A patient is prescribed a calcium channel blocker for the management of hypertension. Which adverse effect should the nurse monitor closely in the patient?

Correct Answer: D

Rationale: Calcium channel blockers are often prescribed for the management of hypertension because they can help relax blood vessels and slow the heart rate, thus reducing blood pressure. One of the major adverse effects associated with calcium channel blockers is bradycardia (slow heart rate) or even more rarely, tachycardia (fast heart rate). Therefore, in a patient prescribed a calcium channel blocker for hypertension, the nurse should closely monitor for any signs and symptoms of tachycardia as it can be a serious adverse effect that needs prompt evaluation and intervention to prevent complications.

Correct Answer: C

Rationale: Mastitis is an infection of the breast tissue that may occur in postpartum clients. When a postpartum client exhibits signs of mastitis, including breast tenderness, erythema, and warmth, it is crucial to notify the healthcare provider immediately. Prompt medical evaluation is necessary to determine the appropriate treatment plan, which may include antibiotics. Delay in treatment can lead to complications, such as abscess formation. Encouraging the client to continue breastfeeding and applying warm compresses may provide some relief but do not address the underlying infection. Administering oral antibiotics would require a prescription from the healthcare provider, hence notifying the provider is the most appropriate initial nursing action in this situation.

Correct Answer: A

Rationale: Administering a stool softener as ordered is the most appropriate nursing intervention for a postpartum client experiencing severe perineal pain and difficulty passing stools following a vaginal delivery. Stool softeners help to soften the stool, making it easier for the client to pass without straining, which can exacerbate perineal pain. It is important to follow the healthcare provider's orders when administering medications to ensure proper dosing and effectiveness. Encouraging the client to refrain from defecation may lead to constipation and worsen the situation. Applying ice packs to the perineum can provide temporary pain relief, but addressing the underlying issue of constipation with a stool softener is more effective in the long term. Providing education on proper perineal hygiene is important for overall postpartum care, but addressing the immediate issue of constipation with a stool softener takes precedence in this scenario.

Correct Answer: A

Rationale: Providing education on strategies for initiating and maintaining milk supply should be prioritized to support successful breastfeeding in this situation. Preterm infants can benefit significantly from breast milk due to its unique composition that supports their growth and development. Educating the client on techniques such as pumping to establish and maintain milk supply, proper latching techniques, and understanding the benefits of breastfeeding for preterm infants can help alleviate her concerns and increase her confidence in breastfeeding her premature infant. Additionally, promoting skin-to-skin contact and frequent feedings can also help stimulate milk production and foster bonding between the mother and infant. Encouraging and supporting the client with evidence-based information will be crucial in promoting successful breastfeeding outcomes for the preterm infant.

Correct Answer: B

Rationale: Option B is the most appropriate response when addressing a postpartum client's concerns about resuming sexual activity after a vaginal delivery. Educating the client about the normal changes in sexual desire and response following childbirth can help alleviate anxiety and provide reassurance. It is crucial for the nurse to explain that it is common for women to experience changes in libido, physical discomfort, and emotional adjustments after giving birth. By discussing these normal postpartum changes, the nurse can support the client in understanding that her feelings are valid and that it may take time for her to feel ready to engage in sexual activity again. Furthermore, the nurse can provide information on ways to enhance comfort and intimacy when resuming sexual activity, such as communication with partners, using lubricants, and gradually easing back into sexual activity as desired.

Correct Answer: B

Rationale: Nitrous oxide, also known as "laughing gas," is a safe and effective pharmacological option for pain management during labor. Nitrous oxide is commonly used in labor and delivery settings as it has minimal effects on the baby and allows the woman to remain in control of her pain management. It provides quick pain relief when inhaled and can be adjusted to the woman's needs during labor. Ibuprofen, morphine, and diazepam are not typically used for pain management during labor due to their potential risks and side effects, especially for the baby.

Correct Answer: B

Rationale: Uterine hyperstimulation, also known as tachysystole, is a condition where the uterus contracts too frequently and/or too forcefully, leading to a decreased uterine blood flow. This can result in maternal fatigue and decreased oxygenation to the fetus, as mentioned in the scenario. Uterine hyperstimulation can be caused by several factors, including the excessive use of uterotonic medications, such as oxytocin, or the presence of uterine abnormalities.

Correct Answer: C

Rationale: The night nurse is expected to collect the patient charts from various departments every three nights. Among the tasks listed, binding the charts as they are is not typically a responsibility of the night nurse. This task is usually handled by administrative staff or professional medical records technicians who are trained to manage the organization and storage of patient charts. The night nurse's primary focus should be on ensuring the correct order of the charts, checking for completeness, and addressing any issues such as torn pages by taping or repairing them to maintain the integrity of the patient records.

Correct Answer: B

Rationale: When the supervisor allocates nurses to the priority wards in response to the situation of several nurses not reporting due to the Jeepney strike, she is practicing the ethical principle of justice. Justice in healthcare pertains to the fair distribution of resources and the equitable treatment of individuals. By ensuring that nurses are allocated fairly and appropriately to address the urgent needs of the hospital and its patients, the supervisor is upholding the principle of justice. This decision aims to ensure that all patients receive the care they need despite the unexpected staffing shortage.