A client whose labor is being augmented with an oxytocin infusion requests an epidural for pain control.
Findings of the last vaginal exam, performed one hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station.
Which action should the nurse implement first?

Request placement of the epidural.

Determine current cervical dilation.

Decrease the oxytocin infusion rate.

Give a bolus of intravenous fluids.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Requesting placement of the epidural should be based on the current cervical dilation and labor progress. Administering an epidural too early may lead to prolonged labor and increased risk of interventions.

Choice B rationale

Determining current cervical dilation is essential to assess the progress of labor and to make informed decisions about pain management and the use of epidurals. This ensures appropriate timing for interventions.

Choice C rationale

Decreasing the oxytocin infusion rate would not be the first action without assessing the current cervical dilation and labor progress. Oxytocin adjustments should be based on specific clinical indications and findings.

Choice D rationale

Giving a bolus of intravenous fluids is typically done before administering an epidural to prevent hypotension. However, this should be preceded by assessing cervical dilation to determine the timing and need for an epidural.

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Correct Answer is B

Explanation

Choice A rationale

Latanoprost eye drops are used to reduce intraocular pressure in glaucoma patients and are not relevant for a newborn exposed to Neisseria gonorrhoeae.

Choice B rationale

Erythromycin ointment is the correct medication to administer to a newborn exposed to Neisseria gonorrhoeae. It is used to prevent ophthalmia neonatorum, an eye infection caused by the bacteria. Administering erythromycin ointment is essential to protect the newborn's eyes from potential blindness or severe infection.

Choice C rationale

Tetracaine eye drops are a topical anesthetic used to numb the eyes during procedures and are not indicated for preventing neonatal eye infections caused by Neisseria gonorrhoeae.

Choice D rationale

Neomycin ointment is an antibiotic used for treating bacterial infections, but it is not the standard treatment for preventing ophthalmia neonatorum in newborns exposed to Neisseria gonorrhoeae. Erythromycin ointment is the recommended prophylactic treatment. .

A. Genital warts. B. German measles. C. Syphilis. D. Herpes simplex virus.

Correct Answer is D

Explanation

Choice A rationale

Genital warts, caused by human papillomavirus (HPV), typically present as small, flesh-colored or gray swellings in the genital area. They do not usually cause pain or vesicular lesions like those described. Genital warts may be flat or cauliflower-like in appearance but are generally distinct from the symptoms described in the question.

Choice B rationale

German measles (rubella) is a viral infection characterized by a red rash, mild fever, and swollen lymph nodes. It is not associated with vesicular lesions on the genital area. The virus primarily affects the respiratory system, and symptoms do not typically include shallow vesicles on the pubis, labia, and perineum.

Choice C rationale

Syphilis, caused by the bacterium Treponema pallidum, presents in stages. Primary syphilis manifests as a single sore (chancre), while secondary syphilis involves skin rashes and mucous membrane lesions. Tertiary syphilis can cause severe medical problems. The symptoms described do not align with any syphilis stage but rather suggest a different condition.

Choice D rationale

Herpes simplex virus (HSV) causes painful, shallow vesicles or ulcers in the genital area. HSV lesions are typically small, fluid-filled blisters that can rupture and form ulcers. The client's symptoms of shallow, small vesicles on her pubis, labia, and perineum are indicative of genital herpes.

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A client whose labor is being augmented with an oxytocin infusion requests an epidural for pain control.Findings of the last vaginal exam, performed one hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station.Which action should the nurse implement first?

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Naxlex Comprehensive Predictor Exams

A client who is positive for Neisseria gonorrhoeae vaginally delivered a newborn.Which medication should the nurse administer to the newborn?

Correct Answer is B

Explanation

A client at 37 weeks gestation presents to labor and delivery with contractions every 2 minutes.The nurse observes several shallow, small vesicles on her pubis, labia, and perineum.The nurse should recognize the client is exhibiting symptoms of which condition?

Correct Answer is D

Explanation

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A client whose labor is being augmented with an oxytocin infusion requests an epidural for pain control.Findings of the last vaginal exam, performed one hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station.Which action should the nurse implement first?

A client whose labor is being augmented with an oxytocin infusion requests an epidural for pain control.
Findings of the last vaginal exam, performed one hour ago, were 3 cm cervical dilation, 60% effacement, and a -2 station.
Which action should the nurse implement first?