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A nurse is performing a vaginal exam on a client who is in active labor. The nurse notes the umbilical cord protruding through the cervix. Which of the following actions should the nurse take?
- A. Administer oxytocin to the client via intravenous infusion.
- B. Apply oxygen at 2 L/min via nasal cannula.
- C. Prepare for insertion of an intrauterine pressure catheter.
- D. Assist the client in the knee-chest position.
Correct Answer: D
Rationale: Placing the client in the knee-chest position reduces cord compression and improves oxygenation. Other interventions, such as administering oxygen, may be helpful but are secondary to relieving pressure on the cord.
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A woman is using the basal body temperature (BBT) method of contraception. She calls the clinic and tells the nurse, 'My period is due in a few days, and my temperature has not gone up.' What is the nurse's most appropriate response?
- A. This probably means you're pregnant.
- B. Don't worry; it's probably nothing.
- C. Have you been sick this month?
- D. You probably didn't ovulate during this cycle.
Correct Answer: D
Rationale: The absence of a temperature rise indicates that ovulation has not occurrePregnancy cannot occur without ovulation, so the lack of BBT increase suggests an anovulatory cycle.
Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during the puerperium?
- A. Varicosities of the legs
- B. Carpal tunnel syndrome
- C. Periodic numbness and tingling of the fingers
- D. Headaches
Correct Answer: D
Rationale: Headaches in the postpartum period can have a number of causes, some of which deserve medical attention.
The nurse at a family practice clinic is providing care to a 47-year-old obese patient. The patient
states that she realizes that she has put on extra weight but is reluctant to go to any exercise
classes. She states that she often has to cross her legs when she sneezes and cannot do any
exercises with her legs crossed. The health care provider has prescribed tolterodine (Detrol). What
is the rationale for this medication?
- A. Tolterodine is used to treat overactive bladders and to decrease urinary frequency,
urgency, and urge incontinence. - B. Tolterodine is used to improve the tone and tissue in the urethral and vaginal areas.
- C. Tolterodine is used to facilitate weight loss by acting as an appetite suppressant.
- D. Tolterodine is used to improve blood flow to the pelvic muscles to decrease
urinary tract infections.
Correct Answer: B
Rationale: The correct answer is B: Tolterodine is used to improve the tone and tissue in the urethral and vaginal areas. Tolterodine is a medication used to treat overactive bladders by relaxing the bladder muscles, reducing urinary urgency, frequency, and urge incontinence. Improving tone and tissue in the urethral and vaginal areas can help in controlling bladder function. Choices A, C, and D are incorrect because tolterodine does not act as an appetite suppressant, facilitate weight loss, or improve blood flow to pelvic muscles to decrease urinary tract infections. The primary mechanism of action of tolterodine is related to bladder muscle relaxation rather than weight loss or blood flow improvement.
The United States ranks poorly in terms of worldwide infant mortality rates. Which factor has the greatest impact on decreasing the mortality rate of infants?
- A. Providing more women’sN sheRlterIs G B.C M U S N T O
- B. Ensuring early and adequate prenatal care
- C. Resolving all language and cultural differences
- D. Enrolling pregnant women in the Medicaid program by their eighth month of pregnancy
Correct Answer: B
Rationale: The correct answer is B: Ensuring early and adequate prenatal care. Early and adequate prenatal care is crucial in identifying and addressing any potential health issues for both the mother and the baby, leading to healthier outcomes and a decrease in infant mortality rates. Providing more women's shelters (A) may help with social support but does not directly impact infant mortality rates. Resolving all language and cultural differences (C) is important for effective communication but does not directly impact infant mortality rates. Enrolling pregnant women in the Medicaid program (D) is beneficial for access to healthcare, but ensuring early and adequate prenatal care is more directly linked to decreasing infant mortality rates.
Which key point is important for the nurse to understand regarding the perinatal continuum of care?
- A. Begins with conception and ends with the birth
- B. Begins with family planning and continues until the infant is 1 year old
- C. Begins with prenatal care and continues until the newborn is 24 weeks old
- D. Refers to home care only
Correct Answer: B
Rationale: The perinatal continuum of care spans from family planning through to the infant's first year, including both home and healthcare facility services. It covers more than just prenatal care and birth.