Nokea
A nurse is teaching about clomiphene citrate to a client who is experiencing infertility. Which of the following adverse effects should the nurse include?
- A. Tinnitus
- B. Urinary Frequency
- C. Breast Tenderness
- D. Chills
Correct Answer: C
Rationale: The correct answer is C: 'Breast Tenderness.' Clomiphene citrate is known to cause breast tenderness as a common side effect due to its hormonal effects on the body. Tinnitus (choice A), which is a ringing in the ears, is not typically associated with clomiphene citrate. Urinary frequency (choice B) is not a common adverse effect of this medication. Chills (choice D) are also not commonly linked to clomiphene citrate use.
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When do mothers usually feel the first fetal movements during pregnancy?
- A. At 18-20 weeks
- B. During the first month
- C. Rarely
- D. Never
Correct Answer: A
Rationale: Mothers usually feel the first fetal movements, known as 'quickening,' around the 18th to 20th week of pregnancy. Feeling fetal movements during the first month is unlikely and uncommon. Therefore, option B is incorrect. Options C and D are also incorrect as mothers typically do feel fetal movements during pregnancy, just not during the first month.
Which of the following statements is true of Down's syndrome?
- A. Down's syndrome is usually caused by an extra copy of chromosome 21 in an individual.
- B. The symptoms of Down's syndrome are similar to those of sickle-cell anemia.
- C. Down's syndrome is caused by a sexually transmitted infection (STI) during conception.
- D. The probability of having a child with Down's syndrome increases with the age of the parents.
Correct Answer: D
Rationale: The correct answer is D. The likelihood of having a child with Down's syndrome increases as the age of the parents increases, particularly the mother's age. Choice A is incorrect because Down's syndrome is caused by an extra copy of chromosome 21, not a defect in the sex chromosomes. Choice B is incorrect as the symptoms of Down's syndrome and sickle-cell anemia are different. Choice C is also incorrect as Down's syndrome is not caused by a sexually transmitted infection during conception.
A client at 34 weeks gestation comes to the birthing center complaining of vaginal bleeding that began one hour ago. The nurse's assessment reveals approximately 30ML of bright red vaginal bleeding, fetal heart rate of 130 - 140 beats per minute, no contractions, and no complaints of pain. What is the most likely cause of this client's bleeding?
- A. Abruptio Placenta
- B. Placenta Previa
- C. Normal bloody show indicating induction of labor
- D. A ruptured blood vessel in the vaginal vault
Correct Answer: B
Rationale: Placenta previa, a condition where the placenta covers the cervix, can cause painless, bright red vaginal bleeding in the third trimester. In this scenario, the absence of contractions and pain, along with the presence of significant bright red bleeding, is more indicative of placenta previa rather than abruptio placenta or a ruptured vessel. A normal bloody show typically occurs closer to the onset of labor and is not associated with the amount of bleeding described in the question.
At 12 hours after the birth of a healthy infant, the mother complains of feeling constant vaginal pressure. The nurse determines the fundus is firm and at midline with moderate rubra lochia. Which action should the nurse take?
- A. Check the suprapubic area for distention
- B. Inform the client to take a warm sitz bath
- C. Inspect the client's perineal and rectal areas
- D. Apply a fresh pad and check in 1 hour
Correct Answer: C
Rationale: In this situation, the mother's complaint of constant vaginal pressure along with a firm fundus and moderate rubra lochia indicates a potential perineal injury or hematoma. The correct action for the nurse to take is to inspect the client's perineal and rectal areas to assess for any signs of trauma or hematoma. Checking the suprapubic area for distention (Choice A) is not the priority here since the symptoms suggest a perineal issue. Advising a warm sitz bath (Choice B) may not address the underlying issue and could potentially worsen any existing trauma. Applying a fresh pad and checking in 1 hour (Choice D) does not address the need for immediate assessment of the perineal and rectal areas in response to the reported symptoms.
A client is receiving oxytocin by continuous IV infusion for labor induction. Which of the following interventions should the nurse include in the plan?
- A. Increase the infusion rate every 30 to 60 minutes.
- B. Maintain the client in a supine position.
- C. Titrate the infusion rate by 4 milliunits/min.
- D. Limit IV intake to 4 L per 24 hours.
Correct Answer: A
Rationale: The correct answer is to increase the infusion rate every 30 to 60 minutes. This approach allows for the careful monitoring and adjustment of oxytocin administration during labor induction. Choice B is incorrect because maintaining the client in a supine position can decrease blood flow to the placenta and compromise fetal oxygenation. Choice C is incorrect as titrating the infusion rate by 4 milliunits/min is not a standard practice for oxytocin administration. Choice D is incorrect as limiting IV intake to 4 L per 24 hours is not specifically related to the administration of oxytocin for labor induction.