A nurse is caring for a client who is receiving morphine intravenously. Which of the following findings indicates the client is experiencing morphine toxicity?

Prolonged QT interval

Fluid retention

Bradypnea

Hyperactive deep tendon reflexes

Answer and Explanation

The Correct Answer is C

Rationale:

A. Prolonged QT interval: This is not a typical sign of morphine toxicity. QT prolongation is more commonly associated with certain antipsychotics, antiarrhythmics, or methadone, not opioids like morphine.

B. Fluid retention: Morphine does not typically cause fluid retention. While it may contribute to urinary retention, generalized fluid accumulation is not characteristic of opioid toxicity and may point to other causes like heart or renal failure.

C. Bradypnea: Respiratory depression, including bradypnea, is the hallmark sign of opioid toxicity. Morphine suppresses the brainstem’s respiratory centers, reducing respiratory rate and depth, which can become life-threatening without intervention.

D. Hyperactive deep tendon reflexes: Opioids tend to cause central nervous system depression, which would more likely lead to diminished reflexes. Hyperactive reflexes are not associated with morphine toxicity and may suggest a different neurological issue.

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Correct Answer is B

Explanation

Rationale:

A. Avoid talking to the client about the newborn: Avoidance may intensify the client’s sense of isolation and loss. Acknowledging the newborn and offering opportunities to express emotions helps validate the grief and supports emotional healing.

B. Offer to take pictures of the newborn for the client: Creating mementos such as photographs allows the client and family to honor the baby’s memory and supports healthy grieving. These keepsakes may become meaningful in the healing process over time.

C. Assure the client that she can have additional children: While well-intended, this statement can minimize the significance of the loss. Grief must be acknowledged in the present without shifting focus to future pregnancies, which may feel dismissive.

D. Discourage the client from allowing friends to see the newborn: Families should be supported in making choices about how they wish to say goodbye. Discouraging this may interfere with personal grieving preferences and disrupt closure.

A. Limited hip abduction B. Equal leg length C. Symmetric gluteal and thigh skin folds D. Femoral head remains in the acetabulum during the Barlow maneuver

Correct Answer is A

Explanation

Rationale:

A. Limited hip abduction: Limited abduction of the hips in a 1-month-old can indicate developmental dysplasia of the hip (DDH). This finding warrants further evaluation, such as ultrasound imaging, to rule out structural abnormalities and initiate early treatment if needed.

B. Equal leg length: Equal leg length is a normal finding and does not require intervention. Leg length discrepancies are more concerning and often associated with hip dislocation or other musculoskeletal conditions.

C. Symmetric gluteal and thigh skin folds: Symmetry in the gluteal and thigh folds is a reassuring sign that typically rules out DDH. Asymmetry would be more suggestive of a hip abnormality requiring follow-up.

D. Femoral head remains in the acetabulum during the Barlow maneuver: This is a normal finding. The Barlow test assesses for hip instability, and if the femoral head remains stable within the socket, no further evaluation is needed.

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A nurse is caring for a client who is receiving morphine intravenously. Which of the following findings indicates the client is experiencing morphine toxicity?

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