Nokea
A client is considering the withdrawal method. Which of the following client statements indicates understanding?
- A. It requires careful timing and control.
- B. It is more effective than oral contraceptives.
- C. It provides protection against STIs.
- D. It is 100% effective with perfect use.
Correct Answer: A
Rationale: The withdrawal method requires careful timing and control to be effective. It is less effective than oral contraceptives, does not protect against STIs, and is not 100% effective, even with perfect use.
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A multigravid client at 38 weeks' gestation, G4 P3, is 6 cm dilated with contractions every 3 minutes. The nurse observes meconium-stained amniotic fluid after spontaneous rupture of membranes. What is the priority nursing action?
- A. Prepare for immediate cesarean delivery.
- B. Assess the fetal heart rate pattern.
- C. Suction the client's oropharynx.
- D. Document the fluid characteristics.
Correct Answer: B
Rationale: Meconium-stained fluid raises the risk of fetal distress. Assessing the fetal heart rate pattern immediately ensures the fetus is tolerating labor. Cesarean delivery is not automatic, suctioning is irrelevant, and documentation follows assessment.
A primigravid client at 41 weeks' gestation is admitted to the hospital's labor and delivery unit in active labor. After 25 hours of labor with membranes ruptured for 24 hours, the client delivers a healthy neonate vaginally with a midline episiotomy. Which of the following nursing diagnoses should the nurse identify as the priority for the client?
- A. Activity intolerance related to difficult labor process.
- B. Sleep deprivation related to prolonged labor.
- C. Situational low self-esteem related to lengthy labor process.
- D. Risk for infection related to birth trauma and prolonged ruptured membranes.
Correct Answer: D
Rationale: Prolonged rupture of membranes (>24 hours) and episiotomy increase infection risk, making this the priority post-delivery. Activity intolerance, sleep deprivation, and self-esteem are less urgent.
The nurse on the postpartum mother-baby unit is assigned to take care of four couplets and a new couplet will be admitted within the next 30 minutes. All assessments are complete. The nurse can delegate care for which couplet to the unlicensed nursing personnel?
- A. A G1 P1 with gestational diabetes who is 12 hours postpartum and who still requires insulin.
- B. A G4 P4 who is breast-feeding an 8 lb infant without difficulty.
- C. A G3 P3 postpartum client who is receiving Magnesium Sulfate and whose infant has a respiratory rate of 20.
- D. A G2 P2 who delivered vaginally 2 days ago with an infant having low blood glucose levels the first 24 hours post delivery.
Correct Answer: B
Rationale: The G4 P4 client with stable breastfeeding is appropriate for UAP delegation, as no complex medical needs are present.
A primigravid client delivered vaginally 2 hours ago with no complications. As the nurse plans care for this postpartum client, which postpartum goal would have the highest priority?
- A. By discharge, the family will bond with the neonate.
- B. The client will demonstrate self-care and infant care by the end of the shift.
- C. The client will state instructions for discharge during the first postpartum day.
- D. By the end of the shift, the client will describe a safe home environment.
Correct Answer: B
Rationale: The highest priority in the immediate postpartum period is ensuring the client can perform self-care and infant care, as this promotes safety and independence, which are critical for recovery and newborn care.
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.