Nokea
A client asks about the risks of the hormonal IUD. Which of the following would the nurse include?
- A. Increased risk of breast cancer.
- B. Irregular bleeding, especially initially.
- C. Permanent infertility.
- D. Guaranteed regular menstrual cycles.
Correct Answer: B
Rationale: The hormonal IUD may cause irregular bleeding, especially initially, which often decreases over time. It does not increase breast cancer risk, cause permanent infertility, or guarantee regular cycles.
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After being treated with heparin therapy for thrombophlebitis, a multiparous client who delivered 4 days ago is to be discharged on oral warfarin (Coumadin). After teaching the client about the medication and possible effects, which of the following client statements indicates successful teaching?
- A. I can take two aspirin if I get uterine cramps.
- B. Protamine sulfate should be available if I need it.
- C. I should use a soft toothbrush to brush my teeth.
- D. I can drink an occasional glass of wine if I desire.
Correct Answer: C
Rationale: Using a soft toothbrush minimizes bleeding risk, a key consideration with warfarin.
During a scheduled cesarean delivery of a primigravid client with a fetus at 39 weeks' gestation in a breech presentation, a neonatologist is present in the operating room. The nurse explains to the client that the neonatologist is present because neonates born by cesarean delivery tend to have an increased incidence of which of the following?
- A. Congenital anomalies.
- B. Pulmonary hypertension.
- C. Meconium aspiration syndrome.
- D. Respiratory distress syndrome.
Correct Answer: D
Rationale: Cesarean delivery, especially without labor, increases the risk of respiratory distress syndrome due to retained lung fluid. Breech presentation may exacerbate this. Congenital anomalies, pulmonary hypertension, and meconium aspiration are less directly related.
A client asks about the disadvantages of oral contraceptives. Which of the following would the nurse include?
- A. They must be taken at the same time daily for maximum effectiveness.
- B. They provide long-term contraception for up to 5 years.
- C. They are highly effective without side effects.
- D. They protect against STIs.
Correct Answer: A
Rationale: Oral contraceptives must be taken at the same time daily for maximum effectiveness, as timing affects hormone levels. They are short-term (daily), have potential side effects, and do not protect against STIs.
A laboring client at -2 station has a spontaneous rupture of the membranes and a cord immediately protrudes from the vagina. The nurse should first:
- A. Place gentle pressure upward on the fetal head.
- B. Place the cord back into the vagina to keep it moist.
- C. Begin oxygen by face mask at 8 to 10 L/min.
- D. Turn the client on her left side.
Correct Answer: A
Rationale: Gentle pressure prevents cord compression.
A primiparous client who underwent a cesarean delivery 30 minutes ago is to receive Rho(D) immune globulin (RhoGAM). The nurse should administer the medication within which of the following time frames after delivery?
- A. 8 hours.
- B. 24 hours.
- C. 72 hours.
- D. 96 hours.
Correct Answer: C
Rationale: RhoGAM should be administered within 72 hours postpartum to prevent Rh sensitization.