Nokea
A nurse is teaching a client about the use of spermicides. Which of the following instructions should the nurse include?
- A. Spermicides must be applied at least 1 hour before intercourse.
- B. Spermicides are most effective when used alone.
- C. Spermicides should be used with barrier methods for increased effectiveness.
- D. Spermicides provide long-term contraception for up to 24 hours.
Correct Answer: C
Rationale: Spermicides are most effective when used with barrier methods like condoms or diaphragms, as they increase efficacy. They should be applied 10-30 minutes before intercourse, are less effective alone, and are effective for about 1 hour, not 24 hours.
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The nurse is managing care of a primigravida at full term who is in active labor. What should be included in developing the plan of care for this client?
- A. Oxygen saturation monitoring every half hour.
- B. Supine positioning on back, if it is comfortable.
- C. Anesthesia/pain level assessment every 30 minutes.
- D. Vaginal bleeding, ROM assessment every shift.
Correct Answer: C
Rationale: Regular assessment of anesthesia/pain levels is critical to ensure the client's comfort and to adjust pain management strategies as labor progresses. Oxygen saturation monitoring is not typically required every half hour unless specific complications arise. Supine positioning can cause supine hypotensive syndrome and is generally avoided. Vaginal bleeding and rupture of membranes (ROM) assessments are important but typically performed more frequently than every shift during active labor.
The nurse is evaluating the client who delivered vaginally 2 hours ago and is experiencing postpartum pain rated 8 on scale of 1 to 10. The client is a G 4, P 4, breast-feeding mother who would like medication to decrease the pain in her uterus. Which of the medications listed on the orders sheet would be the most appropriate for this client?
- A. Aspirin 1,000 mg P.O. q 4 to 6 hour p.r.n.
- B. Ibuprofen 800 mg P.O. q 6 to 8 hour p.r.n.
- C. Colace 100 mg P.O. b.i.d.
- D. Vicodin 1 to 2 tabs P.O. q 4 to 6 hour p.r.n.
Correct Answer: B
Rationale: Ibuprofen is safe for breastfeeding mothers and effective for uterine cramping pain, unlike aspirin (risk of bleeding), Colace (stool softener), or Vicodin (opioid, less preferred due to sedation risks).
A multigravid client is admitted at 16 weeks' gestation with a diagnosis of hyperemesis gravidarum. The nurse should explain to the client that hyperemesis gravidarum is thought to be related to high levels of which of the following hormones?
- A. Progesterone.
- B. Estrogen.
- C. Somatotropin.
- D. Aldosterone.
Correct Answer: B
Rationale: High estrogen levels are associated with hyperemesis gravidarum.
A multiparous client delivers dizygotic twins at 37 weeks' gestation. The twin neonates require additional hospitalization after the client is discharged. In planning the family's care, an appropriate goal for the nurse to formulate is that, while the twins are hospitalized, the parents will do which of the following?
- A. Discuss how they will cope with twin infants at home.
- B. Participate in care of the twins as much as possible.
- C. Take turns providing 24-hour observation of the twins.
- D. Identify complications that may occur as the twins develop.
Correct Answer: B
Rationale: Parental participation in twin care during hospitalization promotes bonding, confidence, and skill development. Discussing coping, 24-hour observation, or identifying complications are less immediate or unrealistic.
Which of the following would be the priority when the form of primigravid client whose exercise is dilated at 6 cm when the fetus is at 1+ station and the client has had no analgesia or anesthesia?
- A. Giving frequent sips of water.
- B. Applying extra blankets for warmth.
- C. Providing frequent perineal cleansing.
- D. Offering encouragement and support.
Correct Answer: D
Rationale: At 6 cm dilation without analgesia, the client is likely experiencing significant pain and anxiety. Offering encouragement and support is the priority to help her cope emotionally and physically. Hydration, warmth, and perineal cleansing are secondary concerns.