Nokea
A nulliparous client says that she and her husband plan to use a diaphragm with spermicide to prevent conception. Which of the following should the nurse include as the action of spermicides when teaching the client?
- A. Destruction of spermatozoa before they enter the cervix.
- B. Prevention of spermatozoa from entering the uterus.
- C. A change in vaginal pH from acidic to alkaline.
- D. Slowing of the movement of the migrating spermatozoa.
Correct Answer: A
Rationale: Spermicides destroy spermatozoa before they can enter the cervix, preventing fertilization.
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The charge nurse on an antepartal unit is preparing to complete assignments for the day. There is an RN, licensed practical nurse (LPN), and an unlicensed personnel (UAP) to care for 25 clients. The nurse should assign which of the following clients to the:
- A. A newly admitted G5 P2 Ab 2 with second trimester bleeding, reportedly currently saturating 1-2 pads in 12 hours.
- B. A 22-year-old G2 P1 with urinary retention who is being catheterized with an intermittent in and out every 4 to 6 hours p.r.n. while awaiting urine cultures to be returned.
- C. A G4 P2 with a twin pregnancy who was admitted in preterm labor and is now able to ambulate 2 to 3 times daily and having no contractions.
- D. A 30-year-old G4 P0 who was admitted in sickle unless currently receiving blood and pain medication.
Correct Answer: C
Rationale: The client with a stable twin pregnancy who is ambulating and has no contractions can be assigned to the LPN or UAP, as this client requires less complex care compared to others with active medical issues.
The nurse is beginning the shift and is now responsible for the following clients on the postpartum unit and has not yet made rounds on the clients. Additionally, the nurse is responsible for three other clients who are currently listed as stable. The nurse will also be getting a new admission in 15 minutes. For the best utilization of time and client safety, the nurse should make rounds on which of the following clients first?
- A. The three clients who are reported to be stable.
- B. The mother with a 4-hour-old infant with initial blood glucose of 33 mg\dL and now at 15 mg/dL.
- C. A mother who had a spontaneous vaginal delivery (SVD) client and received methylergonovine maleate (Methergine) 1 hour ago for increased bleeding.
- D. A mother with a 3-day-old who had a bilirubin level of 13 mg\dL 30 minutes ago, and is now in a 'bili blanket' at the mother's bedside.
Correct Answer: B
Rationale: The infant with a blood glucose of $15 \mathrm{mg} / \mathrm{dL}$ is critically low, indicating severe hypoglycemia, which requires immediate intervention to prevent neurological damage.
The nurse is preparing to assess a client admitted with a diagnosis of trigeminal neuralgia (tic douloureux). On review of the client's record, which symptom should the nurse expect the client is experiencing?
- A. Bilateral pain in the area of the sixth cranial nerve
- B. Unilateral pain in the area of the sixth cranial nerve
- C. Abrupt onset of pain in the area of the fifth cranial nerve
- D. Chronic, intermittent pain in the area of the seventh cranial nerve
Correct Answer: C
Rationale: Trigeminal neuralgia is a chronic syndrome characterized by an abrupt onset of pain. It involves one or more divisions of the trigeminal nerve (cranial nerve V). The remaining options are incorrect.
A client tells the nurse that she has had sexual contact with someone whom she suspects has genital herpes. Which of the following instructions should the nurse give the client in response to this information?
- A. Anticipate lesions within 25 to 30 days.
- B. Continue sexual activity unless lesions are present.
- C. Report any difficulty urinating.
- D. Drink extra fluids to prevent lesions from forming.
Correct Answer: C
Rationale: Difficulty urinating can indicate herpes-related urinary retention, a serious complication requiring medical attention.
The nurse is caring for a client post-total knee replacement. Which sign indicates a potential deep vein thrombosis?
- A. Calf swelling and pain
- B. Fever of 100°F (37.8°C)
- C. Mild incisional redness
- D. Joint stiffness
Correct Answer: A
Rationale: Calf swelling and pain are classic signs of deep vein thrombosis, a common postoperative complication requiring immediate evaluation.