A new mom delivered her baby 2 months ago. The baby's father calls into the office to report that his wife is angry.
She is confused and having conversations with herself.
What is the appropriate response that the nurse should make?
Please take your wife to the nearest emergency room for evaluation.
Please bring your wife to the office for medication.
Your wife needs outpatient care.
Your wife needs behavioral therapy.
The Correct Answer is A
Choice A rationale:
The symptoms described by the baby's father, including confusion and having conversations with herself, are concerning and could indicate a severe mental health issue or a neurological problem. Urgent evaluation in an emergency room is necessary to rule out any acute medical or psychiatric condition that could be causing these symptoms. This is crucial for ensuring the safety and well-being of both the mother and the newborn.
Choice B rationale:
Bringing the wife to the office for medication is not appropriate in this situation without a proper evaluation. The symptoms described are severe and require immediate attention in an emergency room setting, where comprehensive assessments can be conducted.
Choice C rationale:
Outpatient care is not suitable for the described symptoms. The mother's confusion and hallucinations suggest a severe condition that requires urgent evaluation in a controlled environment like an emergency room. Outpatient care might be considered after the initial assessment and stabilization, but the immediate concern is the acute nature of the symptoms.
Choice D rationale:
Behavioral therapy is not appropriate for the described
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Explaining how SIDS could have been predicted and prevented might not be appropriate immediately after the loss, as it can come across as insensitive. The focus should be on providing emotional support to the grieving family.
Choice B rationale:
While it's essential to gather information about the circumstances surrounding the infant's death, conducting an in-depth interview immediately might be overwhelming for the parents. Sensitivity and timing are crucial in approaching this aspect of the situation.
Choice C rationale:
Discouraging parents from making a last visit with the infant is highly inappropriate and insensitive. Parents should be allowed to have their final moments with their children and say their goodbyes in a way that brings them comfort and closure.
Choice D rationale:
Making a follow-up home visit to parents as soon as possible after the infant's death is a crucial nursing responsibility. This visit provides an opportunity to offer emotional support, answer any questions the parents might have, and connect them with appropriate resources for coping with their loss. It demonstrates the nurse's ongoing commitment to the family's well-being during this challenging time.
Correct Answer is A
Explanation
Choice A rationale:
The medication, Methylergonovine 0.2mg IM, is contraindicated due to the client's blood pressure. The patient's blood pressure reading is 155/95 mmHg, which indicates hypertension (high blood pressure). Methylergonovine is a medication used to manage postpartum hemorrhage by causing uterine contractions and reducing bleeding. However, it is contraindicated in patients with hypertension because it can significantly raise blood pressure, leading to complications such as stroke, heart attack, or hypertensive crisis. Administering this medication to a patient with high blood pressure can worsen their condition and pose serious risks.
Choice B rationale:
The multigravity (G-5) of the client (having had 5 pregnancies) is not a contraindication for Methylergonovine. The number of pregnancies a patient has had does not impact the contraindication criteria for this medication.
Choice C rationale:
The client's drug allergy to penicillin is not a contraindication for Methylergonovine. Allergies to specific medications do not affect the use of Methylergonovine for postpartum hemorrhage.
Choice D rationale:
The client's heart rate, which is not provided in the medical chart, does not directly contraindicate Methylergonovine. However, hypertension (elevated blood pressure) is the primary concern in this scenario, making choice A the correct answer.
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