Chapter 55: Postpartum and Newborn Drugs Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 55: Postpartum and Newborn Drugs

Test Bank

MULTIPLE CHOICE

1. A client complains of constipation during the postpartum period. Which nursing intervention would be highest priority to include in the clients plan of care?

a.

Drink 3 to 4 glasses of fluid per day.

b.

Limit activity.

c.

Eat beans or cabbage.

d.

Avoid using laxatives for longer than a week.

ANS: D

Laxative use should be limited to 1 week to prevent adverse effects. Activity should be encouraged to promote peristalsis. The client should drink at least 6 to 8 glasses of fluid per day and should avoid foods that promote gas, such as beans or cabbage.

DIF: Cognitive Level: Application REF: p. 856

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Postpartal Care

2. The nurse is caring for a newborn immediately after birth. The highest priority nursing intervention to prevent bleeding is to:

a.

administer feeding formula that contains iron.

b.

order clotting factor studies after birth.

c.

wrap the baby in double blankets.

d.

administer vitamin K.

ANS: D

Because neonates have a sterile gut, they do not make vitamin K and must receive it to prevent bleeding.

DIF: Cognitive Level: Application REF: p. 858

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. The client expresses concern to the nurse about her need for an effective nonpharmacologic measure during the postpartum period to promote bowel function and prevent constipation. What is the nurses best recommendation to the client?

a.

Rest on left side in bed during the first 6 to 8 hours after delivery.

b.

Order cottage cheese on meal tray to promote bowel flora.

c.

Drink a minimum of 24 ounces of fluid per day.

d.

Do not attempt early defecation because urge sensation can present as referred pain.

ANS: C

Hydration allows for softer stools, which helps prevent constipation and facilitates bowel function.

DIF: Cognitive Level: Application REF: p. 853

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Postpartal Care

4. The nurse is developing a client teaching session about the use of witch hazel in the postpartum period. What is the most accurate instruction that the nurse can provide?

a.

Contact a healthcare provider if perineal discomfort does not improve within 7 days.

b.

Warm commercial witch hazel pads to increase analgesic properties.

c.

Pour lukewarm liquid witch hazel into a cup and soak gauze squares in solution before application.

d.

Insert medicated pads gently into the rectum if hemorrhoids are present.

ANS: A

The primary healthcare provider should be contacted if the client does not obtain relief in 7 days.

DIF: Cognitive Level: Application REF: p. 852

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. How should the nurse interpret a rubella titer of 1:6/1:10?

a.

The rubella vaccine is likely to cause anaphylactic reaction.

b.

The rubella vaccine will likely be ineffective with this client.

c.

The client has no need for the rubella vaccine.

d.

The client has a need for the rubella vaccine.

ANS: D

A rubella titer of less than 1:8/1:10 (agency lab), negative, or not immunized indicates need for rubella vaccine administration.

DIF: Cognitive Level: Application REF: p. 860

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Immunizations

6. Which baby would not be a candidate to receive Rho (D) immune globulin (RhoGAM)?

a.

Direct Coombs test positive

b.

Mother is indirect Coombs test negative

c.

Rho(D) positive

d.

Rho(D) negative

ANS: A

Positive Coombs test indicates no antigen-antibody response.

DIF: Cognitive Level: Application REF: pp. 854, 857-858

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Postpartal Care

7. The instruction that would be contraindicated for women with fourth-degree perineal lacerations is to use:

a.

topical witch hazel.

b.

rectal suppositories.

c.

peribottles frequently.

d.

sitz baths frequently.

ANS: B

To prevent the risk of infection, rectal suppositories should not be used by women with fourth-degree perineal lacerations.

DIF: Cognitive Level: Application REF: p. 850

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Immunizations

8. A client is experiencing postpartum discomfort. Three days postpartum, which analgesic will the nurse offer first?

a.

Morphine

b.

Meperidine

c.

Ibuprofen

d.

Aspirin

ANS: C

By 3 days postpartum, ibuprofen is the appropriate choice of medication.

DIF: Cognitive Level: Application REF: pp. 849-850

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Postpartal Care

9. A nurse is teaching a woman about the care of her newborns umbilical cord. Which reflects the current recommendations?

a.

The use of triple dye

b.

Dry cord care

c.

The use of alcohol

d.

The use of bacitracin ointment

ANS: B

Current literature supports dry cord care with no agents applied.

DIF: Cognitive Level: Application REF: p. 858

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Postpartal Care

10. A woman with a newborn elects not to breastfeed. Which measure will most effectively assist in suppressing her milk supply?

a.

Stimulation of the breasts

b.

Restriction of fluid intake

c.

A supportive bra worn at all times

d.

Heat applied to the breasts

ANS: C

Presently, nonpharmacologic measures (wearing a supportive bra 24 hr/day for 10 to 14 days, breast binding, and axillary ice packs) are recommended for lactation suppression.

DIF: Cognitive Level: Application REF: pp. 850, 853

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Postpartal Care

11. The client is scheduled to be treated with bisacodyl (Dulcolax) to promote postpartum bowel function. What is the most important instruction that the nurse should give the client?

a.

Always crush the tablets.

b.

Give within 1 hour of drinking milk.

c.

Never crush the tablets.

d.

Give within 1 hour of taking an antacid.

ANS: C

Do not crush tablets (enteric coated). Do not administer within 1 h of milk or antacid, because enteric coating may dissolve, resulting in abdominal cramping and vomiting.

DIF: Cognitive Level: Application REF: pp. 855-856

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Postpartal Care

12. The client has a perineal wound as a result of a laceration that occurred during the birth process. What is the most accurate nonpharmacologic measure that the nurse teaches the client to use for relief?

a.

Warm sitz bath 2 to 3 hours after delivery

b.

Cool sitz bath 12 to 24 hours after delivery

c.

Client positioned supine or prone

d.

Early and frequent ambulation

ANS: D

Early and frequent ambulation will assist in relief; cool sitz baths should be used 2 to 3 hours after delivery, with warm sitz baths used 12 to 24 hours after delivery; the client should be positioned on her side.

DIF: Cognitive Level: Application REF: p. 854

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Health Promotion and Maintenance: Postpartal Care

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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