A nurse is assessing a client who is at 32 weeks of gestation and is receiving magnesium sulfate via continuous IV infusion.
Which of the following findings should the nurse report to the provider?
Decrease in frequency of contractions.
Urinary output 35 mL/hr.
Absent deep-tendon reflexes.
BP 150/100 mm Hg.
The Correct Answer is C
A nurse should report absent deep-tendon reflexes to the provider when a client is receiving magnesium sulfate via continuous IV infusion.
This is because reduced tendon reflexes can be a side effect of magnesium sulfate use during pregnancy.
Choice A is not correct because a decrease in the frequency of contractions is an expected outcome of magnesium sulfate use as a tocolytic to stop preterm labor.
Choice B is not correct because a urinary output of 35 mL/hr is within the normal range.
Choice D is not correct because an elevated blood pressure is not a known side effect of magnesium sulfate use during pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
If a prolapsed cord is identified, the nurse should perform a vaginal examination and ensure the presenting part is pushed upwards to relieve pressure on the cord.
Choice A) is not correct because while it is important to cover the cord with a sterile saline saturated towel if it has prolapsed externally 1, it is not the next action after calling for assistance and notifying the provider.
Choice C) is not correct because administering oxygen via non-rebreather mask at 8 L/min is not mentioned as an immediate intervention for a prolapsed cord .
Choice D) is not correct because initiating an infusion of IV fluids for the client is not mentioned as an immediate intervention for a prolapsed cord .
Correct Answer is E
Explanation
None of the choices provided indicate that suctioning of the nasopharynx is needed for a newborn.
Nasopharyngeal suctioning is performed to remove mucus or saliva from the back of the throat when a newborn is unable to cough or swallow. It is commonly used in infants with bronchiolitis.
Choice A, “The newborn’s respiratory rate is 32/min,” is not an answer because a respiratory rate of 32/min is within the normal range for a newborn.
Choice B, “The newborn’s respiratory rate is irregular,” is not an answer because irregular breathing paterns are common in newborns.
Choice C, “The newborn is beginning to cough,” is not an answer because coughing is a normal reflex that helps clear the airway.
Choice D, “The newborn’s pulse oximetry is 91,” is not an answer because pulse oximetry measures oxygen saturation and does not indicate the need for nasopharyngeal suctioning.
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