Nokea
A 24-year-old primigravid client in active labor requests use of the jet hydrotherapy tub to aid in pain relief. The nurse bases the response on the understanding that this therapy is commonly contraindicated for clients with which of the following?
- A. A required membranes.
- B. Multifetal gestation.
- C. Diabetes mellitus.
- D. Hypotonic labor patterns.
Correct Answer: A
Rationale: Jet hydrotherapy (e.g., whirlpool tubs) is contraindicated with ruptured membranes due to the risk of infection from water entering the vaginal canal. Multifetal gestation, diabetes, and hypotonic labor are not absolute contraindications unless other complications are present.
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The nurse is caring for a primiparous client and her neonate immediately after delivery. The neonate was born at 41 weeks' gestation and weighs 4,082 g (9 lb). Assessing for signs and symptoms of which of the following conditions should be a priority in the neonate?
- A. Anemia.
- B. Hypoglycemia.
- C. Delayed meconium.
- D. Elevated bilirubin.
Correct Answer: B
Rationale: Large-for-gestational-age neonates (e.g., 4,082 g) are at risk for hypoglycemia due to increased metabolic demand and potential maternal diabetes. Hypoglycemia screening is a priority. Anemia, delayed meconium, or hyperbilirubinemia are less immediate.
When developing the plan of care for a multigravid client with class III heart disease, which of the following areas should the nurse expect to assess frequently?
- A. Dehydration.
- B. Nausea and vomiting.
- C. Iron-deficiency anemia.
- D. Tachycardia.
Correct Answer: D
Rationale: Class III heart disease indicates significant cardiac limitation, making tachycardia a critical sign of cardiac stress during labor. Frequent assessment ensures early detection of decompensation. Dehydration, nausea, or anemia are less immediate concerns.
A client at 28 weeks' gestation in premature labor was placed on ritodrine(Yutopar). To maintain the pregnancy, the physician orders the client to have 10 mg now, 10 mg in 2 hours, and then 20 mg every 4 hours while contractions persist, not to exceed the maximum daily oral dose of 120 mg. At what time will the client have reached the maximum dose if she begins taking the medication at 10:00 a.m. and follows the physician's order?
- A. 10:00 a.m.
- B. 10:00 p.m.
- C. 12:00 a.m.
- D. 2:00 a.m.
Correct Answer: B
Rationale: The client will reach the maximum dose at 10:00 p.m.
When performing Leopold's maneuvers on a primigravid client, the nurse is palpating the uterus as shown below. Which of the following maneuvers is the nurse performing?
- A. First maneuver.
- B. Second maneuver.
- C. Third maneuver.
- D. Fourth maneuver.
Correct Answer: C
Rationale: The third Leopold's maneuver involves palpating the suprapubic area to determine the presenting part and its engagement, typically performed as described in the context. The first identifies the fundal contents, the second locates the fetal back, and the fourth assesses cephalic prominence.
A primiparous client diagnosed with cystitis at LIM 48 hours postpartum who is receiving intravenous ampicillin asks the nurse, "Can I still continue to breast-feed my baby?" The nurse should tell the client:
- A. You can continue to breast-feed as long as you want to do so.
- B. Alternate your breast-feeding with formula feeding to help you rest.
- C. You'll need to discontinue breast-feeding until the antibiotic therapy is stopped.
- D. You'll need to modify your technique by manually pumping your breasts.
Correct Answer: A
Rationale: Ampicillin is generally safe for breastfeeding, allowing the client to continue without interruption.