Nokea
A client is considering the fertility awareness method. Which of the following factors should the nurse discuss as affecting its reliability?
- A. The client's age and parity.
- B. The consistency of the client's menstrual cycle.
- C. The client's history of STIs.
- D. The client's use of hormonal contraceptives.
Correct Answer: B
Rationale: The consistency of the client's menstrual cycle significantly affects the reliability of the fertility awareness method, as irregular cycles make ovulation prediction difficult. Age, parity, STIs, and hormonal contraceptives are less directly relevant.
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A nurse is counseling a client about the use of a vaginal contraceptive ring. Which of the following client statements indicates understanding?
- A. I should remove the ring every night before bed.
- B. The ring is left in place for three weeks, then removed for one week.
- C. I need to replace the ring every two weeks.
- D. The ring protects against HIV transmission.
Correct Answer: B
Rationale: The vaginal contraceptive ring is left in place for three weeks, then removed for one week to allow a withdrawal bleed. It is not removed nightly, replaced every two weeks, or protective against HIV.
Which of the following should the nurse include in the teaching plan for a primiparous client who asks about weaning her neonate?
- A. Wait until you have breast-fed for at least 4 months.
- B. Eliminate the baby's favorite feeding times first.
- C. Plan to omit the daytime feedings last.
- D. Gradually eliminate one feeding at a time.
Correct Answer: D
Rationale: Gradual weaning by eliminating one feeding at a time minimizes discomfort and distress for both mother and baby.
A primiparous client asks how to store breast milk safely at room temperature. The nurse should instruct the client that breast milk can be left at room temperature for up to:
- A. 2 hours.
- B. 4 hours.
- C. 6 hours.
- D. 8 hours.
Correct Answer: C
Rationale: Breast milk is safe at room temperature (up to 77°F) for up to 6 hours, minimizing bacterial growth.
For the past 8 hours, a 20-year-old primigravid client in active labor with intact membranes has been experiencing regular contractions. The fetal heart rate is 136 bpm with good variability. After determining that the client is still in the latent phase of labor, the nurse should observe the client for:
- A. Exhaustion.
- B. Chills and fever.
- C. Fluid overload.
- D. Meconium-stained fluid.
Correct Answer: A
Rationale: Prolonged latent phase (8 hours) in a primigravid client can lead to maternal exhaustion due to sustained effort and lack of progress, impacting labor stamina. Chills/fever, fluid overload, or meconium-stained fluid are less likely without specific risk factors.
A multigravid client at 39 weeks' gestation diagnosed with insulin-dependent diabetes is admitted for induction of labor with oxytocin (Pitocin). Which of the following should the nurse include in the teaching plan as a possible disadvantage of this procedure?
- A. Urinary frequency.
- B. Maternal hypoglycemia.
- C. Preterm birth.
- D. Neonatal jaundice.
Correct Answer: B
Rationale: Oxytocin induction in diabetic clients increases metabolic demand, risking maternal hypoglycemia due to insulin use. Urinary frequency is unrelated, preterm birth is not a concern at 39 weeks, and neonatal jaundice is not directly linked.