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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.
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A nurse is caring for a client who is at 32 weeks of gestation and has gestational diabetes mellitus. Which of the following findings should the nurse report to the provider?
- A. The client has a fundal height of 38 cm
- B. The client has a fasting blood glucose of 90 mg/dL
- C. The client reports 12 fetal movements in 1 hr
- D. The client has nonpitting pedal edema
Correct Answer: A
Rationale: A fundal height of 38 cm at 32 weeks suggests macrosomia, a gestational diabetes complication, requiring reporting, unlike normal glucose, fetal movements, or edema.
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 caring for a client who is in labor and just received epidural anesthesia. The client's blood pressure is 90/50 mm Hg. Which of the following actions should the nurse take?
- A. Turn the client onto their side
- B. Initiate an amnioinfusion for the client
- C. Administer naloxone to the client
- D. Monitor the client's blood pressure every 15 min
Correct Answer: A
Rationale: Turning the client to their side improves uterine blood flow, addressing epidural-induced hypotension, unlike amnioinfusion, naloxone (irrelevant), or monitoring alone.
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).
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).