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A nurse is caring for a client who is at 20 weeks of gestation and has trichomoniasis. Which of the following findings should the nurse expect?
- A. Thick, white vaginal discharge
- B. Urinary frequency
- C. Vulva lesions
- D. Malodorous discharge
Correct Answer: D
Rationale: The correct answer is D: Malodorous discharge. Trichomoniasis is a sexually transmitted infection caused by a parasite, leading to a characteristic foul-smelling vaginal discharge. This discharge is typically greenish-yellow, frothy, and may be accompanied by itching or irritation. Thick, white discharge (choice A) is more indicative of a yeast infection. Urinary frequency (choice B) is not a common symptom of trichomoniasis. Vulva lesions (choice C) are more likely to be seen in other infections or conditions. Therefore, the malodorous discharge is the most specific finding associated with trichomoniasis at 20 weeks of gestation.
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A nurse is assessing a client who is 3 days postpartum. Which of the following findings should the nurse report to the provider?
- A. Cool, clammy skin
- B. Moderate lochia serosa
- C. Heart rate 89/min
- D. BP 120/70 mm Hg
Correct Answer: A
Rationale: The correct answer is A: Cool, clammy skin. This finding could indicate hypovolemia or shock, which are serious postpartum complications. The nurse should report this to the provider immediately for further evaluation and intervention.
Other choices are not as urgent:
B: Moderate lochia serosa is expected 3 days postpartum.
C: Heart rate of 89/min is within normal range for a postpartum client.
D: BP of 120/70 mm Hg is also within normal limits.
Therefore, the nurse should prioritize reporting the cool, clammy skin over the other findings.
A nurse is caring for a client who reports spontaneous rupture of membranes. The nurse observes fetal bradycardia on the FHR tracing and notices that the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following actions should the nurse take next?
- A. Perform a vaginal examination by applying upward pressure on the presenting part.
- B. Cover the umbilical cord with a sterile saline-saturated towel.
- C. Administer oxygen via nonrebreather mask at 8 L/min.
- D. Initiate an infusion of IV fluids for the client.
Correct Answer: B
Rationale: Correct Answer: B - Cover the umbilical cord with a sterile saline-saturated towel.
Rationale: Protruding umbilical cord is a medical emergency that can lead to cord compression and compromise blood flow to the baby, resulting in fetal distress. Covering the cord with a sterile saline-saturated towel helps to prevent cord compression and maintain blood flow until delivery can be expedited. This action ensures the baby continues to receive oxygen and nutrients.
Summary of Incorrect Choices:
A: Performing a vaginal examination could further compress the cord and worsen the situation.
C: Administering oxygen may be beneficial for the mother but does not address the immediate risk to the baby from cord compression.
D: Initiating an IV infusion is important but does not address the urgent need to protect the umbilical cord.
E, F, G: No information provided.
A nurse is caring for a newborn who has jaundice and a new prescription for phototherapy. Which of the following actions should the nurse take?
- A. Provide the newborn with 15 mL glucose water after each feeding.
- B. Turn the newborn every 4 hr.
- C. Apply hydrating lotion to the newborn’s skin prior to treatment.
- D. Close the newborn's eyes before applying eyepatches.
Correct Answer: D
Rationale: The correct answer is D: Close the newborn's eyes before applying eyepatches. This is important to prevent damage to the eyes from the bright light used in phototherapy. Infants' eyes are sensitive, and prolonged exposure can lead to eye damage. Option A is incorrect as glucose water is not indicated for jaundice treatment. Option B is incorrect as turning the newborn every 4 hours is not specific to phototherapy treatment. Option C is incorrect as hydrating lotion is not necessary for phototherapy. Therefore, the crucial step of closing the newborn's eyes before applying eyepatches is essential for protecting the eyes during phototherapy.
Which of the following conditions should the nurse identify as being consistent with the adolescent's assessment findings? For each finding click to specify if the assessment findings are consistent with trichomoniasis, gonorrhea, or candidiasis. Each finding may support more than one disease process.
- A. Abdominal pain.
- B. Greenish discharge.
- C. Diabetes.
- D. Pain on urination.
- E. Absence of condom.
Correct Answer: B, D
Rationale: The correct answer is B, D . Abdominal pain (A) is not specific to any of the given conditions. Diabetes (C) is not directly related to the assessment findings provided. Absence of condom (E) is not an assessment finding, but a behavior. Trichomoniasis is characterized by greenish discharge, and pain on urination can be a symptom of both gonorrhea and trichomoniasis.
A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include?
- A. Feed the newborn 5 to 10 min per breast.
- B. Offer the newborn 30 mL (1 oz) of water between feedings.
- C. Expect two to four wet diapers every 24 hr.
- D. Allow the baby to feed at least every 3 hr.
Correct Answer: D
Rationale: The correct answer is D: Allow the baby to feed at least every 3 hours. This is crucial for maintaining the baby's nutrition and ensuring an adequate milk supply. Breastfeeding on demand helps establish a healthy feeding pattern and promotes bonding between the mother and baby. Option A is incorrect because newborns should feed until they are satisfied, not based on time. Option B is incorrect as newborns should not be given water as it can interfere with breastfeeding and lead to water intoxication. Option C is incorrect as newborns should have at least 6-8 wet diapers a day.