When providing care for a client in preterm labor at 32 weeks of gestation, which medication should the nurse anticipate the provider will prescribe to hasten fetal lung maturity?
- A. Calcium gluconate
- B. Indomethacin
- C. Nifedipine
- D. Betamethasone
Correct Answer: D
Rationale: Step 1: Betamethasone is a corticosteroid that promotes fetal lung maturity by stimulating the production of surfactant, essential for lung function.
Step 2: At 32 weeks, the fetus may benefit from accelerated lung development to reduce respiratory distress.
Step 3: Calcium gluconate is used for hypocalcemia, not for fetal lung maturity.
Step 4: Indomethacin is a nonsteroidal anti-inflammatory drug used to delay preterm labor, not for lung maturity.
Step 5: Nifedipine is a calcium channel blocker to prevent preterm labor, not for fetal lung maturity.
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A client in a family planning clinic requests oral contraceptives. Which of the following findings in the client's history should be recognized as contraindications to oral contraceptives? (Select all that apply.)
- A. Cholecystitis
- B. Hypertension
- C. Migraine headaches
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Cholecystitis, hypertension, and migraine headaches are all contraindications to oral contraceptives. Cholecystitis can be exacerbated by oral contraceptives. Hypertension increases the risk of cardiovascular events with oral contraceptives. Migraine headaches, especially with aura, are associated with an increased risk of stroke when combined with oral contraceptives. Therefore, considering these risks, it is crucial to recognize these findings as contraindications to prescribing oral contraceptives.
A nurse is developing a plan of care for a client who has preeclampsia and is receiving magnesium sulfate via a continuous IV infusion. Which of the following interventions should the nurse include in the plan?
- A. Monitor the client's blood pressure every hour.
- B. Restrict the total hourly intake to 200 mL.
- C. Monitor the FHR continuously.
- D. Administer protamine sulfate for manifestations of toxicity.
Correct Answer: C
Rationale: The correct answer is C: Monitor the FHR continuously. This is essential in preeclampsia as magnesium sulfate can affect fetal heart rate (FHR). Continuous monitoring helps detect any changes promptly.
A: Monitoring blood pressure is important but not as critical as FHR monitoring in this scenario.
B: Restricting total hourly intake to 200 mL is not necessary for magnesium sulfate administration.
D: Administering protamine sulfate is incorrect as it is used for heparin toxicity, not magnesium sulfate toxicity.
In a prenatal clinic, a client in the first trimester of pregnancy has a health record that includes this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? (Select all that apply)
- A. Client has delivered one newborn at term
- B. Client has experienced no preterm labor
- C. Client has had two prior pregnancies
- D. ALL OF THE ABOVE - has one living child
Correct Answer: D
Rationale: The data "G3 T1 P0 A1 L1" indicates the client has had 3 pregnancies (G3), 1 term delivery (T1), 0 preterm deliveries (P0), 1 living child (A1), and 1 living child currently (L1). Therefore, the correct interpretation is that the client has one living child (A1) from one term delivery (T1). Choice D ("ALL OF THE ABOVE - has one living child") is correct as it summarizes the information accurately. Choices A, B, and C are incorrect because they do not encompass all the aspects of the data provided in the client's health record.
A client who received carboprost for postpartum hemorrhage is being assessed by a nurse. Which of the following findings is an adverse effect of this medication?
- A. Hypertension
- B. Hypothermia
- C. Constipation
- D. Muscle weakness
Correct Answer: A
Rationale: The correct answer is A: Hypertension. Carboprost is a prostaglandin used to treat postpartum hemorrhage that can cause hypertension as an adverse effect due to its vasoconstrictive properties. This can lead to increased blood pressure, which should be monitored closely. Hypothermia (choice B) is not a common adverse effect of carboprost. Constipation (choice C) and muscle weakness (choice D) are also not typically associated with carboprost use. Monitoring blood pressure and signs of hypertension is crucial due to the potential adverse effects of carboprost.
When caring for a client in labor, which of the following infections can be treated during labor or immediately following birth? (Select all that apply)
- A. Gonorrhea
- B. Chlamydia
- C. HIV
- D. All of the Above
Correct Answer: D
Rationale: The correct answer is D: All of the Above. All three infections - Gonorrhea, Chlamydia, and HIV - can be treated during labor or immediately following birth to prevent transmission to the newborn. Antibiotics can be administered for Gonorrhea and Chlamydia, while antiretroviral medications can be given for HIV. Prompt treatment is crucial to reduce the risk of vertical transmission. The other choices are incorrect because each infection listed can be effectively managed during labor or post-birth, making choice D the most comprehensive and accurate option.
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