Nokea
A full-term client is admitted for induction of labor. When admitted, her cervix is 2/50/0. The initial goal is cervical ripening prior to labor induction. Which drug will prepare her cervix for induction?
- A. Nalbuphine (Nubain).
- B. Oxytocin (Pitocin).
- C. Dinoprostone (Cervidil).
- D. Betamethasone (Celestone).
Correct Answer: C
Rationale: Dinoprostone (Cervidil) is a prostaglandin used for cervical ripening in clients with an unfavorable cervix (e.g., 2 cm, 50% effaced). Nalbuphine is for pain, oxytocin induces contractions, and betamethasone promotes fetal lung maturity.
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The nurse is caring for a neonate shortly after birth when the neonate is diagnosed with sepsis and is to be treated with intravenous antibiotics. Which of the following should the nurse instruct the parents to do because of the neonate's infection?
- A. Use caution near the isolation incubator and equipment.
- B. Visit but do not touch the neonate.
- C. Wash their hands thoroughly before touching the neonate.
- D. Wear a mask when holding the neonate.
Correct Answer: C
Rationale: Thorough hand washing is critical to prevent further infection in a neonate with sepsis.
A client asks about the risks of long-term oral contraceptive use. Which of the following would the nurse include in the response?
- A. Long-term use eliminates the risk of ovarian cancer.
- B. Long-term use may increase the risk of blood clots.
- C. Long-term use causes permanent infertility.
- D. Long-term use leads to significant weight loss.
Correct Answer: B
Rationale: Long-term use of oral contraceptives may increase the risk of blood clots, especially in smokers or those with other risk factors. It reduces ovarian cancer risk, does not cause permanent infertility, and weight changes vary.
A 24-year-old primigravid client who delivers a viable term neonate is ordered to receive the primary effect of the placenta. Which of the following signs would indicate to the nurse that the placenta is about to be delivered?
- A. The cord lengthens outside the vagina.
- B. There is decreased vaginal bleeding.
- C. The uterus cannot be palpated.
- D. Uterus changes to discoid shape.
Correct Answer: A
Rationale: A lengthening umbilical cord outside the vagina indicates placental separation and descent, signaling imminent delivery. Decreased bleeding or a non-palpable uterus are not reliable signs, and the uterus becomes globular, not discoid, after placental delivery.
A primiparous client who underwent a cesarean delivery 30 minutes ago is to receive Rho(D) immune globulin (RhoGAM). The nurse should administer the medication within which of the following time frames after delivery?
- A. 8 hours.
- B. 24 hours.
- C. 72 hours.
- D. 96 hours.
Correct Answer: C
Rationale: RhoGAM should be administered within 72 hours postpartum to prevent Rh sensitization.
After delivery of a viable neonate, a 20-year-old primiparous client comments to her mother and the nurse about the baby. Which of the following comments would the nurse interpret as a possible sign of potential maternal-infant bonding problems?
- A. He's got my funny-looking ears!'
- B. He's got my mother should give him the first feeding.'
- C. He's a lot bigger than I expected him to be.'
- D. I want to buy him a blue outfit to wear when we get home.'
Correct Answer: B
Rationale: Delegating the first feeding to the grandmother suggests reluctance to engage in early bonding activities, which could indicate bonding issues. Other comments reflect normal observations or positive engagement with the neonate.