Nokea
A nurse is teaching a client about the use of the contraceptive injection. Which of the following instructions should the nurse include?
- A. The injection is given every 6 months.
- B. The injection may cause a delay in return to fertility.
- C. The injection protects against STIs.
- D. The injection is taken orally daily.
Correct Answer: B
Rationale: The contraceptive injection (Depo-Provera) may cause a delay in return to fertility, sometimes up to 18 months. It is given every 3 months, does not protect against STIs, and is not taken orally.
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The nurse is assessing a multigravida client at 12 weeks' gestation who has been admitted to the emergency department with sharp right-sided abdominal pain and vaginal spotting. Which of the following should the nurse obtain about the client's history? Select all that apply.
- A. History of sexually transmitted infections.
- B. Number of sexual partners.
- C. Last menstrual period.
- D. Cesarean section.
- E. IUD use.
- F. Contraceptive use.
Correct Answer: A,B,C,E,F
Rationale: These factors increase the risk of ectopic pregnancy.
Which of the following nursing diagnoses would be the priority for a multigravid diabetic client at 38 weeks' gestation who is scheduled for labor induction with oxytocin (Pitocin)?
- A. Risk for deficient fluid volume related to oxytocin infusion.
- B. Pain related to prolonged labor and uterine ischemia.
- C. Fear related to possible need for cesarean delivery.
- D. Risk for injury, maternal or fetal, related to potential uterine hyperstimulation.
Correct Answer: D
Rationale: Oxytocin can cause uterine hyperstimulation, risking maternal or fetal injury (e.g., fetal hypoxia). This is the priority in a diabetic client due to increased fetal vulnerability. Fluid volume, pain, and fear are less immediate.
Assessment of a primigravid client in active labor who has had no analgesia or anesthesia reveals complete cervical effacement, dilation of 8 cm, and the fetus at 0 station. The nurse should expect the client to exhibit which of the following behaviors during this phase of labor?
- A. Excitement.
- B. Loss of control.
- C. Numbness of the legs.
- D. Feelings of relief.
Correct Answer: B
Rationale: During the transition phase (8–10 cm dilation), primigravid clients without analgesia often experience intense contractions and may feel overwhelmed, leading to a perceived loss of control. Excitement is more common in early labor, numbness of the legs is associated with epidural anesthesia, and feelings of relief typically occur after delivery.
A client asks about the benefits of the copper IUD. Which of the following would the nurse include?
- A. It reduces menstrual bleeding.
- B. It is hormone-free and effective for up to 10 years.
- C. It requires daily monitoring.
- D. It prevents ovulation.
Correct Answer: B
Rationale: The copper IUD is hormone-free and effective for up to 10 years, offering long-term contraception. It may increase menstrual bleeding, does not require daily monitoring, and does not prevent ovulation.
A primigravid client in active labor has had no anesthesia. The client's cervix is 7 cm dilated, and she is starting to feel considerable discomfort during the first 10 cm to the client's sacral client is a left side-lying position. The nurse should encourage which of the following?
- A. Rapid, shallow chest breathing.
- B. Deep chest breathing.
- C. Rapid pant-blow breathing.
- D. Slow abdominal breathing.
Correct Answer: D
Rationale: Slow abdominal breathing promotes relaxation and oxygenation, helping manage discomfort in active labor without anesthesia. Rapid or shallow breathing may lead to hyperventilation, and deep chest breathing is less effective for pain control.