Nokea
A nurse is counseling a client about the use of a diaphragm. Which of the following client statements indicates a need for further teaching?
- A. I need to use spermicide with the diaphragm.
- B. I can insert the diaphragm up to 6 hours before intercourse.
- C. I should leave the diaphragm in place for at least 6 hours after intercourse.
- D. I can reuse the diaphragm without cleaning it.
Correct Answer: D
Rationale: The diaphragm must be cleaned after each use to maintain hygiene and effectiveness. The other statements are correct, indicating a need for further teaching about cleaning.
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A multiparous client, 72 hours postpartum, reports a sudden gush of lochia rubra. The nurse should suspect:
- A. Normal involution.
- B. Uterine subinvolution.
- C. Cervical laceration.
- D. Retained placental fragments.
Correct Answer: D
Rationale: A sudden gush of lochia rubra after 72 hours suggests retained placental fragments, which can cause hemorrhage.
A primiparous client, 4 hours postpartum, reports feeling overwhelmed and anxious about caring for her newborn. Which nursing intervention is most appropriate?
- A. Encourage the client to rest and limit visitors.
- B. Teach the client basic newborn care skills immediately.
- C. Administer an anxiolytic medication as prescribed.
- D. Refer the client to a social worker for counseling.
Correct Answer: B
Rationale: Teaching basic newborn care skills empowers the client, reduces anxiety, and promotes confidence in the early postpartum period.
A client asks about the benefits of breastfeeding for contraception. Which of the following responses by the nurse is most accurate?
- A. Breastfeeding is a reliable contraceptive method for the first year postpartum.
- B. The lactational amenorrhea method is effective only if the client is exclusively breastfeeding and amenorrheic.
- C. Breastfeeding prevents ovulation permanently while nursing.
- D. Breastfeeding is equally effective whether the client supplements with formula.
Correct Answer: B
Rationale: The lactational amenorrhea method (LAM) is effective for up to 6 months postpartum if the client is exclusively breastfeeding, amenorrheic, and the infant is under 6 months. It is not reliable for a year, does not permanently prevent ovulation, and is less effective with formula supplementation.
A primigravid client in the second stage of labor feels the urge to push. The client has had no analgesia or anesthesia. Anatomically, which of the following would be the best position for the client to assume?
- A. Dorsal recumbent.
- B. Lithotomy.
- C. Hands and knees.
- D. Squatting.
Correct Answer: D
Rationale: Squatting is anatomically optimal for pushing in the second stage as it widens the pelvic outlet, aligns the fetus with the birth canal, and uses gravity to aid descent. Dorsal recumbent and lithotomy positions restrict pelvic mobility, and hands and knees, while helpful for back pain, is less effective for pushing.
A primiparous client who will be bottle-feeding her neonate asks, "What is the best position for the baby after feeding?" Which of the following positions should the nurse recommend to aid digestion?
- A. Supine position.
- B. On the left side.
- C. Prone with the infant's head elevated on a pillow.
- D. Sitting on the caregiver's lap for 20 minutes.
Correct Answer: D
Rationale: Sitting upright after feeding aids digestion by allowing gravity to keep formula in the stomach.