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Questions 227

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Extract:

Thirty minutes after delivery the nurse finds that a mother's uterus is relaxed and the lochia is excessive.


Question 1 of 5

The fist action by the nurse should be to:

Correct Answer: D

Rationale: Massaging the uterus promotes contraction, reducing excessive lochia and preventing hemorrhage.

Extract:


Question 2 of 5

The nurse is administering terbutaline (Brethine) to a client in labor. Prior to administration of the medication, the nurse assesses the client's pulse to be 144. The nurse's priority action should be to

Correct Answer: A

Rationale: Terbutaline, a tocolytic, can cause maternal tachycardia. A pulse of 144 indicates significant tachycardia, a side effect requiring the medication to be withheld to prevent further cardiovascular strain. Decreasing the dose (
B) is not within nursing scope, administering (
C) ignores the risk, and waiting (
D) delays intervention.

Extract:

Following Nitroglycerin patch application


Question 3 of 5

An expected outcome experienced by the client would be one of the following:

Correct Answer: B

Rationale: Nitroglycerin may cause reflex tachycardia as a compensatory response to vasodilation.

Extract:

Patients with myasthenia gravis, Guillain-Barre syndrome, or amyotrophic lateral sclerosis experience:


Question 4 of 5

Patients with myasthenia gravis, Guillain-Barre syndrome, or amyotrophic lateral sclerosis experience:

Correct Answer: B

Rationale: These conditions impair respiratory muscles, increasing the risk of complications.

Extract:

After a painful exacerbation of rheumatoid arthritis, a patient is to begin a walking and exercise program.


Question 5 of 5

An appropriate outcome would be that the patient:

Correct Answer: D

Rationale: Exercising until discomfort becomes too great balances activity with joint protection, promoting safe participation.

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