Nokea
A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include?
- A. You should wash your diaphragm in gentle soap and water after each use
- B. You should keep your diaphragm in place for at least 4 hours after intercourse
- C. You will use an oil-based vaginal lubricant when inserting your diaphragm
- D. You should have a provider refit you for a new diaphragm
Correct Answer: D
Rationale: Postpartum vaginal changes require diaphragm refitting for effectiveness, unlike incorrect washing (correct but not primary), 4-hour retention (6 hours minimum), or oil-based lubricant (damages diaphragm).
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A nurse is observing an adolescent client who is offering her newborn a bottle while he is lying in the bassinet. When the nurse offers to pick the newborn up and place him in the client's arms, the mother states, 'No, the baby is too tired to be held.' Which of the following actions should the nurse take?
- A. Offer to take the newborn to the nursery to finish his feeding
- B. Insist that the mother pick up the newborn to feed him
- C. Demonstrate how to hold the newborn and allow the client to practice
- D. Persuade the client to breastfeed the newborn to promote bonding
Correct Answer: C
Rationale: Demonstrating safe holding respects the client's concerns while promoting bonding, unlike nursery removal, insistence, or pushing breastfeeding.
A nurse is planning care immediately following birth for a newborn who has a myelomeningocele that is leaking cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?
- A. Monitor the rectal temperature every 4 hr
- B. Administer broad-spectrum antibiotics
- C. Cleanse the site with povidone-iodine
- D. Prepare for surgical closure after 72 hr
Correct Answer: B
Rationale: Broad-spectrum antibiotics prevent meningitis from CSF leakage, unlike rectal temperature (contraindicated), povidone-iodine (neurotoxic), or delayed surgery (urgent within 24-48 hours).
A nurse is reviewing the chart of a client who is 2 days postpartum following a vaginal delivery and reports constipation. Which of the following findings should the nurse identify as a contraindication to the use of a suppository?
- A. Abdominal distention
- B. Third-degree perineal laceration
- C. Vaginal candidiasis
- D. Afterpain
Correct Answer: B
Rationale: A third-degree perineal laceration contraindicates suppositories to avoid further trauma and delayed healing, unlike distention, candidiasis, or afterpain, which are not contraindications.
A nurse is teaching a client and her partner about the technique of counterpressure during labor. Which of the following statements by the nurse is appropriate?
- A. Your partner will apply pressure to the top of your uterus during contractions.
- B. Your partner will apply steady pressure with a tennis ball to your lower back.
- C. Your partner will apply continuous, firm pressure between your thumb and index finger.
- D. Your partner will apply upward pressure on your lower abdomen between contractions.
Correct Answer: B
Rationale: Counterpressure on the lower back with a tennis ball relieves labor pain, unlike uterine pressure (harmful), hand pressure (ineffective), or abdominal pressure (unrelated to pain relief).
A nurse manager on the labor and delivery unit is teaching a group of newly licensed nurses about maternal cytomegalovirus. Which of the following information should the nurse manager include in the teaching?
- A. Transmission can occur via the saliva and urine of the newborn
- B. This infection requires that airborne precautions be initiated for the newborn
- C. Mothers will receive prophylactic treatment with acyclovir prior to delivery
- D. Lesions are visible on the mother's genitalia
Correct Answer: A
Rationale: CMV transmission occurs through newborn saliva and urine, unlike requiring airborne precautions, acyclovir (herpes treatment), or visible genital lesions (not typical).