Nokea
A client asks about the risks of the contraceptive patch. Which of the following would the nurse include?
- A. Increased risk of blood clots.
- B. Permanent infertility.
- C. Guaranteed weight loss.
- D. Elimination of menstrual periods.
Correct Answer: A
Rationale: The contraceptive patch may increase the risk of blood clots, especially in smokers or those with risk factors. It does not cause permanent infertility, guarantee weight loss, or eliminate periods (it causes withdrawal bleeding).
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A client asks about the effectiveness of the vaginal contraceptive ring. Which of the following responses by the nurse is accurate?
- A. The ring is 100% effective in preventing pregnancy.
- B. The ring is highly effective when used correctly.
- C. The ring does not require a prescription.
- D. The ring is less effective than condoms.
Correct Answer: B
Rationale: The vaginal contraceptive ring is highly effective when used correctly, with a low failure rate. It is not 100% effective, requires a prescription, and is generally more effective than condoms.
A 29-year-old multigravida at 37 weeks' gestation is being treated for severe preeclampsia and has magnesium sulfate infusing at 3 g/hour. The nurse has determined the priority nursing diagnosis to be: risk for central nervous system injury related to hypertension, edema of cerebrum. To maintain safety for this client, the nurse should:
- A. Maintain continuous fetal monitoring.
- B. Encourage family members to remain at bedside.
- C. Assess reflexes, clonus, visual disturbances, and headache.
- D. Monitor maternal liver studies every 4 hours.
Correct Answer: C
Rationale: Monitoring signs of CNS irritability such as reflexes, clonus, visual disturbances, and headache helps detect worsening preeclampsia.
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.
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 primigravid client at 36 weeks' gestation with premature rupture of the membranes is to be discharged home on bed rest with follow-up by the home health nurse. After instruction about care while at home, which of the following client statements indicates effective teaching?
- A. "It is permissible to douche if the fluid irritates my vaginal area."
- B. "I can take either a tub bath or a shower when I feel like it."
- C. "I should limit my fluid intake to less than 1 quart daily."
- D. "I should contact the doctor if my temperature is 100.4° F or higher."
Correct Answer: D
Rationale: Contacting the doctor for fever is appropriate.