Nokea
A breast-feeding primiparous client asks the nurse how breast milk differs from cow's milk. The nurse responds by saying that breast milk is higher in which of the following?
- A. Fat.
- B. Iron.
- C. Sodium.
- D. Calcium.
Correct Answer: A
Rationale: Breast milk has higher fat content, which is essential for neonatal growth and brain development.
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A nurse is counseling a client about the contraceptive sponge. Which of the following instructions should the nurse include?
- A. Insert the sponge at least 1 hour before intercourse.
- B. Leave the sponge in place for at least 6 hours after intercourse.
- C. Reuse the sponge if it is undamaged.
- D. Apply spermicide to the sponge after insertion.
Correct Answer: B
Rationale: The contraceptive sponge should be left in place for at least 6 hours after intercourse to ensure effectiveness. It should be inserted just before intercourse, cannot be reused, and contains spermicide, so additional application is not needed.
A nurse is counseling a client about the use of a diaphragm for contraception. Which of the following instructions should the nurse include?
- A. Insert the diaphragm up to 6 hours before intercourse.
- B. Remove the diaphragm immediately after intercourse.
- C. Use a spermicide with the diaphragm for each act of intercourse.
- D. Store the diaphragm in a dry, airtight container.
Correct Answer: C
Rationale: Using spermicide with the diaphragm for each act of intercourse is essential for effectiveness. The diaphragm can be inserted up to 6 hours before and left in place for at least 6 hours after intercourse but not more than 24 hours. It should be stored in a clean, dry container, not necessarily airtight.
A client is considering the contraceptive patch. Which of the following instructions should the nurse provide?
- A. Apply a new patch daily for three weeks, then skip a week.
- B. Change the patch weekly for three weeks, then have a patch-free week.
- C. Wear the patch for one month, then replace it.
- D. Apply the patch to the genital area for best results.
Correct Answer: B
Rationale: The contraceptive patch is changed weekly for three weeks, followed by a patch-free week to allow for a withdrawal bleed. It is not applied daily, worn for a month, or placed on the genital area.
A primigravida is admitted to the labor area with ruptured membranes and contractions occurring every 2 to 3 minutes, lasting 45 seconds. After 3 hours of labor, the client's contractions are now every 7 to 10 minutes, lasting 30 seconds. The nurse administers oxytocin (Pitocin) as ordered. The expected outcome of this drug is:
- A. The cervix will begin to dilate 2 centimeters per hour.
- B. Contractions will occur every 2 to 3 minutes, lasting 40 to 60 seconds, moderate intensity, resting tone between contractions.
- C. The cervix will change from firm to soft, efface to 40% to 50%, and move from a posterior to anterior position.
- D. Contractions will be every 2 minutes, lasting 60 to 90 seconds, with intrauterine pressure of 70 mm Hg.
Correct Answer: B
Rationale: Oxytocin is used to augment labor by increasing contraction frequency, duration, and intensity. The expected outcome is regular contractions every 2–3 minutes, lasting 40–60 seconds, with moderate intensity and adequate resting tone, promoting effective labor progression. The other options describe unrealistic or unrelated effects.
After explaining to a primiparous client about the causes of her neonate's cranial molding, which of the following statements by the mother indicates the need for further instruction?
- A. The molding was caused by an overlapping of the baby's cranial bones during my labor.'
- B. The amount of molding is related to the amount and length of pressure on the head.'
- C. The molding will usually disappear in a couple of days.'
- D. Brain damage may occur if the molding doesn't resolve quickly.'
Correct Answer: D
Rationale: Cranial molding is a normal process that resolves within days and does not cause brain damage, indicating the mother needs further instruction.