When assessing a recently delivered, multigravida client, the nurse finds that her vaginal bleeding is more than expected. Which factor in this client's history is related to this finding?

She is a gravida 6, para 5.

She received butorphanol 2 mg IV during labor.

She is over 35 years of age.

The second stage of labor lasted 10 minutes.

Answer and Explanation

The Correct Answer is A

Rationale:

A. She is a gravida 6, para 5: A high parity (multiple previous births) stretches the uterus significantly over time, increasing the risk of uterine atony—a leading cause of postpartum hemorrhage due to the uterus failing to contract effectively.

B. She received butorphanol 2 mg IV during labor: Butorphanol is a narcotic analgesic and does not directly contribute to excessive postpartum bleeding or uterine atony in typical doses.

C. She is over 35 years of age: Advanced maternal age can increase some obstetric risks, but it is not as directly associated with postpartum hemorrhage as high parity.

D. The second stage of labor lasted 10 minutes: A short second stage may lead to perineal trauma, but it is less likely to cause excessive vaginal bleeding compared to uterine atony from high parity.

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

Explanation

Rationale:
A. Any antianxiety medications: Antianxiety medications are not contraindicated with ophthalmic timolol. Unless they directly impact heart rate or blood pressure significantly, they are generally safe to continue in clients with glaucoma using topical beta blockers.

B. Over-the-counter oral antipyretics: Oral antipyretics like acetaminophen are not known to interact adversely with timolol. These medications can be used safely unless otherwise contraindicated for specific patient conditions like liver disease.

C. Nonsteroidal antiinflammatory drugs: NSAIDs such as ibuprofen, when used long-term with beta blockers like timolol or carvedilol, may blunt the antihypertensive effect and increase renal risk, especially in clients on diuretics like spironolactone. This triple combination increases the chance of nephrotoxicity.

D. Other beta-adrenergic blocker agents: Using timolol with systemic beta blockers like carvedilol increases the risk of bradycardia, hypotension, and heart block. Though timolol is topical, systemic absorption can still occur, requiring caution when combining with other beta-blockers.

E. Oral and subcutaneous anticoagulants: There is no direct contraindication between timolol and anticoagulants. Unless the client has bleeding risks associated with other therapies or conditions, concurrent use is generally acceptable.

A. Assess level of consciousness and vital signs for both clients. B. Administered pain medication to the client with incisional discomfort. C. Complete a head-to-toe physical assessment for the client with pneumonia. D. Review the plan of care and the medications for both clients.

Correct Answer is A

Explanation

Rationale:
A. Assess level of consciousness and vital signs for both clients: This action prioritizes airway, breathing, and circulation (ABCs) and ensures prompt identification of any deterioration in either client's condition. It provides critical data needed to safely proceed with further interventions such as administering medications or conducting full assessments.

B. Administered pain medication to the client with incisional discomfort: While pain management is important, it is not the priority over initial assessment of both clients' status—especially the one on mechanical ventilation with an elevated temperature.

C. Complete a head-to-toe physical assessment for the client with pneumonia: A full assessment is essential, but it is not the most immediate action. Checking vital signs and neurological status first can quickly reveal urgent issues that might require rapid intervention.

D. Review the plan of care and the medications for both clients: This is necessary but should be done after determining the clients’ current conditions. Immediate physiological assessment takes precedence in critical care settings to prevent delays in interventions.

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When assessing a recently delivered, multigravida client, the nurse finds that her vaginal bleeding is more than expected. Which factor in this client's history is related to this finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse administers ophthalmic timolol to a client with glaucoma. The client routinely takes carvedilol, spironolactone, and ibuprofen daily. Which medication(s) should the nurse withhold? Select all that apply.

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

Explanation

Correct Answer is A

Explanation

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