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Question 1 of 5

The primary reason that an increase in heart rate (100 bpm) detrimental to the client with a myocardial infarction (MI) is that:

Correct Answer: D

Rationale: Decreased stroke volume and blood pressure will occur secondary to decreased diastolic filling. Tachycardia primarily decreases diastole; systolic time changes very little. Contractility decreases owing to the decreased filling time and decreased time for fiber lengthening. Decreased O2 supply due to decreased time for filling of the coronary arteries increases ischemia and infarct size. Tachycardia primarily robs the heart of diastolic time, which is the primary time for coronary artery filling.

Question 2 of 5

A client in labor has an order for Demerol (meperidine) 75 mg. IM to be administered 10 minutes before delivery. The nurse should:

Correct Answer: B

Rationale: Meperidine given close to delivery can cause neonatal respiratory depression due to its sedative effects crossing the placenta. The nurse should question the timing of the order.

Question 3 of 5

The nurse is assessing the deep tendon reflexes of a client with preeclampsia. Which method is used to elicit the biceps reflex?

Correct Answer: A

Rationale:
To elicit the biceps reflex the nurse places a thumb on the biceps tendon in the antecubital space and taps it with a reflex hammer. The other methods describe techniques for eliciting different reflexes (e.g. triceps or patellar).

Question 4 of 5

A client is admitted to the postpartal unit with a large amount of lochia rubra, uterine enlargement, and excessive clots. Which medication will likely be ordered for the client?

Correct Answer: D

Rationale: Hemabate, a prostaglandin, is used to treat postpartum hemorrhage by promoting uterine contractions to control bleeding. Fentanyl and Stadol are analgesics, and Prepidil is for labor induction, not hemorrhage.

Question 5 of 5

A 3-year-old child is hospitalized with burns covering her trunk and lower extremities. Which of the following would the nurse use to assess adequacy of fluid resuscitation in the burned child?

Correct Answer: C

Rationale: Blood pressure can remain normotensive even in a state of hypovolemia. Serum potassium is not reliable for determining adequacy of fluid resuscitation. Urine output, alteration in sensorium, and capillary refill are the most reliable indicators for assessing adequacy of fluid resuscitation. Pulse rate may vary for many reasons and is not a reliable indicator for assessing adequacy of fluid resuscitation.

Similar Questions

The nurse is teaching a client with a history of allergic rhinitis about self-care. The nurse should tell the client to:
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A 10-month-old infant's mother says that he takes fresh whole milk eagerly, but that when she offered him baby foods at 6 months of age, he pushed them out of his mouth. Because he has gained weight appropriately, she has quit trying to get him to eat other foods. The nurse's response is based on the knowledge that:
When assessing the client's blood pressure, the nurse should use a cuff with a width that is __% of the circumference of the extremity. (Fill in the blank.)
A 3-year-old female client is brought into the pediatric clinic because she limps. She has not been to the clinic since she was 9 months old. The nurse practitioner describes the limp as a 'Trendelenburg gait.' This gait is characteristic of:

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