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 have your provider refit you for a new diaphragm.'
- B. You should use an oil-based vaginal lubricant when inserting your diaphragm.'
- C. You should keep the diaphragm in place for at least 4 hours after intercourse.'
- D. You should store your diaphragm in sterile water after each use.'
Correct Answer: A
Rationale: The correct answer is A: "You should have your provider refit you for a new diaphragm." After giving birth, a woman's body goes through changes, including weight loss, which can affect the fit and effectiveness of the diaphragm. It is essential for the client to be refitted by a healthcare provider to ensure proper fit and efficacy of the contraception.
Choice B is incorrect because oil-based lubricants can damage the diaphragm material.
Choice C is incorrect because diaphragms should be kept in place for at least 6 hours after intercourse.
Choice D is incorrect because diaphragms should be stored in a cool, dry place, not in sterile water.
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Which of the following is a potential complication of a placental abruption?
- A. Preterm labor
- B. Fetal distress
- C. Polyhydramnios
- D. All of the above
Correct Answer: B
Rationale: The correct answer is B: Fetal distress. Placental abruption is the premature separation of the placenta from the uterus, leading to decreased oxygen and nutrients to the fetus, causing fetal distress. Preterm labor (choice A) can occur due to placental abruption, but it is not a direct complication. Polyhydramnios (choice C) is excessive amniotic fluid, which is not typically associated with placental abruption. Choice D is incorrect as preterm labor and polyhydramnios are not direct complications. Fetal distress is the most immediate and concerning complication of placental abruption due to the compromised blood flow to the fetus.
A nurse is caring for a client who is at 38 weeks of gestation. Which of the following actions should the nurse take prior to applying an external transducer for fetal monitoring?
- A. Determine progression of dilatation and effacement.
- B. Perform Leopold maneuvers.
- C. Complete a sterile speculum exam.
- D. Prepare a Nitrazine paper test.
Correct Answer: B
Rationale: Performing Leopold maneuvers helps the nurse determine the fetal position and presentation, which is essential for accurate placement of the external transducer.
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. Administer broad-spectrum antibiotics.
- B. Monitor the rectal temperature every 4 hr.
- C. Cleanse the site with povidone-iodine.
- D. Prepare for surgical closure after 72 hr.
Correct Answer: A
Rationale: The correct answer is A: Administer broad-spectrum antibiotics. This is crucial in preventing infection, as the leaking cerebrospinal fluid puts the newborn at risk for meningitis. Antibiotics help reduce the risk of infection until surgical closure can be performed. Monitoring rectal temperature (B) is important but not the priority. Cleansing the site with povidone-iodine (C) may further irritate the area. Planning for surgical closure after 72 hr (D) is important, but immediate infection prevention is the priority.
A nurse is developing a plan of care for a newborn who is to undergo phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan?
- A. Feed the newborn 1 oz of water every 4 hr.
- B. Apply lotion to the newborn’s skin three times per day.
- C. Remove all clothing from the newborn except the diaper.
- D. Discontinue therapy if the newborn develops a rash.
Correct Answer: C
Rationale: The correct answer is C: Remove all clothing from the newborn except the diaper. This is essential during phototherapy to maximize the skin's exposure to the light. The light helps breakdown bilirubin in the skin, reducing jaundice. Choice A is incorrect as water will not treat hyperbilirubinemia. Choice B is incorrect as lotions can interfere with the effectiveness of phototherapy. Choice D is incorrect as a rash is a common side effect of phototherapy and should not lead to discontinuation unless severe.
A nurse is admitting a client who is 1 week postpartum and reports excessive vaginal bleeding. The nurse speaks a different language than the client. The client's partner and 10-year-old child are accompanying her. Which of the following actions should the nurse take to gather the client's admission data?
- A. Have the client's child translate.
- B. Ask a nursing student who speaks the same language as the client to translate.
- C. Request a female interpreter through the facility
- D. Allow the client's partner to translate.
Correct Answer: C
Rationale: Requesting a female interpreter through the facility ensures accurate and professional communication, respecting the client's privacy and cultural preferences. Using a child or partner to translate is inappropriate and may lead to misunderstandings.