Nokea
A client asks about the benefits of breastfeeding for contraception. Which of the following responses by the nurse is most accurate?
- A. Breastfeeding is a reliable contraceptive method for the first year postpartum.
- B. The lactational amenorrhea method is effective only if the client is exclusively breastfeeding and amenorrheic.
- C. Breastfeeding prevents ovulation permanently while nursing.
- D. Breastfeeding is equally effective whether the client supplements with formula.
Correct Answer: B
Rationale: The lactational amenorrhea method (LAM) is effective for up to 6 months postpartum if the client is exclusively breastfeeding, amenorrheic, and the infant is under 6 months. It is not reliable for a year, does not permanently prevent ovulation, and is less effective with formula supplementation.
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The nurse and a nursing assistant are caring for clients in a birthing center. Which of the following tasks should the nurse delegate to the nursing assistant? Select all that apply.
- A. Removing a Foley catheter from a preeclamptic client.
- B. Assisting an active labor client with breathing and relaxation.
- C. Ambulating a postcesarean client to the bathroom.
- D. Calculating hourly I.V. totals for a preterm labor client.
- E. Intake and output catheterization for culture and sensitivity.
- F. Calling a report of normal findings to the health care provider.
- G. Removing lunch trays and documenting lunch intake.
Correct Answer: C,G
Rationale: Delegating ambulation and lunch tray removal is appropriate for a nursing assistant.
A primigravida admitted to the hospital with a diagnosis of hyperemesis gravidarum is placed on nothing-by-mouth(NPO) status and is receiving intravenous(IV) fluid replacement therapy. In planning this client's care, the nurse should collaborate with the health care provider(HCP) to carry out which of the following?
- A. Withhold oral fluids indefinitely until acidosis is corrected.
- B. Give oral fluids in small quantities whenever the client desires.
- C. Per HCP orders, provide clear liquids by mouth after 24 hours if vomiting subsides.
- D. Withhold oral fluids until total parenteral nutrition replaces lost electrolytes.
Correct Answer: C
Rationale: Gradual reintroduction of oral fluids is appropriate once vomiting subsides.
A primigravid client whose cervix is 7 cm dilated with the fetus at 0 station and in a left occipitoposterior (LOP) position requests pain relief for severe back pain. The nurse should:
- A. Provide firm pressure to the client's sacral area.
- B. Prepare the client for a cesarean delivery.
- C. Prepare the client for a precipitate delivery.
- D. Place the client in a left side-lying position.
Correct Answer: A
Rationale: LOP position often causes severe back pain due to the fetal occiput pressing against the sacrum. Firm sacral pressure (counterpressure) can alleviate this pain. Cesarean or precipitate delivery is not indicated unless other complications arise, and side-lying may help but is less specific.
A client is considering the cervical cap. Which of the following statements by the nurse is accurate?
- A. The cervical cap can be left in place for up to 72 hours.
- B. The cervical cap does not require spermicide.
- C. The cervical cap requires a prescription and fitting.
- D. The cervical cap is highly effective for women who have given birth.
Correct Answer: C
Rationale: The cervical cap requires a prescription and fitting by a healthcare provider for proper use. It can be left in place for up to 48 hours, requires spermicide, and is less effective for women who have given birth.
While assessing the episiotomy site of a primiparous client on the first postpartum day, the nurse observes a fairly large hemorrhoid at the client's rectum. After instructing the client about measures to relieve hemorrhoid discomfort, which of the following client statements indicates the need for additional teaching?
- A. I should try to gently manually replace the hemorrhoid.
- B. Analgesic sprays and witch hazel pads can relieve the pain.
- C. I should lie on my back as much as possible to relieve the pain.
- D. I should drink lots of water and eat foods that have a lot of roughage.
Correct Answer: C
Rationale: Lying on the back increases pressure on hemorrhoids, worsening discomfort; the other statements reflect correct measures.