Nokea
A breast-feeding primiparous client with a midline episiotomy is prescribed ibuprofen 200 mg orally. The nurse instructs the client to take the medication:
- A. Before going to bed.
- B. Midway between feedings.
- C. Immediately after a feeding.
- D. When providing supplemental formula.
Correct Answer: C
Rationale: Taking ibuprofen after feeding minimizes the amount of medication in breast milk during the next feeding.
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A nurse is counseling a client about the fertility awareness method. Which of the following client statements indicates a need for further teaching?
- A. I will track my basal body temperature daily.
- B. I will monitor my cervical mucus for changes.
- C. I will avoid intercourse during my fertile days.
- D. I can rely on this method even with irregular cycles.
Correct Answer: D
Rationale: The fertility awareness method is less reliable with irregular cycles, as ovulation is harder to predict. The other statements reflect correct understanding, indicating a need for further teaching about cycle regularity.
While caring for the neonate of a human immunodeficiency virus-positive mother, the nurse prepares to administer an ordered hepatitis B intramuscular injection at 4 hours after birth. Which of the following actions should the nurse do first?
- A. Bathe the neonate with an antibacterial soap.
- B. Place the neonate under a radiant warmer.
- C. Wash the injection site with povidone-iodine (Betadine) solution.
- D. Apply clean gloves before administering the medication.
Correct Answer: D
Rationale: Applying clean gloves ensures infection control and safety during the administration of the injection.
The nurse assesses a swollen ecchymosed area to the right of an episiotomy on a primiparous client 6 hours after a vaginal delivery. The nurse should next:
- A. Apply an ice pack to the perineal area.
- B. Assess the client's temperature.
- C. Have the client take a warm sitz bath.
- D. Contact the physician for orders for an antibiotic.
Correct Answer: A
Rationale: Applying an ice pack reduces swelling and bruising in the perineal area, which is appropriate for the described symptoms.
A client is considering the lactational amenorrhea method (LAM) for contraception. Which of the following conditions must be met for LAM to be effective?
- A. The client must be exclusively breastfeeding, amenorrheic, and less than 6 months postpartum.
- B. The client must be breastfeeding at least once daily and less than 12 months postpartum.
- C. The client must be amenorrheic and supplementing with formula.
- D. The client must be exclusively breastfeeding and have regular periods.
Correct Answer: A
Rationale: LAM is effective when the client is exclusively breastfeeding, amenorrheic, and less than 6 months postpartum, as these conditions suppress ovulation. The other options include factors that reduce its effectiveness, such as formula supplementation or regular periods.
A couple is inquiring about vasectomy as a permanent method of contraception. Which teaching statement would the nurse include in the teaching plan?
- A. Another method of contraception is needed until the sperm count is 0.
- B. Vasectomy is easily reversed if children are desired in the future.
- C. Vasectomy is contraindicated in males with prior history of cardiac disease.
- D. Vasectomy requires only a yearly follow-up once the procedure is completed.
Correct Answer: A
Rationale: After a vasectomy, another contraception method is needed until a follow-up semen analysis confirms a zero sperm count, ensuring sterility.