Correct Answer: C

Rationale: Uterine contractions lasting 90 seconds indicate adequate contraction strength and duration, suggesting that the oxytocin infusion is effective, but the nurse should assess if the frequency and cervical progression support increasing the rate to achieve active labor (contractions every 2-3 minutes).
Choice A is wrong because contractions every 4 minutes may indicate early labor, and increasing the oxytocin rate may be premature without assessing cervical change or contraction strength.
Choice B is wrong because a fetal heart rate of 140/min with moderate variability is normal and does not directly indicate the need to adjust the oxytocin rate.
Choice D is wrong because a cervical dilation of 2 cm after 6 hours of labor suggests protracted labor, but increasing the oxytocin rate should be based on a comprehensive assessment, including contraction pattern and fetal status, not dilation alone.

Correct Answer: A

Rationale: A gastric residual volume of 300 mL suggests delayed gastric emptying, requiring provider notification. Mild fever, normal heart rate, and blood pressure are not urgent.

Correct Answer: D

Rationale: Monitoring for signs of liver dysfunction (e.g., jaundice, abdominal pain) is critical, as naltrexone, an opioid antagonist, can cause hepatotoxicity, requiring regular liver function tests.
Choice A is incorrect because naltrexone should not be started until the client is opioid-free for 7-10 days to avoid precipitating withdrawal.
Choice B is incorrect because naltrexone reduces cravings over time, not immediately.
Choice C is incorrect because naltrexone can be taken with or without food; a high-fat meal is not necessary.

Correct Answer: A

Rationale: A respiratory rate of 10/min is below the normal range (12-20/min) and indicates potential magnesium sulfate toxicity, which can lead to respiratory depression or arrest. This finding should be reported immediately to the provider, and the infusion may need to be stopped.
Choice B is wrong because a blood pressure of 150/90 mm Hg, while elevated, is not unexpected in preeclampsia and does not indicate immediate toxicity; it should be monitored, but it is not the priority.
Choice C is wrong because a urine output of 40 mL/hr is within the acceptable range (at least 30 mL/hr) for a client receiving magnesium sulfate and does not indicate renal compromise.
Choice D is wrong because deep tendon reflexes of 2+ are normal and do not suggest magnesium toxicity, which would present with absent or diminished reflexes.

Correct Answer: A

Rationale: Taking sumatriptan at the onset of migraine symptoms is critical, as it is most effective when used early to abort the migraine by constricting cranial blood vessels and blocking pain pathways.
Choice B is incorrect because sumatriptan can be taken with or without food; food does not significantly affect its absorption.
Choice C is incorrect because drowsiness is not a common side effect; sumatriptan may cause dizziness or tingling, but alertness is usually unaffected.
Choice D is incorrect because sumatriptan is used for acute migraine treatment, not daily for prevention, which requires other medications like propranolol.