NURS 327 EXAM: Pain Management During Birth, Exams of Nursing

Download NURS 327 EXAM: Pain Management During Birth and more Exams Nursing in PDF only on Docsity! 1/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED MULTIPLE CHOICE 1. Childbirth preparation can be considered successful if the outcome is described as which of the following? a. Labor was pain-free. b. The birth experiences of friends and families were ignored. c. Only nonpharmacologic methods for pain control were used. d. The client rehearsed labor and practiced skills to master pain. ANS: D Preparation allows the woman to rehearse for labor and to learn new skills to cope with the pain of labor and the expected behavioral changes. Childbirth preparation does not guarantee a pain-free labor. A woman should be prepared for pain and anesthesia-analgesia realistically. Friends and families can be an important source of support if they convey realistic information about labor pain. Women will not always achieve their desired level of pain control by using nonpharmacologic methods alone. PTS: 1 DIF: Cognitive Level: Analysis REF: 281 OBJ: Nursing Process Step: Evaluation MSC: Client Needs: Psychosocial Integrity 2. A woman with a known heroin habit is admitted in early labor. Which drug is contraindicated with opiate- dependent patients? a. Nalbuphine (Nubain) b. Hydroxyzine (Vistaril) c. Promethazine (Phenergan) 2/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED d. Diphenhydramine (Benadryl) ANS: A Nalbuphine may precipitate withdrawal if given to an opiate-dependent woman. Hydroxyzine is an antihistamine with antiemetic effects. Promethazine usually relieves nausea and vomiting. Diphenhydramine is commonly used to relieve pruritus from epidural narcotics. PTS: 1 DIF: Cognitive Level: Understanding REF: 293 OBJ: Nursing Process Step: Planning MSC: Client Needs: Physiologic Integrity 3. A client is admitted to the labor and birth room in active labor; contractions are 4 to 5 minutes apart and last for 30 seconds. The nurse needs to perform a detailed assessment. When is the best time to ask questions or do procedures? a. After the contraction is over b. When it is all right with the coach c. During increment of next contraction d. After administration of analgesic-anesthetic ANS: A Reduce intrusions as much as possible. Longer assessments may span several contractions. The coach is the support person. The woman needs to feel confident in her ability to go through labor and birth, and she should be encouraged to express her own needs and concerns. The increment is the beginning of the next contraction. It is best to stop with questions and procedures during each contraction. An analgesic or anesthetic may cause adverse reactions in the woman, preventing her from answering questions correctly. 5/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED b. more complete pain relief is possible. c. the woman remains fully alert at all times. d. there are no side effects or risks to the fetus. ANS: D Because nonpharmacologic pain management does not include analgesics, adjunct drugs, or anesthesia, it is harmless to the mother and the fetus. There is less pain relief with nonpharmacologic pain management during childbirth. Pain management may or may not alter the length of labor. At times, when pain is decreased, the mother relaxes and labor progresses at a quicker pace. The woman’s alertness is not altered by medication, but the increase in pain will decrease alertness. PTS: 1 DIF: Cognitive Level: Understanding REF: 281 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity 8. The best time to teach nonpharmacologic pain control methods to an unprepared laboring client is during which stage? a. Latent phase b. Active phase c. Second stage d. Transition phase ANS: A The latent phase of labor is the best time for intrapartum teaching because the woman is usually anxious enough to be attentive yet comfortable enough to understand the teaching. During the active phase, the woman is focused internally and unable to concentrate on teaching. During the second stage, the woman is 6/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED focused on pushing. She normally handles the pain better at this point because she is active in doing something to hasten the birth. During transition, the woman is focused on keeping control; she is unable to focus on anyone else or learn at this time. PTS: 1 DIF: Cognitive Level: Understanding REF: 282 OBJ: Nursing Process Step: Planning MSC: Client Needs: Health Promotion and Maintenance 9. The primary side effect of maternal narcotic analgesia in the newborn is: a. tachypnea. b. bradycardia. c. acrocyanosis. d. respiratory depression. ANS: D 7/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED An infant delivered within 1 to 4 hours of maternal analgesic administration is at risk for respiratory depression from the sedative effects of the narcotic. The infant who is having a side effect to maternal analgesics normally would have a decrease in respirations, not an increase. Bradycardia is not the anticipated side effect of maternal analgesics. Acrocyanosis is an expected finding in a newborn and is not related to maternal analgesics. PTS: 1 DIF: Cognitive Level: Understanding REF: 293 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity 10. A client received 25 mg of meperidine (Demerol) intravenously 1 hour before birth. Which drug should the nurse have readily available? a. Naloxone (Narcan) b. Butorphanol (Stadol) c. Nalbuphine (Nubain) d. Promethazine (Phenergan) ANS: A Naloxone (Narcan) reverses narcotic-induced respiratory depression, which may occur with the administration of narcotic analgesia. Phenergan is normally given for nausea. Nubain and Stadol are analgesics given to women in labor. PTS: 1 DIF: Cognitive Level: Application REF: 294 OBJ: Nursing Process Step: Planning MSC: Client Needs: Physiologic Integrity 11. The nerve block used in labor that provides anesthesia to the lower vagina and perineum is a(n): a. local. 10/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED a. Narcotics b. Spinal block c. Epidural anesthesia d. Breathing and relaxation techniques ANS: D Nonpharmacologic methods of pain management may be the best option for a woman in advanced labor. At 8 cm cervical dilation there probably not enough time remaining to administer spinal anesthesia or epidural anesthesia. A narcotic given at this time may reach its peak at about the time of birth and result in respiratory depression in the newborn. PTS: 1 DIF: Cognitive Level: Application REF: 297 OBJ: Nursing Process Step: Planning MSC: Client Needs: Physiologic Integrity 15. A laboring client who imagines her body opening to let the baby out is using a mental technique called: a. imagery. b. effleurage. c. distraction. d. dissociation. ANS: A Imagery is a technique of visualizing images that will assist the woman in coping with labor. Effleurage is self-massage. Distraction can be used in the early latent phase by having the woman involved in 11/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED another activity. Dissociation helps the woman learn to relax all muscles except those that are working. PTS: 1 DIF: Cognitive Level: Understanding REF: 283 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity 16. When giving a narcotic to a laboring client, which statement explains why the nurse should inject the medication at the beginning of a contraction? a. The medication will be rapidly circulated. b. Less medication will be transferred to the fetus. c. The maternal vital signs will not be adversely affected. d. Full benefit of the medication is received during that contraction. ANS: B Injecting at the beginning of a contraction, when blood flow to the placenta is normally reduced, limits transfer to the fetus. It will not increase the circulation of the medication. It will not alter the vital signs any more than giving it at another time. The full benefit will be received by the woman, but it will decrease the amount reaching the fetus. PTS: 1 DIF: Cognitive Level: Application REF: 293, 294 OBJ: Nursing Process Step: Implementation MSC: Client Needs: Physiologic Integrity 17. The method of anesthesia in labor that is considered the safest for the fetus is: a. epidural block. b. pudendal block. 12/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED c. local infiltration. d. spinal (subarachnoid) block. ANS: C Local infiltration of the perineum rarely has any adverse effects on the mother or the fetus. With an epidural, pudendal, or spinal block the fetus can be affected by maternal side effects and maternal hypotension. PTS: 1 DIF: Cognitive Level: Understanding REF: 295 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Physiologic Integrity 18. To improve placental blood flow immediately after the injection of an epidural anesthetic, the nurse should: a. give the woman oxygen. b. turn the woman to the right side. c. decrease the intravenous infusion rate. d. place a wedge under the woman’s right hip. ANS: D Tilting the woman’s pelvis to the left side relieves compression of the vena cava and compensates for a lower blood pressure without interfering with dispersal of the epidural medication. Oxygen administration will not improve placental blood flow. The woman needs to maintain the supine position for proper dispersal of the medication. However, placing a wedge under the hip will relieve compression of the 15/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) evidence-based practice guidelines note that maternal blood pressure and fetal heart tones should be assessed following any bolus of additional medication via the epidural route. Obtaining a pain scale response is not typically used for the laboring client but used for postoperative and/or chronic pain clients. Intake and output should be documented as part of the clinical record but is not the priority intervention based on this client’s situation. Increasing the flow rate of parenteral fluids requires a physician’s order, and there is no clinical evidence that this is needed. Giving parenteral fluids in excess can lead to fluid retention and fluid volume excess. PTS: 1 DIF: Cognitive Level: Analysis REF: 285 OBJ: Nursing Process Step: Implementation MSC: Client Needs: Safe and Effective Care Environment/Establishing Priorities 22. The process of labor places significant metabolic demands on the obstetric client. Which physiologic findings would be expected? a. Decreased maternal blood pressure as a result of stimulation of alpha receptors b. Uterine vasoconstriction as a result of stimulation of beta receptors c. Increased maternal demand for oxygen d. Increased blood flow to placenta because of catecholamine release ANS: C With regard to labor, one would expect to see an increase in maternal blood pressure because of stimulation of alpha receptors. Uterine vasoconstriction would occur in response to stimulation of alpha receptors. One would expect to see a decrease in blood flow to the placenta. The maternal metabolic rate is increased during labor, along with an increase in maternal demand for oxygen. PTS: 1 DIF: Cognitive Level: Analysis REF: 279 OBJ: Nursing Process Step: Assessment 16/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED MSC: Client Needs: Physiologic Integrity/Physiologic Adaptation 23. A labor client, gravida 2, para 1, at term has received meperidine (Demerol) for pain control during labor. Her most recent dose was 15 minutes ago and birth is now imminent. Maternal vital signs have been stable and the EFM tracing has not shown any baseline changes. Which medication does the nurse anticipate would be required in the birth room for administration? a. Oxytocin (Pitocin) b. Naloxone (Narcan) c. Bromocriptine (Parlodel) d. Oxygen ANS: B Because birth is imminent, and considering that the client has had a recent dose of narcotics, the nurse anticipates that naloxone (Narcan) will be administered to the newborn to combat the effects of the opioid. Although Pitocin will be given following birth of the placenta, the newborn will be delivered prior to that and will receive priority intervention. Parlodel is not typically given in the labor and birth area any more. It was previously used to suppress lactation. At present, there is no need for the administration of oxygen because there is no evidence that the mother is showing any signs of respiratory depression. PTS: 1 DIF: Cognitive Level: Analysis REF: 291 OBJ: Nursing Process Step: Planning MSC: Client Needs: Physiologic Integrity/Physiologic Adaptation 24. Which statement is true with regard to the type of pain associated with childbirth experience? a. Pain is constant throughout the labor experience. 17/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED b. Labor pain during childbirth is considered to be an abnormal response. c. Pain associated with childbirth is self-limiting. d. Pain associated with childbirth does not allow for adequate preparation. ANS: C The pain associated with childbirth is self-limiting in that it typically stops once the child is delivered. Pain is intermittent during the labor experience. Labor pain is considered to be a normal response during childbirth. Pregnant woman can prepare for the expected pain of childbirth by taking prepared childbirth classes and using relaxation techniques during the course of labor. PTS: 1 DIF: Cognitive Level: Analysis REF: 278 OBJ: Nursing Process Step: Planning MSC: Client Needs: Physiologic Integrity/Physiologic Adaptation 25. A pregnant woman is in the second stage of labor and is actively pushing. What type of pain would she be most likely to experience? a. Deep, poorly localized pain b. Visceral pain c. Slow, dull, aching pain d. Somatic pain ANS: D Somatic pain is quick, sharp, and precisely localized and is seen during the second stage of labor. Deep, poorly localized pain is associated with visceral pain, which predominates during the first stage of 20/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED b. Tell the client that she will not need any pain medication because the birth will be over in a matter of minutes and the pain will stop. c. Assist the client with nonpharmacologic methods of pain distraction during this time as you prepare for vaginal birth. d. Call the physician for admitting orders. ANS: C By assisting the client with nonpharmacologic methods of pain distraction, the nurse is focusing on the client’s needs while still preparing for vaginal birth. The client presents in an emergent situation with birth being imminent. Thus, there is not enough time to administer an epidural. Telling the client that she will not need any pain medication because the birth will be over soon does not address the client’s concerns of apprehension and therefore is not therapeutic. Because this is an emergency birth situation, the nurse should be attending to the client. If needed, another nurse and/or supervisor can contact the physician. PTS: 1 DIF: Cognitive Level: Analysis REF: 287 OBJ: Nursing Process Step: Planning MSC: Client Needs: Safe and Effective Care Environment 29. A labor client has brought in with her a picture of her two children and asks the nurse to place it on the wall so that she can look at it during labor contractions. This is an example of: a. focal point. b. distraction. c. effleurage. d. relaxation. 21/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED ANS: A The use of a focal point (image and/or point reference in the labor room) is an example of nonpharmacologic pain control during labor. The image of the client’s children is not serving as a method of distraction. Effleurage is the use of massage techniques to minimize pain perception. The image of the client’s children is not serving as a method of relaxation. PTS: 1 DIF: Cognitive Level: Application REF: 283 OBJ: Nursing Process Step: Planning MSC: Client Needs: Health Promotion and Maintenance 30. A pregnant woman in labor is quite anxious and has been breathing rapidly during contractions. She now complains of a tingling sensation in her fingers. What is the priority nursing intervention? a. Perform a vaginal exam to denote progress. b. Reposition the client to a side lying position. c. Instruct the client to breathe into her cupped hands. d. Notify the physician about current findings. ANS: C This client is exhibiting signs of hyperventilation associated with a rapid breathing pattern, which can occur during the labor process. The nurse should instruct the client to breathe into her cupped hands to retain carbon dioxide that is being lost from the hyperventilation process. A vaginal exam is not indicated because there is no evidence of fetal distress and/or change in labor progress. Repositioning the client may be an option but is not the priority intervention at this time. Notifying the physician is not appropriate at this time because the RN should attend to actions that are readily available to her based on her scope of practice and standard of care. The physician may have to be notified once the intervention has been performed. PTS: 1 DIF: Cognitive Level: Analysis REF: 285 22/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED OBJ: Nursing Process Step: Implementation MSC: Client Needs: Safe and Effective Care Environment 31. Your laboring client has asked that you help her to use a cutaneous stimulation strategy for pain management, you would then: a. assist her into the shower. b. apply a heat pack to lower back. c. help her to create a relaxing mental scene. d. encourage cleansing breaths and slow-paced breathing. ANS: B Cutaneous stimulation includes self-massage, massage by others, counterpressure, touch, thermal stimulation, and acupressure. A shower, tub, or whirlpool are forms of hydrotherapy; creating a relaxed mental scene is mental stimulation. The use of cleansing breaths and patterned breathing is part of breathing techniques for labor. PTS: 1 DIF: Cognitive Level: Application REF: 282 OBJ: Nursing Process Step: Implementation MSC: Client Needs: Health Promotion and Maintenance 32. To relieve a mild postdural puncture headache, the nurse should encourage the intake of: a. milk. b. orange juice. 25/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED d. Encourage the patient to try to suppress her noisiness during contractions. ANS: A Women should be encouraged to express themselves in any way they find comforting, and the diversity of their expressions must be respected. Loud and vigorous expression may be a woman’s personal pain coping mechanism, whereas a quiet woman may need medication relief but feels the need to remain stoic. Accepting a woman’s individual response to labor and pain promotes a therapeutic relationship. Restraint is difficult because noisy women are challenging to work with and may disturb others. PTS: 1 DIF: Cognitive Level: Application REF: 280 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance 36. A multipara’s labor plan includes the use of jet hydrotherapy during the active phase of labor. What is the priority patient assessment prior to assisting the patient with this request? a. Maternal pulse b. Maternal temperature c. Maternal blood pressure d. Maternal blood glucose level ANS: B A shower, tub bath, or whirlpool bath is relaxing and provides thermal stimulation. Several studies have shown benefits of water therapy during labor, including immersion in a tub or whirlpool (jet hydrotherapy, or Jacuzzi). The major concern about immersion therapy has been newborn and postpartum maternal infections caused by microorganisms in the water. Infections can be caused by the woman’s own ascending 26/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED vaginal bacteria or by preexisting organisms in an improperly cleaned tub. However, several studies have not found a significant association between newborn or postpartum maternal infections and the use of immersion hydrotherapy with proper cleaning. PTS: 1 DIF: Cognitive Level: Application REF: 283 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance 37. A patient in active labor requests an epidural for pain management. What is the nurse’s priority action for this patient? a. Assess the fetal heart rate pattern over the next 30 minutes. b. Take the patient’s blood pressure every 5 minutes for 15 minutes. c. Determine the patient’s contraction pattern for the next 30 minutes. d. Initiate an IV infusion of lactated Ringer’s solution at 2000 mL/hr over 30 minutes. ANS: D Rapid infusion of a nondextrose IV solution, often warmed, such as lactated Ringer’s or normal saline, before initiation of the block fills the vascular system to offset vasodilation. Preload IV quantities are at least 500 to 1000 mL infused rapidly. Vasodilation with corresponding hypotension can reduce placental perfusion and is most likely to occur within the first 15 minutes after the initiation of the epidural. Determining the fetal heart rate every 30 minutes is the standard of care. The patient is in active labor, which indicates a contraction pattern resulting in cervical dilation. PTS: 1 DIF: Cognitive Level: Analysis REF: 289 OBJ: Nursing Process Step: Analysis MSC: Client Needs: Health Promotion and Maintenance 38. Meperidine (Demerol), 50 mg IV, has been ordered for a laboring patient. The patient is contracting every 3 minutes, with a duration of 45 to 60 seconds. What is the nurse’s best plan for administering the 27/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED IV medication? a. Inject the medication between two contractions. b. Inject the medication during and after a single contraction. c. Inject the medication at the start of the next two contractions. d. Inject the medication throughout the duration of a single contraction. ANS: C The suggested administration of IV Demerol is 25 mg/min and therefore will need to be administered over the course of two contractions. Opioid analgesics are given in small frequent doses by the IV route during labor to provide a rapid onset of analgesia and predictable duration of action. The woman will benefit from rapid pain control, with less likelihood of neonatal respiratory depression. Starting the injection at the beginning of the contraction, when blood flow to the placenta is normally reduced, limits transfer to the fetus. When placental blood flow resumes, more of the drug is in maternal tissues. PTS: 1 DIF: Cognitive Level: Analysis REF: 293 OBJ: Nursing Process Step: Analysis MSC: Client Needs: Health Promotion and Maintenance MULTIPLE RESPONSE 39. You are preparing a client for epidural placement by a nurse anesthetist in the LDR. Which interventions should be included in the plan of care? (Select all that apply.) a. Administer a bolus of 500 to 1000 mL of D5 normal saline prior to catheter placement. b. Have ephedrine available at bedside during catheter placement. c. Monitor blood pressure of client frequently during catheter insertion and for the first 15 minutes of epidural administration. 30/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED d. Administer oxygen at 8 to 10 L/min per face mask. e. Administer IV ephedrine in 5- to 10-mg increments as prescribed. ANS: C, D, E If hypotension occurs after an epidural has been placed, techniques such as a rapid nondextrose IV fluid bolus, maternal repositioning, and oxygen administration are implemented. If those interventions are ineffective, IV ephedrine in 5- to 10-mg increments can be prescribed to promote vasoconstriction to raise the blood pressure. The client in active labor should not be encouraged to drink fluids. In a Trendelenburg position, the body is flat, with the feet elevated. This would not be a position to use for a pregnant client. PTS: 1 DIF: Cognitive Level: Application REF: 289 OBJ: Nursing Process Step: Planning MSC: Client Needs: Physiologic Integrity 42. The nurse is preparing a client for a cesarean section scheduled to be done under general anesthesia. Which should the nurse plan to administer, if ordered by the health care provider, to prevent aspiration of gastric contents?(Select all that apply.) a. Citric acid (Bicitra) b. Ranitidine (Zantac) c. Hydroxyzine (Vistaril) d. Glycopyrrolate (Robinul) e. Promethazine (Phenergan) ANS: A, B, D 31/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED To prevent aspiration of gastric contents during general anesthesia administration of medications to raise the gastric pH and make secretions less acidic, such as citric acid (Bicitra) and ranitidine (Zantac) may be prescribed. In addition, medications to reduce secretions, such as glycopyrrolate (Robinul) may be prescribed. Hydroxyzine (Vistaril) and promethazine (Phenergan) are used to prevent and relieve nausea often associated with opioids. PTS: 1 DIF: Cognitive Level: Analysis REF: 296 OBJ: Nursing Process Step: Planning MSC: Client Needs: Physiologic Integrity MATCHING Match each term with the correct definition. a. Pressure applied to specific pressure points using hands, rollers, balls, or other equipment b. Contraction and then release of specific muscle groups until all muscles are relaxed c. Concentrating on something outside the body 43. Focal point 44. Acupressure 45. Progressive relaxation 43. ANS: C PTS: 1 DIF: Cognitive Level: Understanding REF: 291 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance NOT: Progressive relaxation is contraction and then release of specific muscle groups until all muscles are relaxed. Acupressure is pressure applied to specific pressure points using hands, rollers, balls, or other equipment. A focal point is concentrating on an object outside the body and away from the pain of contractions. 32/33 NURS 327 EXAM: Pain Management During Birth QUESTIONS AND ANSWERS 2023A+PASS GUARANTEED 44. ANS: A PTS: 1 DIF: Cognitive Level: Understanding REF: 291 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance NOT: Progressive relaxation is contraction and then release of specific muscle groups until all muscles are relaxed. Acupressure is pressure applied to specific pressure points using hands, rollers, balls, or other equipment. A focal point is concentrating on an object outside the body and away from the pain of contractions. 45. ANS: B PTS: 1 DIF: Cognitive Level: Understanding REF: 283 OBJ: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance NOT: Progressive relaxation is contraction and then release of specific muscle groups until all muscles are relaxed. Acupressure is pressure applied to specific pressure points using hands, rollers, balls, or other equipment. A focal point is concentrating on an object outside the body and away from the pain of contractions. SHORT ANSWER 46. The health care provider’s prescription reads diphenhydramine (Benadryl), 25 mg IV stat. The medication vial reads diphenhydramine (Benadryl), 50 mg/mL. The nurse should prepare how many milliliters to administer the correct dose? Record your answer to one decimal point. mL ANS: 0.5 mL Desired/available  volume = milliliters per dose 25 mg/50 mg  1 mL = 0.5 mL/per dose PTS: 1 DIF: Cognitive Level: Application REF: 283 OBJ: Nursing Process Step: Implementation