Before administering methylergonovine (Methergine), what priority assessment finding would lead the nurse to hold the medication?
Pulse is 90 beats per minute
Pulse is 110 beats per minutes
Blood pressure of 120/70
Blood pressure of 150/90
The Correct Answer is D
A. Pulse is 90 beats per minute is incorrect because a normal heart rate does not contraindicate methylergonovine. The medication’s primary cardiovascular effect is on vascular smooth muscle, not directly on heart rate.
B. Pulse is 110 beats per minute is incorrect because mild tachycardia alone is not a contraindication. However, the nurse should monitor heart rate during administration, especially if hypotension or other complications arise.
C. Blood pressure of 120/70 is incorrect because this is a normal blood pressure and indicates it is safe to give the medication.
D. Blood pressure of 150/90 is correct because hypertension is a contraindication for methylergonovine. Administering the drug to a hypertensive patient can precipitate severe hypertension, stroke, myocardial infarction, or other cardiovascular complications. The nurse must hold the medication, notify the healthcare provider, and implement alternative measures for postpartum bleeding management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.11"]
Explanation
Given:
- Patient weight = 5.6 kg
- Digoxin safe dose = 0.03–0.06 mg/kg/day
Step 1: Calculate the maximum daily dose
Maximum dose = 0.06 mg/kg/day × 5.6 kg
0.06 × 5.6 = 0.336 mg/day
Step 2: Round to the nearest hundredth
0.336 → 0.34 mg/day
Step 3: Divide by the number of doses per day (every 8 hours → 3 times/day)
Maximum single dose = 0.34 mg ÷ 3
0.34 ÷ 3 ≈ 0.1133 mg
Rounded to the nearest hundredth → 0.11 mg per dose
Correct Answer is D
Explanation
A. Non-Hodgkin's lymphoma is more commonly associated with painless, enlarged lymph nodes than Hodgkin's lymphoma is incorrect because both HL and NHL can present with painless lymphadenopathy, so this is not a distinguishing feature.
B. Hodgkin's lymphoma presents with a more aggressive course than Non-Hodgkin's lymphoma is incorrect because, in children, Non-Hodgkin’s lymphoma generally has a more aggressive and rapid course compared with Hodgkin’s lymphoma, which usually progresses more slowly.
C. Non-Hodgkin's lymphoma typically involves the Reed-Sternberg cells is incorrect because Reed-Sternberg cells are characteristic of Hodgkin’s lymphoma, not Non-Hodgkin’s lymphoma. Their presence is a key diagnostic feature of HL.
D. Hodgkin's lymphoma usually has a more predictable and localized spread than Non-Hodgkin's lymphoma is correct. Hodgkin’s lymphoma tends to spread in a contiguous, orderly fashion from one lymph node group to another, often starting in cervical or supraclavicular nodes. Non-Hodgkin’s lymphoma, in contrast, tends to spread more diffusely and rapidly, involving extranodal sites such as the gastrointestinal tract, mediastinum, and bone marrow.
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