A nurse is reinforcing teaching with a client who is at 36 weeks of gestation and is about to undergo an amniocentesis.
Which of the following information should the nurse include in the instructions?
"I will need to give you Rh(D) immune globulin because you are Rh positive.”
"You will need to have an empty bladder for the test.”
"You will have to lie on your left side during the test.”
"You will have to drink 50 grams of oral glucose before the test.”
The Correct Answer is B
Choice A rationale:
The administration of Rh(D) immune globulin (RhoGAM) is typically indicated for Rh-negative mothers who are carrying Rh-positive fetuses to prevent sensitization to Rh antigens. It is not directly related to the amniocentesis procedure. Therefore, this information is not necessary for the client undergoing an amniocentesis.
Choice B rationale:
This is the correct answer. Having an empty bladder is crucial during an amniocentesis procedure because a full bladder can obscure visualization of the fetus and the needle placement. It is essential for a successful and safe procedure. The nurse should instruct the client to empty their bladder before the test.
Choice C rationale:
The position during an amniocentesis is typically dorsal recumbent or semi-Fowler's position to allow for proper visualization of the fetus and needle placement. Lying on the left side is not a standard position for this procedure, so this information is incorrect and not necessary for the client.
Choice D rationale:
Drinking 50 grams of oral glucose is not a requirement for an amniocentesis procedure. This information is unrelated to the amniocentesis and can be confusing for the client. Therefore, it is not necessary to include this in the instructions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer is Choice B: Administer the medication to the toddler each evening.
Choice B rationale: Montelukast is a leukotriene receptor antagonist used for the long-term management of asthma, especially in preventing nighttime symptoms. It is typically prescribed to be administered once daily in the evening to provide optimal therapeutic benefits. By instructing the parents to give the medication each evening, the nurse promotes adherence to the prescribed dosing schedule and helps maximize the medication's effectiveness in controlling the toddler's asthma symptoms.
Choice A rationale: While some medications can be mixed with juice or other liquids to make them more palatable for children, montelukast should not be dissolved in a drink. Instead, it can be mixed with a spoonful of cold, soft food, such as applesauce or ice cream, if necessary, to facilitate administration. Mixing with juice could potentially alter the medication's efficacy or create an unpleasant taste.
Choice C rationale: Montelukast is not indicated for use as a quick-relief medication prior to physical activity. It is a maintenance medication intended for long-term asthma control rather than immediate relief of acute symptoms. Providing an additional dose of montelukast before physical activity would not serve the intended purpose and could increase the risk of side effects.
Choice D rationale: Montelukast is not meant to be used as a rescue medication for acute asthma attacks. It is a long-term control medication that helps prevent asthma attacks and improve overall symptom management. For acute asthma attacks, the toddler would require a fast-acting beta-agonist or other appropriate rescue medication prescribed by their healthcare provider. Administering montelukast during an acute asthma attack would not provide the rapid relief needed to alleviate symptoms and could potentially delay appropriate treatment.
Correct Answer is D
Explanation
The correct answer is d. Hallucinations.
Choice A reason: Hypothermia is not typically associated with MDMA use. Instead, MDMA can cause hyperthermia due to its stimulant effects.
Choice B reason: Muscle weakness is not a common effect of MDMA. The drug is more likely to cause increased energy and endurance.
Choice C reason: Somnolence, or a strong desire for sleep, is unlikely with MDMA use as it is a stimulant and tends to increase alertness.
Choice D reason: Hallucinations are a known effect of MDMA use, where users may experience distortions in perception. Methylenedioxy-methamphetamine (MDMA) is known to cause perceptual changes, including hallucinations.
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