A nurse is caring for a client and her newborn immediately after delivery. The client's medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What is the nurse's most appropriate action?

Prepare the client for motor delays in the infant caused by alcohol use.

Monitor the infant's respiration and prepare to administer naloxone if needed.

Note a high-pitched cry and irritability in the infant and observe for seizures.

Administer opioids to the infant to prevent withdrawal syndrome.

Answer and Explanation

The Correct Answer is B

A) Alcohol use, even before the client knew she was pregnant, may have some impact, but it is not the primary concern immediately after delivery.

B) Intravenous morphine administration during labor can lead to respiratory depression in the newborn, and monitoring is crucial. Naloxone may be needed to reverse opioid effects.

C) A high-pitched cry and irritability may be signs of opioid withdrawal, not related to the alcohol use.

D) Administering opioids to the infant is not appropriate and could worsen any respiratory depression.

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Correct Answer is B

Explanation

a) Concurrent use of acetaminophen is not directly related to heparin therapy for atrial fibrillation. It may need attention but does not warrant immediate reporting.

b) An aPTT of 80 seconds is significantly prolonged and may indicate a risk of bleeding due to excessive anticoagulation. This finding requires immediate notification to the healthcare provider.

c) An INR of 0.8 is within the normal range and does not pose an immediate concern in the context of heparin infusion.

d) Dark, tarry stools could indicate gastrointestinal bleeding but may not be directly related to heparin therapy. It should be monitored and reported, but it's not an immediate concern for heparin infusion.

A. Oral medications are contraindicated in infants. B. Breastfeeding infants are more likely to develop toxicity when given lipid-soluble drugs. C. Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. D. Infants are more sensitive to medications that act on the central nervous system. E. Infants have immature livers, which slow drug metabolism.

Correct Answer is ["C","D","E"]

Explanation

a) This is false because oral medications can be given to infants if they are in liquid form, have a suitable dose, and are administered with a dropper or syringe. However, oral medications should be given with caution and only when prescribed by a doctor.

b) This is false because lipid-soluble drugs are not easily passed into breast milk and do not affect breastfeeding infants. However, some drugs can be harmful to breastfeeding infants and should be avoided or used with caution by nursing mothers.

c) Immaturity of renal function in infancy affects drug excretion, potentially leading to prolonged drug effects and increased risk of toxicity.

d) Infants are more sensitive to medications that act on the central nervous system, and dose adjustments may be needed to prevent adverse effects.

e) Immature liver function in infants can slow down drug metabolism and elimination, leading to a higher risk of drug accumulation and toxicity.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a new diagnosis of atrial fibrillation is receiving a continuous infusion of heparin. Which finding will the nurse report immediately?

Correct Answer is B

Explanation

When administering medications to infants, it is essential to remember which of the following? (Select all that apply.)

Correct Answer is ["C","D","E"]

Explanation

A client is starting to take furosemide and asks the nurse. "When is the best time to take this medication?" What is the nurse's response?

A nurse is giving discharge instructions to a client who is beginning theophylline. The nurse should tell the client that this medication might cause which of the following adverse effects?

A client who is suffering from an acute gout attack wants to know how colchicine differs from probenecid and allopurinol in its actions. Which of these statements shows the need for further teaching regarding the purpose and use of these medications?

A prescriber has ordered medication for a newborn that is eliminated primarily by hepatic metabolism. What would the nurse expect the prescriber to order?

The nurse will include which information when teaching a client about hydroxyzine?

The nurse is scheduled to administer lispro insulin per sliding scale before meals. The serum blood glucose reading before lunch is 152 mg/dl. Given the following sliding scale, how much insulin lispro should be given before lunch? (Select the appropriate parameter.)

Which are preventable causes of medication errors? (Select all that apply.)

A 50-year-old postmenopausal client who has had a hysterectomy has moderate to severe hot flashes and is discussing estrogen therapy with the nurse. What will the nurse tell the client regarding the side effects of estrogen therapy?