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A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include?
- A. You should have your provider refit you for a new diaphragm.'
- B. You should use an oil-based vaginal lubricant when inserting your diaphragm.'
- C. You should keep the diaphragm in place for at least 4 hours after intercourse.'
- D. You should store your diaphragm in sterile water after each use.'
Correct Answer: A
Rationale: The correct answer is A: "You should have your provider refit you for a new diaphragm." This is important because postpartum changes in the body can affect the fit of the diaphragm. A refitting ensures proper size and fit for effective contraception. Choice B is incorrect because oil-based lubricants can damage latex diaphragms. Choice C is incorrect as the diaphragm should be kept in place for at least 6-8 hours, not 4 hours, for effective contraception. Choice D is incorrect as diaphragms should be stored dry, not in sterile water, to prevent damage.
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A nurse is preparing to administer metronidazole 2 g PO to a client who has trichomoniasis. Available is metronidazole 250 mg tablets. How many tablets should the nurse administer?
- A. 8 tablets
- B. 4 Tablets
- C. 2 tablets
- D. 1 tablet
Correct Answer: A
Rationale: The correct answer is A: 8 tablets. To calculate the dose, divide the total dose by the dose per tablet. In this case, 2 g equals 2000 mg. Therefore, divide 2000 mg by 250 mg (dose per tablet), which equals 8 tablets. Each tablet contains 250 mg, so to reach the total dose of 2000 mg, the nurse needs to administer 8 tablets. Choice B (4 tablets) is incorrect because it would only provide 1000 mg, not the required 2000 mg. Choice C (2 tablets) would provide only 500 mg, not the required dose. Choice D (1 tablet) would provide only 250 mg, which is insufficient.
A nurse is providing teaching to the parents of a newborn about the Plastibell circumcision technique. Which of the following information should the nurse include?
- A. The Plastibell will be removed 4 hours after the procedure.
- B. Make sure the newborn’s diaper is snug.
- C. Yellow exudate will form at the surgical site in 24 hours.
- D. Notify the provider if the end of your baby’s penis appears dark red.
Correct Answer: D
Rationale: Correct Answer: D. Notify the provider if the end of your baby’s penis appears dark red.
Rationale: Dark red appearance at the end of the baby's penis could indicate infection or poor blood flow, requiring immediate medical attention to prevent complications. This information is crucial for parents to recognize potential risks post-circumcision.
Summary of other choices:
A: The Plastibell is usually removed after a few days, not 4 hours. Incorrect.
B: Snug diapers can cause irritation. Not relevant to Plastibell circumcision. Incorrect.
C: Yellow exudate forming in 24 hours is normal post-circumcision. Not concerning. Incorrect.
A nurse in a provider’s office is caring for a 20-year-old client who is at 12 weeks of gestation and requests an amniocentesis to determine the sex of the fetus. Which of the following responses should the nurse make?
- A. You cannot have an amniocentesis until you are at least 35 years of age.
- B. This procedure determines if your baby has genetic or congenital disorders.
- C. Your provider will schedule a chorionic villus sampling to determine the sex of your baby.
- D. We can schedule the procedure for later today if you’d like.
Correct Answer: B
Rationale: The correct answer is B: This procedure determines if your baby has genetic or congenital disorders. At 12 weeks of gestation, amniocentesis is typically not done to determine the sex of the fetus but rather to identify genetic abnormalities or congenital disorders. Providing this information allows the client to make informed decisions about their pregnancy and potential interventions.
A: You cannot have an amniocentesis until you are at least 35 years of age - This statement is incorrect as age alone is not the sole criteria for recommending amniocentesis.
C: Your provider will schedule a chorionic villus sampling to determine the sex of your baby - Chorionic villus sampling is also not typically done to determine the sex of the fetus.
D: We can schedule the procedure for later today if you’d like - This is incorrect as scheduling an amniocentesis without a medical indication is not appropriate.
A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow.
- A. Palpate the fundus to identify the fetal part.
- B. Determine the location of the fetal back.
- C. Palpate for the fetal part presenting at the inlet.
- D. Identify the attitude of the head.
Correct Answer: A,B,CD
Rationale: The correct sequence for performing Leopold maneuvers is A, B, C, and D. Firstly, palpating the fundus to identify the fetal part helps determine the position of the baby in the uterus. Secondly, determining the location of the fetal back provides information on the baby's position relative to the mother's spine. Thirdly, palpating for the fetal part presenting at the inlet helps identify which part of the baby is entering the birth canal. Lastly, identifying the attitude of the head gives insight into how the baby is positioned within the pelvis for delivery. This sequential approach allows for a systematic assessment of fetal position and presentation. The other choices are incorrect as they do not follow the correct order of Leopold maneuvers, which can lead to inaccurate assessment and potential complications during labor and delivery.
A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?
- A. Administer broad-spectrum antibiotics.
- B. Monitor the rectal temperature every 4 hr.
- C. Cleanse the site with povidone-iodine.
- D. Prepare for surgical closure after 72 hr.
Correct Answer: A
Rationale: Correct Answer: A. Administer broad-spectrum antibiotics.
Rationale: Administering broad-spectrum antibiotics is essential to prevent infection in the newborn with a leaking myelomeningocele. The exposed spinal cord increases the risk of infection, which can lead to serious complications such as meningitis. Antibiotics can help prevent or treat any potential infections.
Incorrect Choices:
B. Monitoring rectal temperature every 4 hours is not the priority in this situation. Infection prevention and management should take precedence.
C. Cleansing the site with povidone-iodine may not be appropriate as it can be irritating to the exposed spinal cord.
D. Surgical closure after 72 hours may be delayed if there is an infection present. Administering antibiotics is crucial before proceeding with surgical closure.