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A nurse is reinforcing teaching with a client who is at 24 weeks of gestation and has opioid use disorder.
Which of the following statements should the nurse make?
- A. You will be prescribed diazepam.
- B. You will be prescribed naloxone.
- C. You will be prescribed aripiprazole.
- D. You will be prescribed methadone.
Correct Answer: D
Rationale: Methadone is the standard treatment for opioid use disorder in pregnancy because it stabilizes opioid levels, preventing withdrawal symptoms and reducing cravings, minimizing risks of fetal distress, miscarriage, and preterm labor.
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Vital Signs: Blood pressure 130/70 mm Hg, Temperature 38.6° C (101.5° F), Respiratory rate 18/min, Heart rate 102/min, Oxygen saturation 98% on room air. History and Physical: Delivered at 37 weeks of gestation, Routine prenatal care, Iron-deficiency anemia, Rubella immune, Shellfish and penicillin allergy. Current Diagnosis: Mastitis. Laboratory Test Results: Blood type O+, Creatinine 0.8 mg/dL, WBC count 9,500/mm3. Medication Administration Record: Ibuprofen 800 mg PO every 6 hr PRN pain, Doxycycline 100 mg PO every 12 hr, Ferrous sulfate 325 mg PO twice daily, Folic acid 0.5 mg PO once daily, Bisacodyl 10 mg PO once daily, Rho(D) immune globulin 300 mcg IM x1. A nurse is preparing to assist with the administration of medications to a client who is 72 hr postpartum following a caesarean birth.
Which of the following medications requires clarification prior to administration? The nurse should clarify the prescription for ___ because ___
- A. Rho(D) immune globulin; of the client's blood type.
- B. Ibuprofen; of the client's WBC count.
- C. Doxycycline; of the client's heart rate.
- D. Bisacodyl; of the client's blood type.
Correct Answer: A
Rationale: Rh (D) immune globulin is given to Rh-negative clients to prevent Rh sensitization. Since the client is O+ (Rh-positive), there is no risk of Rh incompatibility, making this medication unnecessary.
A nurse is preparing to administer metronidazole 2 g PO. The amount available is 500 mg tablets.
How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero)
Correct Answer: 4 tablets
Rationale: 2 g = 2000 mg; 2000 mg / 500 mg/tablet = 4 tablets.
A nurse in an antepartum unit is assisting with the care of a client who has preeclampsia and is receiving IV magnesium sulfate therapy.
For which of the following adverse effects should the nurse monitor and report to the provider?
- A. Polyuria
- B. Hyporeflexia
- C. Agitation
- D. Tachypnea
Correct Answer: B
Rationale: Hyporeflexia is an early sign of magnesium toxicity, indicating excessive neuromuscular blockade, requiring immediate reporting.
A nurse is contributing to the plan of care for a newborn who requires phototherapy for hyperbilirubinemia.
Which of the following interventions should the nurse recommend including in the plan?
- A. Reposition the newborn every 2 to 3 hr.
- B. Give the newborn 30 mL of distilled water after each feeding
- C. Apply a water-based ointment to the newborn's skin every 4 to 6 hr.
- D. Monitor the newborn's blood glucose level every 2 hr
Correct Answer: A
Rationale: Repositioning every 2-3 hours ensures all skin areas are exposed to phototherapy light, enhancing bilirubin breakdown.
A nurse is assisting with the admission of a client who has hyperemesis gravidarum.
Which of the following laboratory tests is the priority to complete?
- A. CBC
- B. Serum bilirubin
- C. Urinalysis of ketones
- D. Liver enzymes
Correct Answer: C
Rationale: Urinalysis for ketones is the priority as it indicates ketosis from prolonged vomiting, guiding the need for IV fluids and nutritional support in hyperemesis gravidarum.