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A client who delivered vaginally 2 days ago states that she wants to resume using her diaphragm for birth control. What information should you share with her?
- A. The most effective form of contraception is a diaphragm.
- B. The diaphragm must be refitted after childbirth.
- C. Vaseline lubricant can be used when inserting the diaphragm.
- D. The diaphragm should be inserted 2 to 4 hours before intercourse.
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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Twenty minutes after a continuous epidural anesthetic is administered, a laboring client's blood pressure drops from 120/80 to 90/60. What action should the healthcare provider take?
- A. Notify the healthcare provider or anesthesiologist immediately.
- B. Continue to assess the blood pressure every 5 minutes.
- C. Place the woman in a lateral position.
- D. Turn off the continuous epidural.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
During a woman's first prenatal visit, the nurse reviews her health care record, noting a history of chickenpox as a child and syphilis as a teenager. Which action is most important for the nurse to take?
- A. Obtain blood and urine for prenatal screens.
- B. Schedule prenatal visits to occur monthly.
- C. Explain common complications of pregnancy.
- D. Obtain baseline blood pressure and weight.
Correct Answer: A
Rationale: Obtaining blood and urine for prenatal screens is crucial in identifying any potential infections or conditions that may require monitoring throughout the pregnancy. Screening for infections such as syphilis is essential to ensure appropriate management and prevent adverse outcomes. This action helps in early detection and timely intervention, promoting the health and well-being of both the mother and the developing fetus.
A mother calls the school nurse to report that her preschool-aged child was bitten by a tick during a school outing last week. The mother removed the tick and flushed it down the toilet. What action should the school nurse take?
- A. Refer the mother to the Centers for Disease Control and Prevention.
- B. Report the incident to the school principal.
- C. Culture the bite site when the child returns to school.
- D. Schedule a test for Lyme disease if a rash appears.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A woman who delivered a 9-pound baby via cesarean section under spinal anesthesia is recovering in the post-anesthesia care unit. Her fundus is firm at the umbilicus, and a continuous trickle of bright red blood with no clots is observed by the nurse. Which action should the nurse implement?
- A. Assess her blood pressure.
- B. Apply an ice pack to the perineum.
- C. Allow the infant to breastfeed.
- D. Massage the fundus vigorously.
Correct Answer: A
Rationale: In this situation, continuous bleeding despite a firm fundus suggests a possible laceration. The appropriate action for the nurse to take is to assess the woman's blood pressure. This helps determine the severity of blood loss and guides further interventions, such as identifying the need for additional assessments or interventions to control bleeding.
A 34-week primigravida woman with preeclampsia is receiving Lactated Ringer's 500ml with magnesium sulfate 20 grams at the rate of 3g/hr. How many ml/hr should the nurse program the infusion pump?
- A. 75ml/hr
- B. 100ml/hr
- C. 50ml/hr
- D. 25ml/hr
Correct Answer: A
Rationale: To calculate the infusion rate, divide the total quantity to be infused (500ml) by the total time (1 hour) which equals 500ml/hr. Since the magnesium sulfate is being given at 3g/hr, and 1g of magnesium sulfate is in 5ml of solution, the rate will be 3g/hr x 5ml/g = 15ml/hr. Therefore, the total infusion rate should be 500ml/hr + 15ml/hr = 515ml/hr. Hence, the nurse should program the infusion pump to deliver 75ml/hr (515ml/hr total - 500ml/hr Lactated Ringer's rate).