Discuss NCLEX NCLEX-RN Exam Topic 4 Question 23

Assessment of parturient reveals the following: cervical dilation 6 cm and station 22; no progress in the last 4 hours. Uterine contractions decreasing in frequency and intensity. Marked molding of the presenting fetal head is described. The physician orders, ''Begin oxytocin induction at 1 mU/min.'' The nurse should:

ABegin the oxytocin induction as ordered

BIncrease the dosage by 2 mU/min increments at15-minute intervals

CMaintain the dosage when duration of contractions is 40--60 seconds and frequency is at 212--4 minute intervals

DQuestion the order

Suggested Answer: D

(A) Oxytocin stimulates labor but should not be used until CPD (cephalopelvic disproportion) is ruled out in a dysfunctional labor. (B) This answer is the correct protocol for oxytocin administration, but the medication should not be used until CPD is ruled out. (C) This answer is the correct manner to interpret effective stimulation, but oxytocin should not be used until CPD is ruled out. (D) This answer is the appropriate nursing action because the scenario presents adysfunctional labor pattern that may be caused by CPD. Oxytocin administration is contraindicated in CPD.

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15 comments · newest first

Pamella 15 days ago

True, but safety first. We can't rush it.

Mendy 20 days ago

But if contractions are weak, we might need to help them along.

Howard 26 days ago

Agreed, the lack of progress worries me.

Pamella 1 month ago

I would choose D. The situation seems concerning with no progress.

Mendy 1 month ago

I think starting oxytocin is fine, but we should monitor closely.

Howard 1 month ago

This scenario is tricky. I feel like we need to be cautious.

Pete 2 months ago

I’m not sure about this; shouldn’t we assess more before starting?

Rebbecca 2 months ago

Definitely should increase the dosage if no progress is made.

Herminia 2 months ago

Wait, is it really safe to start with that low dose?

Renea 2 months ago

I agree, starting at 1 mU/min is standard practice.

Aimee 2 months ago

Sounds like a classic case for oxytocin induction.

Sylvie 2 months ago

I’m leaning towards option B because I think we should gradually increase the dosage, but I’m not entirely confident about the timing intervals.

Josphine 3 months ago

I feel like I read somewhere that if there’s no progress and contractions are weak, we might need to question the order before starting oxytocin.

German 3 months ago

This question reminds me of a practice case where we had to assess the need for oxytocin based on contraction patterns. I think we might need to evaluate the contractions first.

Blossom 3 months ago

I remember studying that oxytocin is used to augment labor, but I’m not sure if we should start it right away with the current situation.

NCLEX-RN Exam - Topic 4 Question 23 Discussion