Which of the following medications should the nurse plan to administer and document in the client's medical record for a client who is experiencing severe pain during active labor?

Fentanyl citrate

Naloxone hydrochloride

Naproxen

Hydrocodone

Answer and Explanation

The Correct Answer is A

Choice A reason: Fentanyl citrate is appropriate for severe labor pain, as it provides rapid-onset analgesia via IV administration, crossing the blood-brain barrier to block pain signals. Its short half-life minimizes fetal respiratory depression, making it safe for labor. Fentanyl targets opioid receptors, offering effective pain relief, per obstetric analgesia protocols.

Choice B reason: Naloxone hydrochloride is an opioid antagonist used to reverse opioid overdose, not to manage labor pain. It blocks opioid receptors, reversing analgesia, which would exacerbate pain. In labor, naloxone is reserved for neonatal respiratory depression from maternal opioids, not maternal pain relief, per pharmacological principles.

Choice C reason: Naproxen, a nonsteroidal anti-inflammatory drug, is unsuitable for labor pain, as it primarily reduces inflammation and mild pain via prostaglandin inhibition. Labor pain requires rapid, potent analgesia like fentanyl. Naproxen’s slow onset and limited efficacy for visceral pain make it inappropriate for active labor, per pain management guidelines.

Choice D reason: Hydrocodone, an oral opioid, is not used in active labor due to its slow onset and prolonged duration, risking fetal respiratory depression. IV fentanyl provides faster, controlled analgesia suitable for labor’s acute pain. Hydrocodone’s pharmacokinetics are better suited for postpartum or chronic pain, not intrapartum use.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: Critical congenital heart disease (CCHD) screening uses pulse oximetry, not a heel blood sample. Blood sampling is for metabolic screening, not heart defects. Pulse oximetry measures oxygen saturation non-invasively, detecting shunting or cyanotic defects, aligning with CCHD screening’s focus on circulatory assessment.

Choice B reason: CCHD screening is typically performed at 24-48 hours of age, not 6-12 hours, to ensure stable postnatal circulation. Early testing may yield false positives due to transitional physiology. Pulse oximetry at the correct timing accurately detects critical heart defects, per neonatal screening protocols.

Choice C reason: CCHD screening compares oxygen saturation in the upper (right hand) and lower (foot) extremities using pulse oximetry to detect congenital heart defects causing differential cyanosis. A significant difference indicates potential shunting or ductal-dependent lesions, requiring further evaluation, aligning with the physiological basis of CCHD screening.

Choice D reason: CCHD screening results are immediate via pulse oximetry, not delayed 1-2 weeks. Real-time oxygen saturation readings identify potential heart defects, enabling prompt referral for echocardiography. Delayed results apply to metabolic screening, not CCHD, which relies on instant physiological data, per neonatal diagnostic protocols.

A. WBC count 11,000/mm3 (5,000 to 10,000/mm3) B. Hematocrit 37% (37% to 47%) C. Creatinine 0.9 mg/dL (0.5 to 1 mg/dL) D. Fasting blood glucose 180 mg/dL (74 to 106 mg/dL)

Correct Answer is D

Explanation

Choice A reason: A WBC count of 11,000/mm3 is slightly elevated but normal in pregnancy due to physiological leukocytosis from increased immune activity. This supports maternal and fetal protection against infections. It does not indicate pathology requiring reporting, as it aligns with expected gestational changes in immune function, per hematological norms.

Choice B reason: Hematocrit of 37% is within the normal pregnancy range (37-47%), reflecting hemodilution from increased plasma volume. This ensures adequate placental perfusion and oxygen delivery. It does not indicate anemia or other complications requiring reporting, as it aligns with physiological adaptations in pregnancy, per hematological reference ranges.

Choice C reason: Creatinine of 0.9 mg/dL is normal (0.5-1 mg/dL) in pregnancy, reflecting increased glomerular filtration rate due to higher renal blood flow. This supports waste clearance for maternal and fetal health. It does not indicate renal dysfunction or require reporting, as it aligns with expected gestational renal physiology.

Choice D reason: Fasting blood glucose of 180 mg/dL indicates gestational diabetes, as it exceeds the normal range (74-106 mg/dL). Elevated glucose crosses the placenta, risking fetal macrosomia, hypoglycemia, or congenital anomalies. This requires immediate reporting for management to prevent adverse perinatal outcomes, per endocrinological and obstetric guidelines.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Which of the following medications should the nurse plan to administer and document in the client's medical record for a client who is experiencing severe pain during active labor?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following statements should the nurse include in the teaching to the parents of a newborn about the critical congenital heart disease screening?

Correct Answer is C

Explanation

Which of the following findings should a nurse report to the provider for a client who is at 20 weeks of gestation?

Correct Answer is D

Explanation

Which of the following actions should the nurse take for a client who is 1 hr postpartum and has uterine atony exhibiting a large amount of vaginal bleeding?

Which of the following actions should a nurse plan to take for a client who is 1 hr postpartum and has preeclampsia without severe features?

Which of the following findings should the nurse recognize and document as an adverse effect of epidural analgesia for a client who is in labor?

Which of the following findings should the nurse intervene for in a newborn immediately following a vaginal birth?

Which of the following actions should a nurse take for a newborn who has herpes simplex virus as a result of in utero transmission?

Which of the following risk factors should a nurse include when planning a class on postpartum depression for a group of clients who are pregnant?

Which of the following information should a nurse include in the teaching to the parent of a 1-day-old newborn with a prescription for gavage feeding?