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A nurse is teaching a client about the use of oral contraceptives. Which of the following instructions should the nurse include?
- A. Take the pill at the same time daily.
- B. Skip pills during menstruation.
- C. Take two pills daily for maximum effectiveness.
- D. Stop taking the pill if you miss one dose.
Correct Answer: A
Rationale: Oral contraceptives should be taken at the same time daily for maximum effectiveness. They are taken continuously (including during menstruation for combination pills), one pill daily, and missing a dose requires specific instructions, not stopping entirely.
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A primigravid client at 41 weeks' gestation is admitted to the hospital's labor and delivery unit in active labor. After 25 hours of labor with membranes ruptured for 24 hours, the client delivers a healthy neonate vaginally with a midline episiotomy. Which of the following nursing diagnoses should the nurse identify as the priority for the client?
- A. Activity intolerance related to difficult labor process.
- B. Sleep deprivation related to prolonged labor.
- C. Situational low self-esteem related to lengthy labor process.
- D. Risk for infection related to birth trauma and prolonged ruptured membranes.
Correct Answer: D
Rationale: Prolonged rupture of membranes (>24 hours) and episiotomy increase infection risk, making this the priority post-delivery. Activity intolerance, sleep deprivation, and self-esteem are less urgent.
A primiparous client who is bottle-feeding her neonate at 12 hours after birth asks the nurse, "When will my menstrual cycle return?" Which of the following responses by the nurse would be most appropriate?
- A. Your menstrual cycle will return in 3 to 4 weeks.
- B. It will probably be 6 to 10 weeks before it starts again.
- C. You can expect your menses to start in 12 to 14 weeks.
- D. Your menses will return in 16 to 18 weeks.
Correct Answer: B
Rationale: For bottle-feeding mothers, menstruation typically resumes 6 to 10 weeks postpartum due to the absence of breastfeeding's hormonal suppression.
A client visits the clinic seeking a prescription for oral contraceptives. Which of the following would alert the nurse to further assess the client before the contraceptives are prescribed?
- A. The client has a history of fibrocystic breast disease.
- B. The client has a family history of ovarian cancer.
- C. The client is a smoker and 37 years old.
- D. The client experienced irregular menstrual cycles as an adolescent.
Correct Answer: C
Rationale: Smoking at age 37 is a significant risk factor for cardiovascular complications with combined oral contraceptives, requiring further assessment. Fibrocystic breast disease and irregular cycles are not contraindications, and family history of ovarian cancer is less relevant.
Which of the following would lead the nurse to suspect retinopathy of prematurity (ROP) when assessing a neonate at 32 weeks' gestation who weighs 2,000 g ?
- A. Sunken orbital sockets.
- B. Strabismus.
- C. Reaction to bright light.
- D. Constricted retinal vessels.
Correct Answer: D
Rationale: Constricted retinal vessels are a sign of ROP, indicating abnormal retinal vascular development.
A nurse is teaching a client about the use of the contraceptive patch. Which of the following client statements indicates a need for further teaching?
- A. I will change the patch weekly for three weeks.
- B. I will apply the patch to my abdomen or buttocks.
- C. I can wear the patch while swimming or bathing.
- D. The patch will prevent ovulation permanently10 permanently.
Correct Answer: D
Rationale: The contraceptive patch does not prevent ovulation permanently; it suppresses ovulation during use and is reversible. The other statements are correct, indicating a need for further teaching.