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Which medication does the nurse expect to be ordered for the postpartal patient with bleeding uncontrolled by Pitocin (oxytocin)?
- A. Methergine (methylergonovine maleate)
- B. Aquamephyton (phytonadione)
- C. Amicar (aminocaproic acid)
- D. Celestone (betamethasone)
Correct Answer: A
Rationale: Methergine is used to treat postpartum hemorrhage unresponsive to Pitocin by promoting uterine contractions. Aquamephyton is for clotting, Amicar is for fibrinolysis, and Celestone is a corticosteroid, none of which address uterine bleeding.
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The nurse is caring for a client after a burn. Which assessment finding best indicates that the client's respiratory efforts are currently adequate?
- A. The client is able to talk.
- B. The client is alert and oriented.
- C. The client's O2 saturation is 97%.
- D. The client's chest movements are uninhibited.
Correct Answer: C
Rationale: An O2 saturation of 97% directly indicates adequate oxygenation from respiratory efforts. Talking (A), alertness (B), and chest movement (D) are indirect and less specific.
The nurse has been assigned a client who delivered a 6-lb, 12-oz baby boy vaginally 40 minutes ago. The initial assessment of greatest importance for this client would be:
- A. Length of her labor
- B. Type of episiotomy
- C. Amount of IV fluid to be infused
- D. Character of the fundus
Correct Answer: D
Rationale: The length of labor has little bearing on the fourth stage of labor. The type of labor and delivery is significant. The type of episiotomy will affect the client's comfort level. However, the nurse's assessment and implementations center on prevention of hemorrhage during the fourth stage of labor. The amount of bleeding from the episiotomy or hematoma formation is of higher priority than the type of episiotomy. The amount of IV fluid to be infused is a nursing function to be attended to; however, it is lower in priority than determining if hemorrhaging is occurring. Character of the fundus would be the priority nursing assessment because changes in uterine tone may identify possible postpartum hemorrhage.
A client arrives in the emergency room with severe burns of the hands, right arm, face, and neck. The nurse needs to start an IV.
- A. Top of client's right hand
- B. Left antecubital fossa
- C. Top of either foot
- D. Left forearm
Correct Answer: B
Rationale: The left antecubital fossa is suitable for IV placement, avoiding burned areas (right hand, arm, face, neck). The foot (C) is less ideal due to infection risk, and the left forearm (D) may be too close to burn sites.
The nurse is teaching the client with hepatitis B regarding transmission. The nurse should instruct the client to do which of the following?
- A. Refrain from eating fresh fruits and vegetables.
- B. Avoid using another family member's toothbrush.
- C. Clean the commode after each bowel movement.
- D. Boil water prior to drinking and place open containers in the refrigerator.
- E. Inform the dentist of his diagnosis.
Correct Answer: B, E
Rationale: Hepatitis B is transmitted via blood and bodily fluids. Avoiding sharing toothbrushes (B) prevents transmission through saliva or blood. Informing the dentist (E) ensures precautions during procedures. Eating fresh produce (A), cleaning the commode (C), and boiling water (D) are unrelated to hepatitis B transmission.
A male client has been hospitalized with congestive heart failure. Medical management of heart failure focuses on improving myocardial contractility. This can be achieved by administering:
- A. Digoxin (Lanoxin) 0.25 mg po every day
- B. Furosemide (Lasix) 40 mg po every morning
- C. O2 2 L/min via nasal cannula
- D. Nitroglycerin (Nitrol) 1 inch topically every 4 hours
Correct Answer: A
Rationale: Digoxin enhances myocardial contractility, improving cardiac output in heart failure.