Nokea
A client asks about the use of over-the-counter contraceptives. Which of the following would the nurse recommend?
- A. Spermicides and male condoms.
- B. Female condoms and oral contraceptives.
- C. The contraceptive sponge and the patch.
- D. Emergency contraception pills and the diaphragm.
Correct Answer: A
Rationale: Spermicides and male condoms are available over-the-counter and effective when used correctly. Female condoms are also over-the-counter, but oral contraceptives, the patch, and diaphragms require prescriptions. Emergency contraception is over-the-counter but not for regular use.
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The health care provider has performed an amniotomy on a laboring client. Which of the following details must be included in the documentation of this procedure? Select all that apply.
- A. Time of rupture.
- B. Color and clarity of fluid.
- C. Fetal heart rate (FHR) and pattern before and after the procedure.
- D. Size of amnio-hook used during the procedure.
- E. Odor and amount of fluid.
Correct Answer: A,B,C,E
Rationale: Documentation of an amniotomy includes the time, fluid characteristics (color, clarity, odor, amount), and fetal heart rate before and after to assess fetal response. The size of the amnio-hook is not clinically relevant.
A multigravid client at 34 weeks' gestation visits the hospital because she suspects that her water has broken. After testing the leaking fluid with nitrazine paper, the nurse confirms that the client's membranes have ruptured when the paper turns which of the following colors?
- A. Yellow.
- B. Green.
- C. Blue.
- D. Red.
Correct Answer: C
Rationale: Nitrazine paper turns blue in the presence of amniotic fluid.
Which of the following nursing diagnoses would be the priority for a multigravid diabetic client at 38 weeks' gestation who is scheduled for labor induction with oxytocin (Pitocin)?
- A. Risk for deficient fluid volume related to oxytocin infusion.
- B. Pain related to prolonged labor and uterine ischemia.
- C. Fear related to possible need for cesarean delivery.
- D. Risk for injury, maternal or fetal, related to potential uterine hyperstimulation.
Correct Answer: D
Rationale: Oxytocin can cause uterine hyperstimulation, risking maternal or fetal injury (e.g., fetal hypoxia). This is the priority in a diabetic client due to increased fetal vulnerability. Fluid volume, pain, and fear are less immediate.
A multigravid client in active labor at term is diagnosed with polyhydramnios. The physician has instructed the client about possible neonatal complications related to the polyhydramnios. The nurse determines that the client has understood the instructions when the client states that polyhydramnios is associated with which of the following in the fetus or neonate?
- A. Renal dysfunction.
- B. Intrauterine growth retardation.
- C. Pulmonary hypoplasia.
- D. Gastrointestinal disorders.
Correct Answer: D
Rationale: Polyhydramnios is associated with fetal gastrointestinal disorders (e.g., esophageal atresia) that impair amniotic fluid absorption. Renal dysfunction, growth retardation, or pulmonary hypoplasia are more linked to oligohydramnios.
A primigravid client with insulin-dependent diabetes tells the nurse that the contraction stress test performed earlier in the day was suspicious. The nurse interprets this test result as indicating that the fetal heart rate pattern showed which of the following?
- A. Frequent late decelerations.
- B. Decreased fetal movement.
- C. Inconsistent late decelerations.
- D. Lack of fetal movement.
Correct Answer: C
Rationale: Suspicious results indicate inconsistent late decelerations.