Nokea
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." After giving birth, a woman's body goes through changes, including weight loss, which can affect the fit and effectiveness of the diaphragm. It is essential for the client to be refitted by a healthcare provider to ensure proper fit and efficacy of the contraception.
Choice B is incorrect because oil-based lubricants can damage the diaphragm material.
Choice C is incorrect because diaphragms should be kept in place for at least 6 hours after intercourse.
Choice D is incorrect because diaphragms should be stored in a cool, dry place, not in sterile water.
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Which hormone is responsible for triggering milk ejection during breastfeeding?
- A. Progesterone
- B. Estrogen
- C. Prolactin
- D. Oxytocin
Correct Answer: D
Rationale: The correct answer is D: Oxytocin. Oxytocin is responsible for triggering milk ejection during breastfeeding by causing the contraction of muscles around the milk-producing cells, facilitating the release of milk. Progesterone and estrogen are involved in preparing the body for pregnancy and maintaining the uterine lining, not milk ejection. Prolactin stimulates milk production but not milk ejection directly. Therefore, the correct choice is oxytocin as it specifically triggers the release of milk during breastfeeding.
Which of the following is a potential complication of a forceps-assisted delivery?
- A. Fetal distress
- B. Maternal hemorrhage
- C. Neonatal brachial plexus injury
- D. All of the above
Correct Answer: C
Rationale: Forceps-assisted delivery can sometimes result in neonatal brachial plexus injury due to the pressure applied during delivery.
A nurse is caring for a client who reports spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and notices that the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following actions should the nurse take next?
- A. Perform a vaginal examination by applying upward pressure on the presenting part.
- B. Cover the umbilical cord with a sterile saline-saturated towel.
- C. Administer oxygen via nonrebreather mask at 8 L/min.
- D. Initiate an infusion of IV fluids for the client.
Correct Answer: B
Rationale: The correct answer is B: Cover the umbilical cord with a sterile saline-saturated towel. This action is crucial in preventing compression and desiccation of the umbilical cord, which could lead to decreased blood flow and oxygen delivery to the fetus. By covering the cord, the nurse can protect it from further damage while waiting for emergency intervention. Performing a vaginal examination (choice A) could worsen the situation by causing more pressure on the cord. Administering oxygen (choice C) may be important later but is not the immediate priority. Initiating IV fluids (choice D) is not the most urgent action in this scenario.
What is the primary intervention for postpartum hemorrhage?
- A. Oxytocin infusion
- B. Methylergonovine injection
- C. Misoprostol administration
- D. Blood transfusion
Correct Answer: A
Rationale: The correct answer is A: Oxytocin infusion. Oxytocin is the first-line medication for postpartum hemorrhage as it helps to contract the uterus, reducing bleeding. It stimulates uterine contractions, which helps to control bleeding by compressing blood vessels. Methylergonovine (B) is contraindicated in hypertensive disorders, Misoprostol (C) is an alternative if oxytocin is not available, and Blood transfusion (D) is a supportive measure after the bleeding is controlled.
A nurse is performing a routine assessment on a client who is at 18 weeks of gestation. Which of the following findings should the nurse expect?
- A. Deep tendon reflexes 4+.
- B. Fundal height 14 cm.
- C. Blood pressure 142/94 mm Hg.
- D. FHR 152/min.
Correct Answer: D
Rationale: A fetal heart rate (FHR) of 152/min is within the normal range of 110 to 160 beats per minute for a fetus at 18 weeks of gestation.