Nokea
Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80 to 90/60. What action should the healthcare provider take?
- A. Notify the healthcare provider or anesthesiologist immediately.
- B. Continue to assess the blood pressure every 5 minutes.
- C. Place the woman in a lateral position.
- D. Turn off the continuous epidural.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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At 40-weeks gestation, a client presents to the obstetrical floor with spontaneous rupture of amniotic membranes at home, in active labor, and feeling the urge to push. What information should the nurse prioritize obtaining?
- A. Color and consistency of fluid.
- B. Estimated amount of fluid.
- C. Any odor noted at the rupture of membranes.
- D. Time of membrane rupture.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A loading dose of terbutaline (Brethine) 250 mcg IV is prescribed for a client in preterm labor. Brethine 20 mg is added to 1,000 mL of D5W. How many milliliters of the solution should the nurse administer?
- A. 45
- B. 15 mL
- C. 4
- D. 13
Correct Answer: D
Rationale: To calculate the amount of terbutaline to administer, first convert the dose to the same unit. 250 mcg = 0.25 mg. Next, set up a proportion: 20 mg is to 1000 mL as 0.25 mg is to X mL. Cross multiply and solve for X: 20 X = 0.25 1000. X = (0.25 1000) / 20 = 12.5 mL. Therefore, the nurse should administer 13 mL of the solution.
When should the LPN/LVN encourage the laboring client to begin pushing?
- A. When there is only an anterior or posterior lip of cervix left.
- B. When the client describes the need to have a bowel movement.
- C. When the cervix is completely dilated.
- D. When the cervix is completely effaced.
Correct Answer: C
Rationale: The LPN/LVN should encourage the laboring client to begin pushing when the cervix is completely dilated to 10 centimeters. Pushing before full dilation can lead to cervical injury and ineffective labor progress. By waiting for complete dilation, the client can push effectively, aiding in the descent of the baby through the birth canal.
The healthcare provider is preparing to suture a 10-year-old with a lacerated forehead. Both parents and the 12-year-old sibling are at the child's bedside. Which instruction best supports the family?
- A. While waiting for the healthcare provider, only one family member may stay with the child.
- B. All family members should leave while the healthcare provider sutures the child's forehead.
- C. It is best if the sibling goes to the waiting room until the suturing is completed.
- D. Please decide among yourselves who will stay when the healthcare provider begins suturing.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Insulin therapy is initiated for a 12-year-old child who is admitted with diabetic ketoacidosis (DKA). Which action is most important for the nurse to include in the child's plan of care?
- A. Monitor serum glucose for adjustment in the infusion rate of regular insulin (Novolin R).
- B. Determine the child's compliance schedule for subcutaneous NPH insulin (Humulin N).
- C. Demonstrate to the parents how to program an insulin pen for daily glucose regulation.
- D. Consult with the healthcare provider about the use of insulin detemir (Levemir Flex Pen).
Correct Answer: A
Rationale: In managing diabetic ketoacidosis (DKA), monitoring serum glucose levels is crucial to adjust the infusion rate of regular insulin effectively. This helps in controlling blood glucose levels and preventing complications associated with DKA. Close monitoring and adjustments based on glucose levels are essential for the successful management of DKA.