Nokea
A nurse in a provider’s office is caring for a 20-year-old client who is at 12 weeks of gestation and requests an amniocentesis to determine the sex of the fetus. Which of the following responses should the nurse make?
- A. You cannot have an amniocentesis until you are at least 35 years of age.
- B. This procedure determines if your baby has genetic or congenital disorders.
- C. Your provider will schedule a chorionic villus sampling to determine the sex of your baby.
- D. We can schedule the procedure for later today if you’d like.
Correct Answer: B
Rationale: The correct response is B: This procedure determines if your baby has genetic or congenital disorders. Amniocentesis is a diagnostic test that involves taking a sample of the amniotic fluid, which can be analyzed for genetic abnormalities like Down syndrome. It is typically performed between 15-20 weeks of gestation, not based on maternal age. Choice A is incorrect as there is no age requirement for amniocentesis. Choice C is incorrect as chorionic villus sampling is a different procedure used for genetic testing earlier in pregnancy. Choice D is incorrect as amniocentesis is a planned procedure that requires preparation and scheduling, not something to be done on the same day.
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A nurse is caring for a client who is 12 hr postpartum and has a third-degree perineal laceration. The client reports not having a bowel movement for 4 days. Which of the following medications should the nurse administer?
- A. Bisacodyl 10 mg rectal suppository
- B. Magnesium hydroxide 30 mL PO
- C. Famotidine 20 mg PO
- D. Loperamide 4 mg PO
Correct Answer: A
Rationale: A rectal suppository like bisacodyl is effective for relieving constipation and is safe for postpartum clients with perineal lacerations.
Which stage of labor is characterized by cervical dilation from 4-10 cm?
- A. First stage
- B. Second stage
- C. Third stage
- D. Fourth stage
Correct Answer: A
Rationale: The correct answer is A: First stage. This stage of labor is characterized by cervical dilation from 4-10 cm. During this stage, the cervix prepares for childbirth by thinning and opening up to allow the baby to pass through the birth canal. The first stage is further divided into early labor (0-4 cm dilation) and active labor (4-10 cm dilation). It is crucial for monitoring progress and determining when to move to the next stage of labor. The other choices are incorrect because the second stage is characterized by pushing and delivery of the baby, the third stage is delivery of the placenta, and the fourth stage is the postpartum period immediately after delivery.
A nurse is caring for a client who is in active labor with a fetus in the occipitoposterior position. The nurse assists the client into a hands-and-knees position. Which of the following questions should the nurse ask to evaluate the effectiveness of this intervention?
- A. Does that lessen your suprapubic pain?
- B. Are you feeling relief from your pelvic pressure?
- C. Do your contractions feel further apart?
- D. Has your back labor improved?
Correct Answer: D
Rationale: The correct answer is D: "Has your back labor improved?" This question is appropriate because the occipitoposterior position often leads to back labor due to the baby's position pressing on the mother's spine. By asking if the back labor has improved, the nurse can assess the effectiveness of the hands-and-knees position in helping relieve pressure on the mother's back.
Choice A: "Does that lessen your suprapubic pain?" is incorrect because the hands-and-knees position is more effective for back pain relief, not suprapubic pain.
Choice B: "Are you feeling relief from your pelvic pressure?" is incorrect because the hands-and-knees position is more effective for addressing back pain, not pelvic pressure.
Choice C: "Do your contractions feel further apart?" is incorrect as the position change is unlikely to affect the timing of contractions significantly.
In summary, the correct question (Choice D) directly addresses the main issue associated with occipitoposterior
A nurse is caring for an infant who has signs of neonatal abstinence syndrome. Which of the following actions should the nurse take?
- A. Monitor blood glucose level every hr.
- B. Place the infant on his back with legs extended.
- C. Initiate seizure precautions.
- D. Provide a stimulating environment.
Correct Answer: C
Rationale: The correct answer is C: Initiate seizure precautions. The infant with neonatal abstinence syndrome is at risk for seizures due to drug withdrawal. By initiating seizure precautions, the nurse can ensure the safety of the infant by implementing measures such as padding the crib, having emergency medications readily available, and closely monitoring for any signs of seizure activity.
Choice A is incorrect because monitoring blood glucose levels every hour is not typically indicated for neonatal abstinence syndrome. Choice B is incorrect as placing the infant on his back with legs extended does not address the risk of seizures. Choice D is incorrect as providing a stimulating environment can exacerbate the symptoms of withdrawal.
A nurse is assessing a newborn following a forceps-assisted birth. Which of the following clinical manifestations should the nurse identify as a complication of this birth method?
- A. Polycythemia
- B. Hypoglycemia
- C. Bronchopulmonary dysplasia
- D. Facial palsy
Correct Answer: D
Rationale: The correct answer is D: Facial palsy. Forceps-assisted birth can lead to facial nerve injury, resulting in facial palsy. This occurs due to pressure exerted by the forceps on the baby's face during delivery. The other choices are incorrect because: A) Polycythemia is not directly related to forceps-assisted birth. B) Hypoglycemia is more commonly associated with maternal diabetes or prematurity. C) Bronchopulmonary dysplasia is a lung condition seen in premature infants requiring prolonged mechanical ventilation. In summary, facial palsy is the most likely complication of forceps-assisted birth due to potential nerve injury, while the other choices are less directly linked to this birthing method.