Nokea
A nurse is discussing the copper IUD with a client. Which of the following client statements indicates understanding?
- A. The copper IUD is effective for up to 10 years.
- B. The copper IUD prevents ovulation.
- C. The copper IUD reduces menstrual bleeding.
- D. The copper IUD requires daily insertion.
Correct Answer: A
Rationale: The copper IUD is effective for up to 10 years, providing long-term contraception. It does not prevent ovulation, may increase menstrual bleeding, and does not require daily insertion.
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On the first postpartum day, the primiparous client reports perineal pain of 5 on a scale of 1 to 10 that was unrelieved by ibuprofen 800 mg given 2 hours ago. The nurse should further assess the client for:
- A. Puerperal infection.
- B. Vaginal lacerations.
- C. History of drug abuse.
- D. Perineal hematoma.
Correct Answer: D
Rationale: Persistent perineal pain unrelieved by ibuprofen suggests a perineal hematoma, which requires further assessment.
Four days after a vaginal delivery, the client visits the clinic complaining of excessive lochia rubra with clots. The physician orders methylergonovine maleate (Methergine), 0.2 mg intramuscularly. Before administering this drug, the nurse should assess:
- A. Blood pressure.
- B. Pulse rate.
- C. Breath sounds.
- D. Bowel sounds.
Correct Answer: A
Rationale: Methylergonovine can cause hypertension, so blood pressure assessment is essential before administration.
A neonate delivered at 30 weeks' gestation and weighing $2,000 \mathrm{~g}$ is admitted to the neonatal intensive care unit. What nursing measure will decrease insensible water loss in a neonate?
- A. Bathing the baby as soon after birth as possible.
- B. Use of eye patches with phototherapy.
- C. Use of humidity in the incubator.
- D. Use of a radiant warmer.
Correct Answer: C
Rationale: Using humidity in the incubator helps maintain a moist environment, reducing insensible water loss through the skin, which is critical for preterm neonates with immature skin barriers.
Following an epidural and placement of internal monitors, a client's labor is augmented. Contractions are lasting greater than 90 seconds and occurring every 1½ minutes. The uterine resting tone is greater than 20 mm mercury with a nonreassuring fetal heart rate and pattern. Which of the following actions should the nurse take first?
- A. Notify the health care provider.
- B. Turn off the oxytocin (Pitocin) infusion.
- C. Turn the client to her left side.
- D. Increase the maintenance I.V. fluids.
Correct Answer: B
Rationale: Hyperstimulation (contractions >90 seconds, frequent, with high resting tone) and nonreassuring fetal heart rate indicate fetal distress. Stopping oxytocin is the first step to reduce uterine activity and improve fetal oxygenation. Repositioning, notifying the provider, or increasing fluids follow.
The nurse is assessing a multiparous client 12 hours after vaginal delivery. Which finding requires immediate intervention?
- A. Fundus firm, 1 cm above umbilicus.
- B. Lochia rubra with small clots.
- C. Perineal pain rated 3/10.
- D. Pulse 100 bpm, temperature 100.4°F (38°C).
Correct Answer: D
Rationale: An elevated pulse and temperature may indicate infection or hemorrhage, requiring prompt intervention.