A nurse has administered methergine (methylergonovine) 0.2 mg to a grand multipara (G7, P6) who delivered vaginally 30 minutes earlier. Which of the following outcomes indicates that the medication is effective?
Pulse rate 80 and regular.
Fundus firm at umbilicus, lochia moderate.
Blood pressure 120/80.
Increase in prothrombin time.
The Correct Answer is B
Choice A rationale
A pulse rate of 80 and regular does not directly indicate Methergine's effectiveness. Normal pulse ranges from 60 to 100 beats per minute. This could result from overall stabilization rather than medication effect.
Choice B rationale
A firm uterine fundus at the umbilicus and moderate lochia indicate effective uterine contraction and hemostasis, reflecting successful intervention with Methergine in managing postpartum hemorrhage.
Choice C rationale
A blood pressure of 120/80 is within the normal adult range but does not specifically reflect Methergine's uterotonic action. Blood pressure monitoring is essential but not the primary efficacy indicator.
Choice D rationale
An increase in prothrombin time reflects coagulation changes but is unrelated to Methergine's mechanism of action. It focuses on hemostatic effects via uterine contractions rather than coagulation pathways.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Narcan (naloxone) is contraindicated as it can precipitate acute withdrawal symptoms in neonates exposed to opioids in utero, leading to seizures and severe distress due to sudden opioid receptor blockade.
Choice B rationale
Phenobarbital is used to manage neonatal abstinence syndrome by reducing central nervous system hyperexcitability and seizures. It is not contraindicated as it provides symptomatic relief for withdrawal symptoms.
Choice C rationale
Methadone is used to treat neonatal abstinence syndrome by stabilizing opioid levels and preventing withdrawal symptoms. It is not contraindicated and helps manage symptoms effectively in opioid-exposed neonates.
Choice D rationale
Morphine is a first-line treatment for neonatal abstinence syndrome, reducing withdrawal symptoms by mimicking the effects of opioids. It is not contraindicated and is commonly used in neonatal care.
Correct Answer is C
Explanation
Choice A rationale
A respiratory rate of 75 breaths per minute exceeds the normal range of 30 to 60 breaths per minute in neonates. Tachypnea indicates distress, which necessitates immediate intervention to prevent complications.
Choice B rationale
A temperature of 96.5°F is below the normal neonatal range of 97.7°F to 99.5°F, suggesting hypothermia. This can impair enzyme activity, oxygen delivery, and thermoregulatory functions, requiring prompt warming measures.
Choice C rationale
Sucking or licking of the nipples reflects a positive response in kangaroo care, indicative of improved thermoregulation and bonding. This natural behavior also suggests a healthy neonate capable of initiating feeding.
Choice D rationale
Nasal flaring is a sign of respiratory distress, typically indicating increased effort to meet oxygen demands. This would not be considered a positive outcome and requires immediate evaluation and intervention.
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