What must instructions for use of nonoxynol-9 spermicide include?
- A. Nononxynol-9 used with barrier methods increases their efficacy.
- B. When spermicide is used with condoms, it will further decrease the risk of STIs.
- C. Remove excess spermicide from the vagina within 6 hours to reduce vaginal irritation.
- D. Place the spermicide close to the opening of the vagina for maximal effectiveness.
Correct Answer: C
Rationale: The correct answer, C, states that excess spermicide should be removed from the vagina within 6 hours to reduce vaginal irritation. This is important as leaving excess spermicide can lead to discomfort and irritation. It is a crucial instruction to ensure the user's comfort and safety.
Choice A is incorrect as nonoxynol-9 does not necessarily increase efficacy when used with barrier methods.
Choice B is incorrect because while using spermicide with condoms can reduce the risk of STIs, the statement does not specifically address the instructions for use.
Choice D is incorrect as placing the spermicide close to the vagina's opening does not guarantee maximal effectiveness and is not a critical instruction for safe use.
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While evaluating the reflexes of the newborn, the nurse notes that with a loud noise the newborn symmetrically abduct and extend his arms, his fingers fan out and forms a c with the thumb and forefinger. What does the nurse document?
- A. Positive Moro reflex
- B. Positive Babinski reflex
- C. Rooting reflex
- D. Tonic neck reflex
Correct Answer: A
Rationale: The correct answer is A: Positive Moro reflex. The Moro reflex is elicited by a sudden loud noise or a jarring movement. The newborn symmetrically abducts and extends their arms, followed by fanning out their fingers and forming a "C" shape with the thumb and forefinger. This reflex is an involuntary response that indicates the normal development of the newborn's nervous system. The other choices are incorrect because:
B: Positive Babinski reflex is elicited by stroking the sole of the foot, resulting in the toes fanning out and big toe dorsiflexing.
C: Rooting reflex is elicited by touching the newborn's cheek, causing them to turn their head towards the stimulus and open their mouth to seek food.
D: Tonic neck reflex is elicited by turning the newborn's head to one side, causing extension of the arm on that side and flexion of the opposite arm.
Upon delivery of the newborn, the nursing intervention that most promotes parental attachment is:
- A. Placing the infant under the radiant warmer
- B. Allowing the mother to rest immediately after delivery
- C. Placing the newborn on mother's chest and abdomen
- D. Taking the newborn to the nursery for the initial assessment
Correct Answer: C
Rationale: The correct answer is C: Placing the newborn on mother's chest and abdomen. This promotes parental attachment through skin-to-skin contact, facilitating bonding and emotional connection. It also helps regulate the baby's temperature and encourage breastfeeding. Placing the infant under the radiant warmer (A) may disrupt immediate bonding. Allowing the mother to rest (B) is important, but promoting attachment should be prioritized. Taking the newborn to the nursery (D) can delay the crucial bonding process.
The nurse encourages the patient to begin taking folate prior to trying to conceive. Why would the nurse encourage folate intake?
- A. Taking folate increases the chances of conceiving.
- B. Folate helps prevent neural tube defects.
- C. The nurse is preparing the patient to take vitamins during pregnancy.
- D. Folate decreases miscarriage.
Correct Answer: B
Rationale: The correct answer is B: Folate helps prevent neural tube defects. Folate is crucial for fetal development, particularly in preventing neural tube defects like spina bifida. It should be taken before conception to ensure adequate levels early in pregnancy. A: Taking folate does not directly increase the chances of conceiving. C: The nurse is not preparing the patient to take vitamins during pregnancy, but to prevent birth defects. D: Folate may reduce the risk of certain pregnancy complications but does not directly decrease miscarriage rates.
The nurse is assessing a client with suspected chorioamnionitis. What is the priority nursing assessment?
- A. Assess for foul-smelling vaginal discharge.
- B. Monitor maternal blood pressure.
- C. Evaluate fetal heart rate.
- D. Check maternal glucose levels.
Correct Answer: C
Rationale: The correct answer is C: Evaluate fetal heart rate. In chorioamnionitis, fetal distress can occur due to infection and inflammation of the fetal membranes. Monitoring fetal heart rate is crucial to assess the well-being of the baby. Assessing for foul-smelling discharge (A) is important but not the priority. Monitoring maternal blood pressure (B) and checking glucose levels (D) are relevant assessments but do not address the immediate risk of fetal distress in chorioamnionitis.
A nurse is checking postpartum orders, the doctor prescribed bed rest for 6-12 h. The nurse knows this is an appropriate order if the patient had which type of anesthesia?
- A. Spinal
- B. Pudendal
- C. Epidural
- D. General
Correct Answer: C
Rationale: The correct answer is C: Epidural. The rationale for this is that epidural anesthesia is a regional anesthesia that numbs the lower half of the body while allowing the patient to remain conscious. Therefore, prescribing bed rest for 6-12 hours after receiving an epidural is appropriate to ensure the anesthesia wears off gradually and the patient does not experience any complications while regaining sensation and mobility.
Summary of Incorrect Choices:
A: Spinal anesthesia also numbs the lower half of the body, but it typically wears off faster than an epidural, so bed rest may not be necessary for as long.
B: Pudendal anesthesia is specific to numbing the perineum area and does not affect mobility in the same way as epidural anesthesia.
D: General anesthesia does not target a specific area of the body and does not require bed rest for 6-12 hours postpartum.