Nokea
A nurse is planning discharge for a client who is 3 days postpartum. Which of the following non pharmacological interventions should the nurse include in the plan of care for lactation suppression?
- A. Place warm, moist packs on the breast.
- B. Apply cabbage leaves to the breast.
- C. Wear a loose-fitting bra.
- D. Put green tea bags on the breasts.
Correct Answer: B
Rationale: The correct answer is B: Apply cabbage leaves to the breast. Cabbage leaves have been shown to help with lactation suppression due to their anti-inflammatory properties. Placing cabbage leaves on the breasts can help reduce milk supply by decreasing blood flow to the area. This method is safe, inexpensive, and easily accessible.
Choice A (Place warm, moist packs on the breast) is incorrect as warmth can actually stimulate milk production. Choice C (Wear a loose-fitting bra) is also incorrect as it does not directly address lactation suppression. Choice D (Put green tea bags on the breasts) is not effective for lactation suppression and may not be safe for the newborn if ingested.
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Which physiological change takes place during the puerperium?
- A. The endometrium begins to undergo alterations necessary for menstruation.
- B. The placenta begins to separate from the uterine wall.
- C. The uterus returns to a pre-pregnant size and location.
- D. The uterus contracts at regular intervals with dilation of the cervix occurring.
Correct Answer: C
Rationale: During the puerperium, the correct physiological change is that the uterus returns to a pre-pregnant size and location (Choice C). This is because after childbirth, the uterus undergoes involution, gradually decreasing in size back to its pre-pregnant state. This process involves the shedding of excess tissue and contraction of uterine muscles. The endometrium (Choice A) does not undergo alterations for menstruation until after the puerperium, as menstruation typically resumes around 6-8 weeks postpartum. The placenta (Choice B) should have been expelled completely during the third stage of labor, so it does not separate during the puerperium. The uterus does contract, but it is not at regular intervals with cervical dilation (Choice D) during the puerperium.
A nurse is caring for a 3-year-old child with strabismus. Which of the following actions should the nurse advise the parents to implement to help prevent amblyopia?
- A. Wear corrective biconcave lenses.
- B. Prevent trauma to the eyes.
- C. Patch the strong eye.
- D. Instill artificial tears.
Correct Answer: C
Rationale: The correct answer is C: Patch the strong eye. Patching the strong eye helps improve vision in the weaker eye, which is essential in preventing amblyopia. By covering the strong eye, the brain is forced to rely on the weaker eye, strengthening its visual acuity. Wearing corrective biconcave lenses may help with refractive errors but does not directly address amblyopia prevention. Preventing trauma to the eyes is important for overall eye health but does not specifically target amblyopia prevention. Instilling artificial tears is used for dry eye syndrome and does not play a role in preventing amblyopia.
A nurse in a prenatal clinic who reports that her menstrual period is 2 wks late. The client appears anxious and asks the nurse if she is pregnant. Which of the following responses should the nurse make?
- A. You can miss your period for several other reasons, describe your typical menstrual cycle.
- B. If you have been sexually active and haven't used protection, it is likely that you are pregnant.
- C. Let's check to see if you have any other signs of pregnancy, have you noticed any abdominal enlargement yet?
- D. Because you have missed your period, you should try taking a home pregnancy test before you start worrying.
Correct Answer: A
Rationale: Correct Answer: A
Rationale: Response A is the most appropriate because it addresses the client's concerns while also gathering more information. By asking the client to describe her typical menstrual cycle, the nurse can explore other potential reasons for the missed period, such as stress or hormonal imbalances. This approach shows empathy and helps the nurse to provide personalized care based on the client's individual situation.
Summary of Other Choices:
B: This response assumes pregnancy without gathering more information or considering other possibilities, potentially causing unnecessary worry or anxiety.
C: Asking about abdominal enlargement is a specific sign of pregnancy and may not be relevant at this early stage. It also does not address the client's anxiety directly.
D: While suggesting a home pregnancy test is important, it does not address the client's anxiety or gather more information about her menstrual cycle.
The parents of a 4-year-old child state that they had an infant die 2 months ago during childbirth.
- A. "Our child wants to go to the cemetery to be with his sister."'
- B. "Our child asks many questions about what happened to the baby's body."'
- C. "Our child is not sleeping,eating or playing lately and we are worried."'
- D. "Our child blames himself for the baby's death because he said he didn't want a baby brother or sister."'
Correct Answer: D
Rationale: The correct answer is D because it reflects a common behavior in children who have experienced a loss - feeling guilty or blaming themselves for the death. This is known as magical thinking, where children associate their thoughts or actions with causing events. Choice A may indicate a desire for connection but doesn't directly address the child's internal struggle with guilt. Choice B shows curiosity but doesn't address the emotional impact on the child. Choice C highlights concerning behaviors but doesn't capture the underlying psychological issue of guilt. Overall, D is the best choice as it directly addresses the child's emotional response to the loss.
A new client's pregnancy is confirmed at 10 weeks gestation. Her history reveals that her first two pregnancies ended in spontaneous abortion at 12 and 20 weeks. She has a 4-year-old and a set of 1-year-old twins. How should the nurse record the client's current gravida and para status?
- A. Gravida 2, para 3
- B. Gravida 4, para 2
- C. Gravida 5, para 2
- D. Gravida 5, para 4
Correct Answer: C
Rationale: The correct answer is C: Gravida 5, para 2. Gravida refers to the total number of pregnancies, including the current one. The client is currently pregnant (1), had two spontaneous abortions (2), a 4-year-old (3), and a set of 1-year-old twins (4-5). Para refers to the number of viable births (past the age of viability). The client has a 4-year-old and a set of 1-year-old twins, totaling 2 live births. Therefore, the correct status is Gravida 5, para 2.
Choice A (Gravida 2, para 3) is incorrect because it does not account for the client's current pregnancy and the twins. Choice B (Gravida 4, para 2) is incorrect as it overlooks the client's previous spontaneous abortions. Choice D (Gravida 5, para 4) is incorrect as it includes all