions regarding further management and treatment.
Step 4: Encouraging rest (B) may be appropriate after assessment. Administering oxygen and preparing for delivery (C) is premature without assessment. Asking the patient to lie on her left side (D) without initial assessment may delay necessary interventions.
The vessels comprising the umbilical cord are cushioned and protected by a substance called _____________ _____________.
- A. Wharton’s jelly
- B. Endoderm
- C. jelly
- D. haploid
Correct Answer: A
Rationale: Wharton’s jelly is a gelatinous substance surrounding the blood vessels in the umbilical cord. It cushions and protects the vessels from compression and damage during pregnancy.
A woman is planning to become pregnant. Which of the following actions should she be counseled to take before stopping birth control? Select all that apply.
- A. Take a daily multivitamin.
- B. See a medical doctor.
- C. Drink beer instead of vodka.
- D. Stop all over-the-counter medications.
Correct Answer: B
Rationale: Taking a multivitamin, consulting a doctor, and stopping potentially harmful medications are important preconception steps. Alcohol consumption should generally be minimized, but switching from vodka to beer is not a significant improvement.