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A nurse is giving a shift report about a client in labor. Which of the following information is the least important to include to complete the report at the change of shift?
- A. Gravida, term, preterm, abortion, living.
- B. Cervical effacement, dilation, station.
- C. Support persons with the client.
- D. Bottle- or breast-feeding preference.
Correct Answer: D
Rationale: Feeding preference is less critical during labor compared to obstetric history and labor progress.
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The nurse is assessing a multigravida client at 12 weeks' gestation who has been admitted to the emergency department with sharp right-sided abdominal pain and vaginal spotting. Which of the following should the nurse obtain about the client's history? Select all that apply.
- A. History of sexually transmitted infections.
- B. Number of sexual partners.
- C. Last menstrual period.
- D. Cesarean section.
- E. IUD use.
- F. Contraceptive use.
Correct Answer: A,B,C,E,F
Rationale: These factors increase the risk of ectopic pregnancy.
A nurse is discussing the contraceptive injection with a client. Which of the following benefits should the nurse highlight?
- A. It provides protection against STIs.
- B. It is effective for 3 months per injection.
- C. It requires daily administration.
- D. It guarantees regular periods.
Correct Answer: B
Rationale: The contraceptive injection is effective for 3 months per injection, offering convenient long-term contraception. It does not protect against STIs, is not administered daily, and may cause irregular periods.
A nurse is teaching a client about the use of the contraceptive patch. Which of the following instructions should the nurse include?
- A. Apply the patch to the genital area.
- B. Change the patch weekly for three weeks, then have a patch-free week.
- C. Wear the patch for one month without changing.
- D. Apply a new patch daily.
Correct Answer: B
Rationale: The contraceptive patch is changed weekly for three weeks, followed by a patch-free week to allow a withdrawal bleed. It is not applied to the genital area, worn for a month, or changed daily.
A nurse is discussing emergency contraception with a client. Which of the following statements by the nurse is accurate?
- A. Emergency contraception is most effective when taken within 72 hours of unprotected intercourse.
- B. Emergency contraception requires a prescription for all women.
- C. Emergency contraception is 100% effective in preventing pregnancy.
- D. Emergency contraception can be used as a regular method of birth control.
Correct Answer: A
Rationale: Emergency contraception, like Plan B, is most effective within 72 hours of unprotected intercourse. It is available over-the-counter for those 17 and older, is not 100% effective, and is not suitable for regular use due to lower efficacy and side effects.
When developing the teaching plan for a primigravid client at 30 weeks' gestation diagnosed with mild preeclampsia who is being treated at home, which of the following would the nurse identify as the most appropriate client-centered goal?
- A. Return visit to the prenatal clinic in approximately 4 weeks.
- B. Decreased edema after 1 week of a low-protein, low-fiber diet.
- C. Bed rest on the left side during the day, with bathroom privileges.
- D. Immediate reporting of adverse reactions to magnesium sulfate therapy.
Correct Answer: C
Rationale: Bed rest on the left side enhances placental perfusion and reduces blood pressure.