Nokea
A nurse is counseling a client about the use of a diaphragm for contraception. Which of the following instructions should the nurse include?
- A. Insert the diaphragm up to 6 hours before intercourse.
- B. Remove the diaphragm immediately after intercourse.
- C. Use a spermicide with the diaphragm for each act of intercourse.
- D. Store the diaphragm in a dry, airtight container.
Correct Answer: C
Rationale: Using spermicide with the diaphragm for each act of intercourse is essential for effectiveness. The diaphragm can be inserted up to 6 hours before and left in place for at least 6 hours after intercourse but not more than 24 hours. It should be stored in a clean, dry container, not necessarily airtight.
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Which of the following would the nurse include in the teaching plan for a 16-year-old primigravid client in early labor concerning active relaxation techniques to help her cope with pain?
- A. Relaxing uninvolved body muscles during uterine contractions.
- B. Practicing being in a deep, meditative, sleeplike state.
- C. Focusing on an object in the room during the contractions.
- D. Breathing rapidly and deeply between contractions.
Correct Answer: A
Rationale: Active relaxation involves consciously relaxing uninvolved muscles (e.g., face, arms) during contractions to conserve energy and reduce tension, aiding pain management. Meditation is less practical during active labor, focusing on an object is a distraction technique, and rapid breathing between contractions may cause hyperventilation.
The nurse is caring for a multiparous client 48 hours after cesarean delivery. Which finding indicates a potential complication?
- A. Clear urine output via catheter.
- B. Incisional pain relieved by medication.
- C. Scant lochia serosa.
- D. Homan's sign negative bilaterally.
Correct Answer: C
Rationale: Scant lochia serosa at 48 hours may indicate retained clots or infection, requiring further assessment.
A primigravid client at 39 weeks' gestation is admitted to the hospital for induction of labor. The physician has ordered prostaglandin E2 gel (Dinoprostone) for the client. Before administering prostaglandin E2 gel to the client, which of the following should the nurse do first?
- A. Assess the frequency of uterine contractions.
- B. Place the client in a side-lying position.
- C. Determine whether the membranes have ruptured.
- D. Prepare the client for an amniotomy.
Correct Answer: A
Rationale: Prostaglandin E2 gel stimulates contractions, so assessing baseline contraction frequency ensures it is safe to administer (e.g., no hyperstimulation). Membrane status and positioning are secondary, and amniotomy is not required.
A woman who is Rh-negative has delivered an Rh-positive infant. The nurse explains to the client that she will receive RhoGAM. The nurse determines that the client understands the purpose of RhoGAM when she states:
- A. "RhoGAM will protect my next baby if it is Rh-negative."
- B. "RhoGAM will prevent antibody formation in my blood."
- C. "RhoGAM will be given to prevent German measles."
- D. "RhoGAM will be used to prevent bleeding in my newborn."
Correct Answer: B
Rationale: RhoGAM prevents maternal antibody formation against Rh-positive blood.
A 24-year-old primipara who has delivered a healthy neonate in the hospital's birthing center plans to bottle-feed her neonate. When developing the nutritional teaching plan for the mother, the nurse should determine that the number of calories required by the neonate each day per pound of body weight is which of the following?
- A. 30 to 35.
- B. 40 to 45.
- C. 50 to 55.
- D. 60 to 65.
Correct Answer: C
Rationale: Neonates require approximately 50-55 calories per pound of body weight daily for growth and development.