A nurse is caring for a client who is postpartum and has received methylergonovine. Which of the following findings indicates that the medication was effective?

Fundus firm to palpation

Report of absent breast pain

Increase in lochia

Increase in blood pressure

Answer and Explanation

The Correct Answer is A

Choice A reason:
Methylergonovine is used postpartum to prevent or control uterine bleeding by causing the uterus to contract. A firm fundus upon palpation indicates that the uterus is contracting well, which helps to compress the blood vessels and prevent excessive bleeding. This is the expected outcome when methylergonovine is effective.

Choice B reason:
The absence of breast pain is not directly related to the effectiveness of methylergonovine. Breast pain or engorgement typically occurs when milk comes in a few days postpartum and is not influenced by uterotonic medications.

Choice C reason:
An increase in lochia, or postpartum vaginal discharge, is not an indicator of methylergonovine's effectiveness. Lochia will naturally change and decrease as the postpartum period progresses and is not directly affected by the medication.

Choice D reason:
An increase in blood pressure is not an expected effect of methylergonovine and could indicate a side effect or complication. Methylergonovine can cause hypertension as a side effect, so an increase in blood pressure would warrant further assessment rather than indicating effectiveness.

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Correct Answer is B

Explanation

Choice A reason:
This choice is incorrect because the hepatitis B vaccine is recommended to be given within 24 hours of birth, but there is no recommendation for hepatitis B immune globulin (HBIG) to be given every 12 hours for 3 days. The HBIG is typically given as a single dose.

Choice B reason:
This is the correct choice. Newborns whose mothers are positive for the hepatitis B surface antigen should receive both HBIG and the first dose of the hepatitis B vaccine within 12 hours of birth. The HBIG provides immediate protection against hepatitis B infection, and the vaccine begins the process of building long-term immunity.

Choice C reason:
This choice is incorrect because delaying the administration of HBIG and the hepatitis B vaccine until 1 week after birth would leave the newborn vulnerable to hepatitis B infection. The recommended schedule is to administer these within 12 hours of birth.

Choice D reason:
This choice is incorrect because the hepatitis B vaccine is not given monthly. The typical schedule for the hepatitis B vaccine is the first dose at birth, the second dose at 1-2 months of age, and the third dose at 6 months of age. Additionally, the vaccine is not administered based on the newborn's hepatitis B surface antigen status.

A. Slightly below the umbilicus. B. 3 cm above the umbilicus. C. Slightly above the umbilicus. D. 3 cm below the umbilicus.

Correct Answer is C

Explanation

Choice a reason:
Slightly below the umbilicus is not the expected location for the fundus at 22 weeks of gestation. Typically, the fundus is located at the level of the umbilicus at 20 weeks and rises about 1 cm above the umbilicus each week thereafter.

Choice b reason:
3 cm above the umbilicus would be more consistent with a gestational age of approximately 23 weeks, as the fundus rises approximately 1 cm per week after reaching the level of the umbilicus at 20 weeks.

Choice C rationale: At 22 weeks of gestation, the fundus is typically located slightly above the umbilicus. The uterus has grown sufficiently by this stage to reach this position, aligning with the expected fundal height measurements. This corresponds with normal pregnancy progression, as fundal height in centimeters is expected to approximate the gestational age in weeks.

Choice D rationale: By 22 weeks of gestation, the fundus has already risen above the umbilicus, so palpating the fundus 3 cm below the umbilicus is inconsistent with normal pregnancy progression. Earlier in pregnancy, such as around 16 to 18 weeks, the fundus might be found below the umbilicus, but this does not apply at 22 weeks.

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A nurse is caring for a client who is postpartum and has received methylergonovine. Which of the following findings indicates that the medication was effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a newborn whose mother is positive for the hepatitis B surface antigen. Which of the following should the infant receive?

Correct Answer is B

Explanation

A nurse is preparing to measure the fundal height of a client who is at 22 weeks of gestation. At which location should the nurse expect to palpate the fundus?

Correct Answer is C

Explanation

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