A nurse is preparing to administer dinoprostone gel to a client who is pregnant. The client asks the nurse about the purpose of the medication. Which of the following responses should the nurse make?
Dinoprostone stimulates uterine contractions.
Dinoprostone promotes softening of the cervix.
Dinoprostone relaxes uterine contractions.
Dinoprostone assists with ending the pregnancy.
The Correct Answer is B
Choice A reason:
Dinoprostone stimulates uterine contractions is incorrect, as this is not the primary purpose of the medication. Dinoprostone is a prostaglandin that can induce labor by ripening the cervix and enhancing uterine contractility, but it is not used solely for stimulating contractions.
Choice B reason:
Dinoprostone promotes softening of the cervix is correct, as this is the main purpose of the medication. Dinoprostone is used to prepare the cervix for labor by increasing its softness, dilation, and effacement. This can facilitate the descent of the fetus and shorten the duration of labor.
Choice C reason:
Dinoprostone relaxes uterine contractions is incorrect, as this is the opposite effect of the medication. Dinoprostone can increase uterine tone and frequency, which can help initiate or augment labor. The nurse should monitor the client for signs of uterine hyperstimulation or fetal distress.
Choice D reason:
Dinoprostone assists with ending the pregnancy is incorrect, as this is not the intended use of the medication. Dinoprostone can be used to terminate a pregnancy in some cases, such as fetal demise or missed abortion, but it is not routinely used for this purpose. The nurse should explain to the client that dinoprostone is used to induce labor and not to end a pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
Choice A reason: Administer terbutaline if the fundus is boggy is incorrect, as this action is contraindicated for a client who has a boggy fundus. Terbutaline is a tocolytic agent that can relax uterine contractions and worsen uterine atony and hemorrhage. The nurse should administer oxytocin or other uterotonic agents as prescribed to stimulate uterine contraction and prevent bleeding.
Choice B reason: Observe the lochia during palpation of fundus is correct, as this action can provide information about the amount, color, consistency, and odor of lochia. Lochia is the vaginal discharge that occurs after birth, which consists of blood, mucus, and tissue. The nurse should observe the lochia during fundal palpation and report any abnormal findings, such as excessive bleeding, large clots, foul smell, or infection.
Choice C reason: Document fundal height is correct, as this action can provide information about the progress of uterine involution. The fundus is the upper part of the uterus that can be palpated through the abdomen after birth. The nurse should document the fundal height in relation to the umbilicus and note any changes over time.
Choice D reason: Massage a firm fundus is incorrect, as this action is not necessary for a client who has a firm fundus. A firm fundus indicates adequate uterine contraction and involution and prevents excessive bleeding. The nurse should massage a boggy or soft fundus until it becomes firm and midline.
Choice E reason: Determine whether the fundus is midline is correct, as this action can provide information about the position of the uterus and bladder. The fundus should be midline and not displaced to either side. A deviated fundus can indicate bladder distension, which can interfere with uterine contraction and involution and increase the risk of hemorrhage and infection. The nurse should assist the client to empty their bladder and reassess the fundal position.
Correct Answer is D
Explanation
Choice A reason: Check the client's temperature every 4 hr is incorrect, as this action is not frequent enough for a client who had an amniotomy. The nurse should check the client's temperature every 2 hr after an amniotomy, as there is an increased risk of infection due to the rupture of membranes. The nurse should also monitor for signs of chorioamnionitis, such as foul-smelling amniotic fluid, maternal tachycardia, or fetal tachycardia.
Choice B reason: Remind the client to bear down with each contraction is incorrect, as this action is not appropriate for a client who is in the active phase of the first stage of labor. The nurse should instruct the client to avoid bearing down or pushing until they are in the second stage of labor, when the cervix is fully dilated and effaced. Bearing down too early can cause cervical edema, lacerations, or exhaustion.
Choice C reason: Maintain the client in the lithotomy position is incorrect, as this action is not optimal for a client who is in the active phase of the first stage of labor. The lithotomy position is a supine position with the legs elevated and abducted, which can reduce blood flow to the uterus and placenta, increase perineal edema, and limit pelvic outlet diameter. The nurse should encourage the client to change positions frequently and use upright or lateral positions that can enhance uterine contractility, fetal descent, and maternal comfort.
Choice D reason: Encourage the client to empty the bladder every 2 hr is correct, as this action can promote labor progress and prevent bladder distension and infection. The nurse should assist the client to void every 2 hr after an amniotomy, as there may be decreased sensation of bladder fullness due to pressure from the fetal head. A full bladder can interfere with uterine contractions, fetal descent, and cervical dilation.
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