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A client who is anovulatory and has hyperprolactinemia is being treated for infertility with metformin, menotropins (Repronex, MENOPUR®), and human chorionic gonadotropin(hCG). Which side effects should the nurse tell the client to report immediately?
- A. Episodes of headache and irritability
- B. Nausea and vomiting
- C. Rapid increase in abdominal girth
- D. Persistent daytime fatigue
Correct Answer: C
Rationale: Rapid abdominal girth increase (C) may indicate ovarian hyperstimulation syndrome, a serious complication.
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A 26-week gestational primigravida who is carrying twins is seen in the clinic today. Her fundal height is measured at 29 cm. Based on these findings what actions the nurse implement.
- A. Notify the healthcare provider of the finding
- B. Document the finding in the medical record
- C. Schedule the client for a biophysical profile
- D. Request another nurse measure the fundus
Correct Answer: A
Rationale: Fundal height greater than expected may indicate a complication, so notifying the healthcare provider (A) is necessary.
The nurse should encourage the laboring client to begin pushing when
- A. There is only an anterior or posterior lip of cervix left
- B. The client describes the need to have a bowel movement
- C. The cervix is completely dilated
- D. The cervix is completely effaced
Correct Answer: C
Rationale: Pushing begins with the second stage of labor, i.e., when the cervix is completely dilated (C), the cervix can become edematous and may never completely dilate, necessitating an operative delivery. Many primigravidas begin active labor 100% effaced and then proceed to dilate.
Client teaching is an important part of the maternity nurse's role. Which factor has the greatest influence on successful teaching on the gravid client?
- A. The client's readiness to learn
- B. The client's educational background
- C. The order in which the information is presented
- D. The extent to which the pregnancy was planned
Correct Answer: A
Rationale: When teaching any client, readiness to learn (A) is the most important criterion. For example, the client with severe morning sickness in the first trimester may not be 'ready to learn' about ways to relieve morning sickness.
The father of a 3-day old infant who is breastfeeding calls the postpartum help line to report that his wife is acting strangely. She is irritable, cannot cope with the baby, and frequently cries for no appeared reason. What information is most important for the nurse to provide the father?
- A. Contact the clinic if the behaviors continue for more than two weeks or becomes worse
- B. Tell the father count the newborns number of soiled diapers over the next few days.
- C. A fluctuation in hormones in the early postpartum period can cause mood changes.
- D. Recommend giving supplemental bottle feedings to the baby between breast feeding.
Correct Answer: C
Rationale: Hormonal fluctuations (C) are common causes of mood changes in the early postpartum period.
The nurse is caring for a woman with a previously diagnosed heart disease who is in the second stage of labor. Which assessment findings are of greatest concern?
- A. Edema, basilar rales, and an irregular pulse.
- B. Increased urinary output, and tachycardia.
- C. Dyspnea, bradycardia, and hypertension.
- D. Regular heart rate, and hypertension.
Correct Answer: A
Rationale: Edema, basilar rales, and an irregular pulse indicate potential cardiac decompensation, which is of greatest concern in a woman with heart disease during labor.