Nokea
A nurse is counseling a client about the use of a vaginal contraceptive ring. Which of the following client statements indicates understanding?
- A. I should remove the ring every night before bed.
- B. The ring is left in place for three weeks, then removed for one week.
- C. I need to replace the ring every two weeks.
- D. The ring protects against HIV transmission.
Correct Answer: B
Rationale: The vaginal contraceptive ring is left in place for three weeks, then removed for one week to allow a withdrawal bleed. It is not removed nightly, replaced every two weeks, or protective against HIV.
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The physician determines that the fetus of a multiparous client in active labor is in distress, necessitating a cesarean delivery with general anesthesia. Before the cesarean delivery, the anesthesiologist orders cimetidine (Tagamet) 300 mg PO. After administering the drug, the nurse should assess the client for reduction in which of the following?
- A. Incidence of bronchospasm.
- B. Oral and respiratory secretions.
- C. Acid level of the stomach contents.
- D. Incidence of postoperative gastric ulcer.
Correct Answer: C
Rationale: Cimetidine, an H2-receptor blocker, is given before general anesthesia to reduce gastric acid levels, minimizing the risk of aspiration pneumonitis. It does not affect bronchospasm, secretions, or postoperative ulcers directly.
A 6-lb, 8-oz neonate was delivered vaginally at 38 weeks' gestation. At 5 minutes of life, the neonate has the following signs: heart rate 110 , intermittent grunting with respiratory rate of 70 , flaccid tone, no response to stimulus, overall pale white in color. The Apgar score is:
- A. 2
- B. 3
- C. 4
- D. 6
Correct Answer: B
Rationale: Heart rate 110 (2 points), respiratory effort with grunting (1 point), flaccid tone (0 points), no response to stimulus (0 points), pale white color (0 points). Total Apgar score = 3.
The nurse on the postpartum mother-baby unit is assigned to take care of four couplets and a new couplet will be admitted within the next 30 minutes. All assessments are complete. The nurse can delegate care for which couplet to the unlicensed nursing personnel?
- A. A G1 P1 with gestational diabetes who is 12 hours postpartum and who still requires insulin.
- B. A G4 P4 who is breast-feeding an 8 lb infant without difficulty.
- C. A G3 P3 postpartum client who is receiving Magnesium Sulfate and whose infant has a respiratory rate of 20.
- D. A G2 P2 who delivered vaginally 2 days ago with an infant having low blood glucose levels the first 24 hours post delivery.
Correct Answer: B
Rationale: The G4 P4 client with stable breastfeeding is appropriate for UAP delegation, as no complex medical needs are present.
A primiparous client asks how to store breast milk safely at room temperature. The nurse should instruct the client that breast milk can be left at room temperature for up to:
- A. 2 hours.
- B. 4 hours.
- C. 6 hours.
- D. 8 hours.
Correct Answer: C
Rationale: Breast milk is safe at room temperature (up to 77°F) for up to 6 hours, minimizing bacterial growth.
Which of the following actions should the nurse take when performing external cardiac massage on a neonate born at 28 weeks' gestation?
- A. Alternate cardiac massage with ventilation.
- B. Compress the sternum with the palm of the hand.
- C. Compress the chest 70 to 80 times per minute.
- D. Displace the chest 70 to 80 times per minute.
Correct Answer: A
Rationale: Alternating cardiac massage with ventilation follows neonatal resuscitation guidelines to restore circulation and oxygenation.