Nokea
A nurse is providing teaching to a client who is at 35 weeks of gestation and has a prescription for an amniocentesis. Which of the following client statements indicates an understanding of the teaching?
- A. I should empty my bladder before the procedure.
- B. I will be lying on my side during the procedure.
- C. I will be asleep during the procedure.
- D. I should start fasting 24 hours before the procedure.
Correct Answer: A
Rationale: The correct answer is A: "I should empty my bladder before the procedure." This statement indicates understanding because a full bladder can obstruct visualization during amniocentesis. Choice B is incorrect because the client should lie flat on their back during the procedure. Choice C is incorrect as the client is awake for an amniocentesis. Choice D is incorrect because fasting is not required before the procedure.
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Which of the following conditions should the nurse identify as being consistent with the adolescent's assessment findings? For each finding click to specify if the assessment findings are consistent with trichomoniasis, gonorrhea, or candidiasis. Each finding may support more than one disease process.
- A. Abdominal pain.
- B. Greenish discharge.
- C. Diabetes.
- D. Pain on urination.
- E. Absence of condom.
Correct Answer: B, D
Rationale: Greenish discharge and pain on urination are consistent with gonorrhea. Diabetes and absence of condom use are risk factors but not direct symptoms.
A nurse is caring for a client who is at 37 weeks of gestation and is being tested for group B streptococcus ß-hemolytic (GBS). The client is multigravida and multipara with no history of GBS. She asks the nurse why the test was not conducted earlier in her pregnancy. Which of the following is an appropriate response by the nurse?
- A. You didn't report any symptoms of GBS during your pregnancy.'
- B. Your previous deliveries were all negative for GBS.'
- C. There was no indication of GBS in your earlier prenatal testing.'
- D. We need to know if you are positive for GBS at the time of delivery.'
Correct Answer: D
Rationale: The correct answer is D: "We need to know if you are positive for GBS at the time of delivery." This response is appropriate because GBS status can change throughout pregnancy, and testing closer to delivery provides the most accurate information to guide treatment and prevent transmission to the newborn.
Choice A is incorrect as GBS is often asymptomatic and can be present without any noticeable symptoms. Choice B is incorrect because GBS status can change between pregnancies. Choice C is incorrect as GBS testing at 37 weeks is standard practice regardless of earlier prenatal testing results.
A nurse is providing discharge instructions about newborn safety to a client who is 2 days postpartum. Which of the following instructions should the nurse include?
- A. Lay the baby on his stomach to nap during the daytime.
- B. Change smoke detector batteries every other year.
- C. Use a car seat when traveling by airplane
- D. Place a plastic waterproof sheet over the crib bedding
Correct Answer: C
Rationale: Using a car seat during air travel ensures the newborn's safety during takeoff, landing, and turbulence.
A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
- A. Identify the attitude of the head.
- B. Palpate the fundus to identify the fetal part.
- C. Determine the location of the fetal back.
- D. Palpate for the fetal part presenting at the inlet.
Correct Answer: B, C, D, A
Rationale: Leopold maneuvers should be performed in the following sequence: palpate the fundus, determine the location of the fetal back, palpate for the fetal part presenting at the inlet, and identify the attitude of the head.
Which of the following is a potential legal issue related to maternal and newborn healthcare?
- A. Medical malpractice
- B. Patient autonomy
- C. Informed refusal
- D. All of the above
Correct Answer: D
Rationale: Legal issues include medical malpractice, patient autonomy, and informed refusal.