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A client asks about the risks of long-term oral contraceptive use. Which of the following would the nurse include in the response?
- A. Long-term use eliminates the risk of ovarian cancer.
- B. Long-term use may increase the risk of blood clots.
- C. Long-term use causes permanent infertility.
- D. Long-term use leads to significant weight loss.
Correct Answer: B
Rationale: Long-term use of oral contraceptives may increase the risk of blood clots, especially in smokers or those with other risk factors. It reduces ovarian cancer risk, does not cause permanent infertility, and weight changes vary.
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The physician orders an amnioinfusion for a primigravid client at term who is diagnosed with oligohydramnios. Which of the following should the nurse include in the client's teaching plan about the purpose of this procedure?
- A. To decrease the frequency and severity of variable decelerations.
- B. To minimize the possibility of fetal metabolic alkalosis.
- C. To increase the fetal heart rate accelerations during a contraction.
- D. To raise the amniotic fluid index to more than 15 cm.
Correct Answer: A
Rationale: Amnioinfusion replaces amniotic fluid in oligohydramnios, reducing cord compression and the frequency/severity of variable decelerations. It does not affect metabolic alkalosis, heart rate accelerations, or guarantee a specific fluid index.
A nurse is teaching a client about the use of oral contraceptives. Which of the following instructions should the nurse include?
- A. Take the pill at the same time daily.
- B. Skip pills during menstruation.
- C. Take two pills daily for maximum effectiveness.
- D. Stop taking the pill if you miss one dose.
Correct Answer: A
Rationale: Oral contraceptives should be taken at the same time daily for maximum effectiveness. They are taken continuously (including during menstruation for combination pills), one pill daily, and missing a dose requires specific instructions, not stopping entirely.
Which of the following would lead the nurse to suspect retinopathy of prematurity (ROP) when assessing a neonate at 32 weeks' gestation who weighs 2,000 g ?
- A. Sunken orbital sockets.
- B. Strabismus.
- C. Reaction to bright light.
- D. Constricted retinal vessels.
Correct Answer: D
Rationale: Constricted retinal vessels are a sign of ROP, indicating abnormal retinal vascular development.
The nurse is caring for a term neonate who is diagnosed with patent ductus arteriosus. While performing a physical assessment of the neonate, the nurse anticipates that the neonate will exhibit which of the following?
- A. Decreased cardiac output with faint peripheral pulses.
- B. Profound cyanosis over most of the body.
- C. Loud cardiac murmurs through systole and diastole.
- D. Harsh systolic murmurs with a palpable thrill.
Correct Answer: C
Rationale: Patent ductus arteriosus typically causes a loud, continuous cardiac murmur heard through systole and diastole.
Assessment of a 23-year-old primigravid client at term who is admitted to the birthing unit in active labor reveals that her cervix is 4 cm dilated and 100% effaced. Contractions are occurring every 4 minutes. The nurse is developing a care plan with the client to relieve pain based on the gate-control theory of pain. The nurse should explain which of the following to the client?
- A. Input from the large sensory fibers opens the gate.
- B. Labor pain is a matter of individual perception.
- C. Slow abdominal breathing can open the gate.
- D. The gating mechanism is in the spinal cord.
Correct Answer: D
Rationale: The gate-control theory posits that pain signals are modulated in the spinal cord, where non-painful stimuli (e.g., touch) can 'close the gate' to pain transmission. Input from large fibers closes the gate, perception varies but is not the mechanism, and slow breathing helps manage pain but does not open the gate.