Nokea
A client is considering the contraceptive implant. Which of the following benefits should the nurse highlight?
- A. It is effective for up to 3 years and reversible.
- B. It provides protection against STIs.
- C. It requires daily administration.
- D. It causes significant weight loss.
Correct Answer: A
Rationale: The contraceptive implant is effective for up to 3 years and is reversible, offering long-term convenience. It does not protect against STIs, require daily administration, or cause significant weight loss.
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The physician orders an intramuscular injection of phytonadione (AquaMEPHYTON) for a term neonate. The nurse explains to the mother that this medication is used to prevent which of the following?
- A. Hypoglycemia.
- B. Hyperbilirubinemia.
- C. Hemorrhage.
- D. Polycythemia.
Correct Answer: C
Rationale: Phytonadione (vitamin K) is administered to newborns to prevent hemorrhagic disease due to low vitamin K levels, which are necessary for blood clotting.
The nurse is caring for a multigravid client who speaks little English. As the nurse enters the client's room, the nurse observes the client panting on the bed and the fetal head crowning. After calling for assistance and helping the client lie down, which of the following actions should the nurse do next?
- A. Tell the client to push between contractions.
- B. Provide gentle support to the fetal head.
- C. Apply gentle upward traction on the neonate's anterior shoulder.
- D. Massage the perineum to stretch the perineal tissues.
Correct Answer: B
Rationale: With the fetal head crowning, providing gentle support prevents rapid expulsion and perineal trauma. Pushing between contractions is incorrect, traction is for shoulder dystocia, and perineal massage is less urgent.
Assessment of a primigravid client reveals cervical dilation at 8 cm and complete effacement. The client complains of severe back pain during this phase of labor. The nurse explains that the client's severe back pain is most likely caused by the fetal occiput being in a position that is identified as which of the following?
- A. Breech.
- B. Transverse.
- C. Posterior.
- D. Anterior.
Correct Answer: C
Rationale: Severe back pain in labor is commonly associated with a posterior occiput position (e.g., occipitoposterior), where the fetal head presses against the maternal sacrum. Breech, transverse, or anterior positions are less likely to cause intense back pain.
A 30-year-old woman, G 4, P 4, has delivered a healthy term female neonate by cesarean delivery due to a nonreassuring fetal heart rate tracing. At 2 hours postpartum, the nurse assesses the client's retention catheter and observes that the client's urine is slightly red tinged. Which of the following should the nurse do next?
- A. Continue to monitor the client's input and output.
- B. Massage the client's fundus gently every 15 minutes.
- C. Assess the placement of the retention catheter.
- D. Contact the client's physician for further orders.
Correct Answer: C
Rationale: Red-tinged urine may indicate catheter trauma or misplacement, requiring assessment of catheter placement.
The nurse is evaluating the client who delivered vaginally 2 hours ago and is experiencing postpartum pain rated 8 on scale of 1 to 10. The client is a G 4, P 4, breast-feeding mother who would like medication to decrease the pain in her uterus. Which of the medications listed on the orders sheet would be the most appropriate for this client?
- A. Aspirin 1,000 mg P.O. q 4 to 6 hour p.r.n.
- B. Ibuprofen 800 mg P.O. q 6 to 8 hour p.r.n.
- C. Colace 100 mg P.O. b.i.d.
- D. Vicodin 1 to 2 tabs P.O. q 4 to 6 hour p.r.n.
Correct Answer: B
Rationale: Ibuprofen is safe for breastfeeding mothers and effective for uterine cramping pain, unlike aspirin (risk of bleeding), Colace (stool softener), or Vicodin (opioid, less preferred due to sedation risks).