Nokea
A nurse is teaching a client who is to start using a diaphragm for contraception. Which of the following client statements indicate an understanding of the teaching?
- A. I will leave the diaphragm in place for 4 hours following intercourse.
- B. I will remove the diaphragm by catching the rim below the dome with my finger.
- C. I will place a thin layer of mineral oil on the diaphragm once per week.
- D. I will place 2 teaspoons of spermicide on the inside of the diaphragm before inserting it.
Correct Answer: D
Rationale: The client should place spermicide in the diaphragm before insertion to enhance contraceptive effectiveness. The diaphragm should also be left in place for at least 6 hours after intercourse, but not more than 24 hours.
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A client tells the nurse that she suspects she is pregnant because she is able to feel the baby move. The nurse knows that this is a:
- A. Presumptive sign of pregnancy
- B. Probable sign of pregnancy
- C. Positive sign of pregnancy
- D. Possible sign of pregnancy
Correct Answer: A
Rationale: Quickening, or the sensation of fetal movement, is considered a presumptive sign of pregnancy. It is not definitive because other conditions, such as gas or intestinal movement, can mimic the feeling of fetal movement.
A nurse is admitting a client who is at 33 weeks of gestation and has preeclampsia with severe features. Which of the following actions should the nurse take?
- A. Restrict protein intake to less than 40 g/day
- B. Initiate seizure precautions for the client
- C. Initiate an infusion of 0.9% sodium chloride at 150 mL/hr
- D. Encourage the client to ambulate twice per day
Correct Answer: B
Rationale: The nurse should initiate seizure precautions because severe preeclampsia poses a high risk for seizures (eclampsia), ensuring the safety of the client.
Which of the following would increase a client's risk of ovarian cancer?
- A. History of fibroids
- B. Early menopause
- C. Endometriosis
- D. Polycystic ovary syndrome
Correct Answer: C
Rationale: Endometriosis is associated with an increased risk of developing ovarian cancer due to chronic inflammation and hormonal imbalances. The exact cause is not fully understood, but women with endometriosis should be monitored closely.
A nurse is assessing a client who gave birth 1 week ago. The client states, "I don't know what's wrong. I love my baby, but I feel so let down and I seem to cry for no reason." The nurse should identify that the client is experiencing which of the following emotional responses to birth?
- A. Postpartum depression
- B. Taking-in phase
- C. Postpartum blues
- D. Taking-hold phase
Correct Answer: C
Rationale: The client is likely experiencing postpartum blues, which is common and characterized by mood swings, tearfulness, and emotional letdown shortly after delivery.
During a breast examination on a 24-year-old client the nurse notes the following findings. Which finding is of most concern and should be reported to the provider?
- A. An irregularly shaped, nontender lump is palpable in the right breast
- B. Tenderness is present during menstruation
- C. Bilateral, symmetrical lumps that move with palpation
- D. The client reports breast tenderness before menstruation
Correct Answer: A
Rationale: An irregularly shaped, nontender lump is a concerning finding because it may indicate breast cancer. The nurse should report this finding to the provider for further investigation.