Nokea
A client in an obstetrical clinic is discussing using an IUD for contraception with a healthcare provider. Which of the following statements by the client indicates an understanding of the teaching?
- A. An IUD should be replaced annually during a pelvic exam.
- B. I cannot get an IUD until after I've had a child.
- C. I should plan on regaining fertility 5 months after the IUD is removed.
- D. I will check to ensure the strings of the IUD are still present after my periods.
Correct Answer: D
Rationale: The correct answer is D. Checking the strings of the IUD after periods ensures that the device is in place. This indicates understanding of IUD maintenance. Choice A is incorrect because IUDs usually last 3-10 years and do not need annual replacement. Choice B is incorrect because nulliparous women can also use IUDs. Choice C is incorrect as fertility typically returns quickly after IUD removal, not necessarily after 5 months.
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During preterm labor, a client is scheduled for an amniocentesis. The nurse should review which of the following tests to assess fetal lung maturity?
- A. Alpha-fetoprotein (AFP)
- B. Lecithin/sphingomyelin (L/S) ratio
- C. Kleihauer-Betke test
- D. Indirect Coombs' test
Correct Answer: B
Rationale: The correct answer is B: Lecithin/sphingomyelin (L/S) ratio. This test is used to assess fetal lung maturity by determining the ratio of two substances present in amniotic fluid. An L/S ratio of 2:1 or higher indicates mature fetal lungs, reducing the risk of respiratory distress syndrome in preterm infants.
A: Alpha-fetoprotein (AFP) is used to screen for neural tube defects, not fetal lung maturity.
C: Kleihauer-Betke test is used to detect fetal-maternal hemorrhage.
D: Indirect Coombs' test is used to detect antibodies in maternal blood that may attack fetal red blood cells, not assess fetal lung maturity.
In summary, the L/S ratio test is the most appropriate choice to assess fetal lung maturity during preterm labor, as it directly correlates with the development of the fetal lungs.
While assisting with the care of a client in active labor, a nurse observes clear fluid and a loop of pulsating umbilical cord outside the client's vagina. Which of the following actions should the nurse perform first?
- A. Place the client in the Trendelenburg position
- B. Apply finger pressure to the presenting part
- C. Administer oxygen at 10 L/min via a non-rebreather
- D. Call for assistance
Correct Answer: D
Rationale: The correct answer is D: Call for assistance. This is the first action the nurse should take in this emergency situation. Calling for help ensures that additional support and resources are available to manage the situation effectively. Placing the client in the Trendelenburg position (A) is not recommended as it can worsen the prolapsed cord. Applying finger pressure to the presenting part (B) can lead to further complications. Administering oxygen (C) may be necessary but is not the priority when a prolapsed cord is present.
A nurse in a health clinic is reinforcing teaching about contraceptive use with a group of clients. Which of the following client statements demonstrates understanding?
- A. Using a water-soluble lubricant with condoms can help prevent breakage and ensure effectiveness in preventing pregnancy and STIs.
- B. A diaphragm should be removed 2 hours after intercourse.
- C. Oral contraceptives can worsen a case of acne.
- D. A contraceptive patch is replaced once a month.
Correct Answer: A
Rationale: The correct answer is A because using a water-soluble lubricant with condoms can indeed help prevent breakage and maintain effectiveness in preventing pregnancy and STIs. Water-based lubricants are safe to use with condoms as they do not weaken the latex.
Option B is incorrect as a diaphragm should be left in place for at least 6 hours after intercourse, not removed after 2 hours. Option C is also incorrect as oral contraceptives are known to improve acne in many cases. Option D is incorrect as a contraceptive patch is typically replaced weekly, not monthly.
A woman in a women's health clinic is receiving teaching about nutritional intake during her 8th week of gestation. The healthcare provider should advise the woman to increase her daily intake of which of the following nutrients?
- A. Calcium
- B. Vitamin E
- C. Iron
- D. Vitamin D
Correct Answer: C
Rationale: The correct answer is C: Iron. During pregnancy, the body's demand for iron increases to support the growing fetus and placenta. Iron is essential for the production of hemoglobin, which carries oxygen to the baby. Inadequate iron intake can lead to maternal anemia and complications. Calcium is important for bone health, but the focus in the 8th week of gestation should be on iron. Vitamin E is an antioxidant that is important for overall health but not specifically targeted for increased intake in the 8th week of pregnancy. Vitamin D is crucial for calcium absorption and bone health, but iron takes precedence during this stage of pregnancy.
A client who is at 8 weeks of gestation tells the nurse, 'I am not sure I am happy about being pregnant.' Which of the following responses should the nurse make?
- A. I will inform the provider that you are having these feelings.
- B. It is normal to have these feelings during the first few months of pregnancy.
- C. You should be happy that you are going to bring new life into the world.
- D. I am going to make an appointment with the counselor for you to discuss these thoughts.
Correct Answer: B
Rationale: Rationale for Correct Answer B: It is normal to have these feelings during the first few months of pregnancy.
1. Acknowledges client's emotions without judgment.
2. Validates the client's experience as common and normal.
3. Provides reassurance and support.
4. Encourages open communication.
Summary of Incorrect Choices:
A. Not necessary to escalate without client's consent.
C. Invalidates client's feelings and imposes expectations.
D. Implies assumption of severity and may be seen as intrusive.