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A nurse is reviewing the chart of a client who is 2 days postpartum following a vaginal delivery and reports constipation. Which of the following findings should the nurse identify as a contraindication to the use of a suppository?
- A. Abdominal distention
- B. Third-degree perineal laceration
- C. Vaginal candidiasis
- D. Afterpain
Correct Answer: B
Rationale: A third-degree perineal laceration contraindicates suppositories to avoid further trauma and delayed healing, unlike distention, candidiasis, or afterpain, which are not contraindications.
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A nurse is caring for a client who is postpartum and experiencing hypovolemic shock. Which of the following findings should the nurse expect?
- A. Cool, Clammy skin
- B. Respiratory rate 18/min
- C. Bounding pulses
- D. Urinary output 30 mL/hr
Correct Answer: A
Rationale: Cool, clammy skin results from vasoconstriction in hypovolemic shock, unlike normal respiratory rate, bounding pulses (compensatory tachycardia typical), or low-normal urine output.
A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions should the nurse include in the plan of care?
- A. Instruct the client to stop taking the antiretroviral medications at 32 weeks of gestation.
- B. Use a fetal scalp electrode during labor and delivery.
- C. Bathe the newborn before initiating skin-to-skin contact.
- D. Administer a pneumococcal immunization to the newborn within 4 hr following birth.
Correct Answer: C
Rationale: Bathing the newborn removes maternal fluids, reducing HIV transmission risk, unlike stopping antiretrovirals (continued), scalp electrodes (increase risk), or pneumococcal vaccine (not routine).
A nurse is caring for a client who is in labor and just received epidural anesthesia. The client's blood pressure is 90/50 mm Hg. Which of the following actions should the nurse take?
- A. Turn the client onto their side
- B. Initiate an amnioinfusion for the client
- C. Administer naloxone to the client
- D. Monitor the client's blood pressure every 15 min
Correct Answer: A
Rationale: Turning the client to their side improves uterine blood flow, addressing epidural-induced hypotension, unlike amnioinfusion, naloxone (irrelevant), or monitoring alone.
A nurse is caring for a client who is at 30 weeks of gestation and receiving magnesium sulfate for preeclampsia. The nurse should recognize which of the following manifestations is an adverse reaction to the medication?
- A. Hypertension
- B. Hypoglycemia
- C. Respiratory rate 16/min
- D. Urine output 20 mL/hr
Correct Answer: D
Rationale: Urine output of 20 mL/hr suggests oliguria, risking magnesium toxicity due to poor renal excretion, unlike hypertension (preeclampsia symptom), hypoglycemia (unrelated), or normal respiratory rate.
A nurse is providing teaching to a client who is primigravid and is scheduled to have an abdominal ultrasound. Which of the following statements by the client indicates an understanding of the teaching?
- A. I won't apply perfumed lotion to my abdomen before the test.
- B. I can't have anything to eat after midnight.
- C. I need to take a stool softener the night before the test.
- D. I will drink water before the test until my bladder feels full.
Correct Answer: D
Rationale: A full bladder enhances ultrasound visibility by displacing intestines, unlike avoiding lotion, fasting, or stool softeners, which are not required.