A nurse is assessing a woman in labor.
Which finding would the nurse identify as a cause for concern during a contraction?.
Blood pressure rise from 110/60 mm Hg to 120/74.
White blood cell count of 12,000 cells/mm.
Respiratory rate of 10 breaths/minute.
Heart rate increase from 76 bpm to 90 bpm.
The Correct Answer is C
Choice A rationale:
A slight increase in blood pressure during contractions is normal.
Choice B rationale:
A white blood cell count of 12,000 cells/mm is within the normal range.
Choice C rationale:
A respiratory rate of 10 breaths/minute is low and could indicate respiratory depression.
Choice D rationale:
A heart rate increase from 76 bpm to 90 bpm is within the normal range.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Answer and explanation
Choice A rationale:
Butorphanol is an opioid agonist-antagonist. It would not be the first choice to treat opioid-induced respiratory depression because it can also cause respiratory depression.
Choice B rationale:
Promethazine is an antihistamine that has sedative effects and could potentially worsen respiratory depression.
Choice C rationale:
Fentanyl is a potent opioid and would likely exacerbate respiratory depression.
Choice D rationale:
Naloxone is an opioid antagonist used to reverse the effects of opioids such as respiratory depression.
Correct Answer is C
Explanation
Choice A rationale:
The back of the hand is sensitive to temperature, not pressure, making it less suitable for assessing contraction intensity.
Choice B rationale:
Finger tips are sensitive and can detect small changes, but they may not cover a large enough area to accurately assess contraction intensity.
Choice C rationale:
The palm of the hand covers a larger area and can better gauge the overall firmness of the uterus.
Choice D rationale:
Finger pads are sensitive to texture, not pressure, making them less suitable for this task.
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