Nokea
A client is considering the contraceptive implant. Which of the following side effects should the nurse discuss?
- A. Guaranteed weight loss.
- B. Irregular bleeding and headaches.
- C. Permanent infertility.
- D. Increased risk of ovarian cancer.
Correct Answer: B
Rationale: The contraceptive implant may cause irregular bleeding and headaches, especially initially. It does not guarantee weight loss, cause permanent infertility, or increase ovarian cancer risk.
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The nurse is caring for a primigravid client in active labor who has had two fetal blood samplings to check for fetal hypoxia. The nurse determines that the fetus is showing signs of acidosis when the scalp blood pH is below which of the following?
- A. 7.5.
- B. 7.4.
- C. 7.3.
- D. 7.2.
Correct Answer: D
Rationale: A fetal scalp blood pH below 7.2 indicates acidosis, suggesting fetal hypoxia and the need for intervention. Values above 7.25 are typically reassuring, and 7.2–7.25 may warrant close monitoring.
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.
The nurse in the labor and delivery area receives a telephone call from the emergency room announcing that a multigravid client in active labor is being transferred to the labor area. The client has been successful care, when the client arrives by stretcher, she says, 'I think the baby's coming ... Help!' The fetal skull is crowning. The nurse should obtain which of the following information first?
- A. Estimated date of delivery.
- B. Amniotic fluid status.
- C. Gravida and parity.
- D. Prenatal history.
Correct Answer: A
Rationale: With crowning, delivery is imminent, and confirming the estimated date of delivery ensures the neonate's gestational age is known for resuscitation planning. Fluid status, gravida/parity, and prenatal history are secondary.
A multigravid client admitted to the labor area is scheduled for a cesarean delivery under spinal anesthesia. After instructions by the anesthesiologist, the nurse determines that the client has understood the instructions when she says which of the following?
- A. The medication will be administered while I am in a side-lying position.'
- B. The anesthetic may cause a severe headache which is treatable.'
- C. My blood pressure may increase if I lie down too soon after the injection.'
- D. I can expect immediate anesthesia that can be reversed very easily.'
Correct Answer: B
Rationale: Spinal anesthesia carries a risk of post-dural puncture headache, which is treatable (e.g., with a blood patch). The side-lying position is for epidural, not spinal, anesthesia; blood pressure typically decreases; and spinal anesthesia is not easily reversed.
A full-term neonate is admitted to the normal newborn nursery. The nurse notes a Moro reflex. What should the nurse do next?
- A. Call a code.
- B. Identify this reflex as a normal finding.
- C. Place the neonate on seizure precautions.
- D. Start supplemental oxygen.
Correct Answer: B
Rationale: The Moro reflex is a normal finding in full-term neonates, indicating a healthy neurological response.