Nokea
A nurse is discussing the contraceptive injection with a client. Which of the following side effects should the nurse mention?
- A. Guaranteed regular periods.
- B. Irregular bleeding and potential weight gain.
- C. Permanent infertility.
- D. Increased risk of breast cancer.
Correct Answer: B
Rationale: The contraceptive injection may cause irregular bleeding and potential weight gain. It does not guarantee regular periods, cause permanent infertility, or significantly increase breast cancer risk.
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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 preterm neonate who has been stabilized is placed in a radiant warmer and is receiving oxygen via an oxygen hood. While administering oxygen in this manner, the nurse should do which of the following?
- A. Humidify the air being delivered.
- B. Cover the neonate's scalp with a warm cap.
- C. Record the neonate's temperature every 3 to 4 minutes.
- D. Assess the neonate's blood glucose level.
Correct Answer: A
Rationale: Humidifying the air prevents drying of the mucous membranes and maintains airway moisture, which is critical for preterm neonates.
A couple is inquiring about vasectomy as a permanent method of contraception. Which teaching statement would the nurse include in the teaching plan?
- A. Another method of contraception is needed until the sperm count is 0.
- B. Vasectomy is easily reversed if children are desired in the future.
- C. Vasectomy is contraindicated in males with prior history of cardiac disease.
- D. Vasectomy requires only a yearly follow-up once the procedure is completed.
Correct Answer: A
Rationale: After a vasectomy, another contraception method is needed until a follow-up semen analysis confirms a zero sperm count, ensuring sterility.
While the nurse is assessing the fundus of a multiparous client who delivered 24 hours ago, the client asks, "What can I do to get rid of these stretch marks?" Which of the following responses would be most appropriate?
- A. As long as you don't get pregnant again, the marks will disappear completely.
- B. They usually fade to a silvery-white color over a period of time.
- C. You'll need to use a specially prescribed cream to help them disappear.
- D. If you lose the weight you gained during pregnancy, the marks will fade to a pale pink.
Correct Answer: B
Rationale: Stretch marks typically fade to a silvery-white color over time without specific intervention.
A primigravid client whose cervix is 7 cm dilated with the fetus at 0 station and in a left occipitoposterior (LOP) position requests pain relief for severe back pain. The nurse should:
- A. Provide firm pressure to the client's sacral area.
- B. Prepare the client for a cesarean delivery.
- C. Prepare the client for a precipitate delivery.
- D. Place the client in a left side-lying position.
Correct Answer: A
Rationale: LOP position often causes severe back pain due to the fetal occiput pressing against the sacrum. Firm sacral pressure (counterpressure) can alleviate this pain. Cesarean or precipitate delivery is not indicated unless other complications arise, and side-lying may help but is less specific.