A 37 weeks' gestation patient with a scheduled nonstress test (NST) has the following vital signs recorded over two days: 2/10 1535: BP 162/100, HR 78, SpO2 100%; 2/10 1600: BP 168/100, HR 76, SpO2 100%; 2/11 1200: BP 166/100, HR 84, SpO2 99%; 2/11 1818: BP 152/86, HR 78, SpO2 99%. The nurse anticipates needing to administer Magnesium Sulfate to prevent which of the following complications?

Preterm labor.

Gestational diabetes.

Seizures.

Fetal growth restriction.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Preterm labor is defined as labor that occurs between 20 and 37 weeks of gestation. The patient is already at 37 weeks' gestation, so preterm labor is not a complication to prevent.

Choice B rationale

Gestational diabetes is glucose intolerance that develops during pregnancy. While elevated blood pressure can sometimes be associated with gestational diabetes, magnesium sulfate is not a primary treatment or preventative measure for this condition. Management typically involves dietary changes, exercise, and sometimes insulin.

Choice C rationale

Magnesium sulfate is commonly administered in the setting of preeclampsia with severe features or eclampsia to prevent seizures. The patient's consistently elevated blood pressure readings (above 160/110 mmHg on multiple occasions) indicate severe hypertension, a key diagnostic criterion for preeclampsia with severe features, placing her at high risk for seizures (eclampsia). Magnesium sulfate acts as a central nervous system depressant, reducing neuronal excitability and thus the risk of seizures.

Choice D rationale

Fetal growth restriction (FGR) is a condition where the fetus does not grow at the expected rate in utero. While severe preeclampsia can contribute to FGR due to placental insufficiency, magnesium sulfate is not directly used to prevent fetal growth restriction. The primary focus of magnesium sulfate in this scenario is maternal seizure prophylaxis.

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Correct Answer is A

Explanation

Choice A rationale

The morning-after pill, containing levonorgestrel, is intended for emergency contraception and should not be used as a regular method of birth control. Frequent use can disrupt the menstrual cycle and may be less effective over time compared to consistent contraception methods like oral contraceptives, IUDs, or barrier methods. These regular methods provide continuous protection against pregnancy.

Choice B rationale

The morning-after pill is most effective when taken as soon as possible after unprotected intercourse. Its efficacy decreases with time, and it is significantly less effective after 72 hours. The medication works primarily by delaying or preventing ovulation, and its effectiveness is highest when administered before ovulation occurs.

Choice C rationale

The morning-after pill does not provide any protection against sexually transmitted infections (STIs). It only reduces the risk of pregnancy. Individuals should use barrier methods like condoms during sexual activity to protect themselves and their partners from STIs. Emergency contraception addresses pregnancy risk, not STI transmission.

Choice D rationale

The efficacy of the morning-after pill declines significantly if taken more than 72 hours after unprotected sex. While it may still offer some protection up to 120 hours, its effectiveness is considerably reduced compared to when taken within the first 72 hours. Prompt use is crucial for maximizing its contraceptive effect. .

A. Administer intravaginally for cervical ripening. B. Monitor the length, strength, and duration of contractions. C. Ensure the client has a full bladder before administration. D. Administer orally for preeclampsia. E. Monitor for nausea, vomiting, and diarrhea. F. Keep client in supine position with lateral tilt for 30 minutes after administration. G. Avoid use in clients with a history of liver disease. H. Administer IM for postpartum hemorrhage. I. Encourage oral intake of grapefruit juice. J. Monitor for manifestations of hypertensive crisis. K. Administer IV before passage of placenta to stimulate uterine contractions

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"C"},"G":{"answers":"B"},"H":{"answers":"B"},"J":{"answers":"D"},"K":{"answers":"A"}}

Explanation

Oxytocin (Pitocin)

Monitor contractions: Oxytocin stimulates uterine contractions; excessive stimulation can lead to uterine rupture or fetal distress.
Administer IV before placenta delivery: Used to induce labor or manage the third stage by promoting uterine contractions and preventing postpartum hemorrhage.

Carboprost (Hemabate)

Administer IM for postpartum hemorrhage: Carboprost is used when first-line therapies fail to manage bleeding.
Monitor GI side effects: Carboprost can cause nausea, vomiting, and diarrhea.
Avoid in liver disease: Due to its metabolism in the liver, this drug can be harmful to clients with liver impairment.

Misoprostol (Cytotec)

Empty bladder & intravaginal admin: An empty bladder minimizes risk of trauma and enhances the effectiveness of cervical ripening.
Cervical ripening agent: Often used to induce labor.
Position after use: Keeping the client in a supine position with lateral tilt improves drug absorption and reduces the risk of expulsion.

Methylergonovine (Methergine)

Hypertensive crisis risk: This drug causes vasoconstriction, so it is contraindicated in clients with high blood pressure due to the risk of severe complications such as stroke.

Nursing actions without a proper match:

"Ensure the client has a full bladder before administration"
"Administer orally for preeclampsia"
"Encourage oral intake of grapefruit juice"

Some nursing actions do not match the medications provided, as they are irrelevant to the uterotonic drugs listed,

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 19-year-old client comes to the clinic seeking information about the use of the morning-after pill (levonorgestrel) for emergency contraception.Which of the following statements made by the client indicates a need for further teaching?

Correct Answer is A

Explanation

For each medication below, click to select the appropriate nursing action. (Each category can have zero or more response options selected)

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"C"},"G":{"answers":"B"},"H":{"answers":"B"},"J":{"answers":"D"},"K":{"answers":"A"}}

Explanation

A nurse is preparing to administer magnesium sulfate IV to a client who is experiencing preterm labor.Which of the following is the priority nursing assessment for this client?

A male client reports to the nurse that he took sildenafil for erectile dysfunction but did not achieve an erection.Which of the following considerations should the nurse evaluate to determine possible reasons for the lack of response?

A teenager presents to the clinic with complaints of painful lesions, fever, headache, and vaginal discharge.After testing she is diagnosed with Herpes simplex virus type 2. What education should the nurse include in a teaching plan? (Select All that Apply.)

A nurse is caring for a client with the nursing diagnosis of acute pain related to breast engorgement.Which interventions should the nurse include in the plan of care?

A nurse is caring for a client who is 3 days postpartum and is attempting to breastfeed.Which of the following findings indicate mastitis?

A nurse is caring for a client who is 5 hr postpartum following a vaginal birth of a newborn weighing 9 lb 6 oz (4252 g). The nurse should recognize that this client is at risk for which of the following postpartum complications?