Nokea
A patient has had four vaginal deliveries. What barrier contraceptive method’s efficacy is affected by this history?
- A. internal condom
- B. external condom
- C. cervical cap
- D. contraceptive gel
Correct Answer: C
Rationale: The correct answer is C: cervical cap. This barrier contraceptive method's efficacy is affected by the patient's history of four vaginal deliveries due to changes in the cervix and vaginal canal post-deliveries. The cervical cap relies on proper placement over the cervix to prevent sperm from entering the uterus. However, after multiple vaginal deliveries, the cervix may become less firm and may have altered shape or size, leading to reduced effectiveness of the cervical cap.
A: Internal condom and B: external condom are not affected by the history of vaginal deliveries as they do not rely on cervical fit for efficacy.
D: Contraceptive gel is not directly affected by the number of vaginal deliveries as it is applied externally and does not rely on cervical anatomy for effectiveness.
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Which assessment finding suggests that the laboring client's
- B. Reflex grade 0
- C. Urine output 60
- D. Generalized seizure
Correct Answer: D
Rationale: The correct answer is D, Generalized seizure. During labor, a generalized seizure is a critical finding that indicates eclampsia, a severe complication of pregnancy characterized by seizures, hypertension, and proteinuria. This requires immediate medical intervention to prevent harm to the mother and baby. Reflex grade 0 (choice B) is not a typical assessment finding during labor, and it does not indicate any immediate life-threatening condition. Urine output of 60 (choice C) is within the normal range and does not suggest any immediate critical issue. Therefore, choice D is the correct answer due to the urgency and severity of the condition it represents.
The nurse enters the person's room for the first time. What can the nurse do to show cultural sensitivity?
- A. Come in and sit on the bed with the person.
- B. Address the person by their first name.
- C. Make and hold eye contact.
- D. Document their preferred language in their chart.
Correct Answer: D
Rationale: The correct answer is D because documenting the person's preferred language in their chart shows cultural sensitivity by ensuring effective communication. This step acknowledges and respects the person's cultural background and language preferences, facilitating better understanding and care provision.
Choices A, B, and C are incorrect:
A: Sitting on the bed may invade personal space and not be culturally appropriate.
B: Addressing the person by their first name may not be respectful in some cultures.
C: Making and holding eye contact may be considered rude or inappropriate in certain cultures.
The nurse is assessing a client with suspected preterm labor. Which finding confirms the diagnosis?
- A. Regular uterine contractions every 10 minutes.
- B. Cervical dilation of 3 cm.
- C. Lower back pain and cramping.
- D. Positive fetal fibronectin test.
Correct Answer: B
Rationale: The correct answer is B: Cervical dilation of 3 cm. This finding confirms preterm labor as it indicates cervical changes associated with labor progression. Regular uterine contractions every 10 minutes (choice A) may suggest labor but alone doesn't confirm preterm labor. Lower back pain and cramping (choice C) are common symptoms but not specific to preterm labor. A positive fetal fibronectin test (choice D) may indicate an increased risk of preterm labor but doesn't confirm the diagnosis definitively.
A nurse is teaching the parents of a newborn how to care for their child's uncircumcised penis. Which of the following instructions should the nurse include?
- A. Retract the foreskin until you feel resistance.
- B. Use a cotton swab to clean under the foreskin.
- C. Apply petroleum jelly to the foreskin.
- D. Wash the penis once per day with soup and water.
Correct Answer: D
Rationale: The correct answer is D because washing the penis once per day with soap and water is the appropriate way to care for an uncircumcised penis. This helps maintain good hygiene and prevents infections. Retracting the foreskin forcefully (Choice A) can cause injury and should not be done until the child is older. Using a cotton swab (Choice B) can leave fibers behind and may cause irritation. Applying petroleum jelly (Choice C) is unnecessary and can increase the risk of infections. Therefore, washing the penis with soap and water daily is the most effective and safe method for caring for an uncircumcised penis.
A nurse is assessing a client who is 3 days postpartum and is breastfeeding. The nurse notes that the fundus is three fingerbreadths below the umbilicus, lochia rubra is moderate, and the breasts are hard and warm to palpation. Which of the following interpretations of these findings should the nurse make?
- A. The client is exhibiting early indications of mastitis.
- B. Additional interventions are not indicated at this time.
- C. Application of a heating pad to the breasts is indicated.
- D. The client should be advised to remove her nursing bra.
Correct Answer: B
Rationale: Correct Answer: B - Additional interventions are not indicated at this time.
Rationale:
1. Fundus location: Three fingerbreadths below the umbilicus is within normal range for 3 days postpartum.
2. Lochia rubra: Moderate lochia rubra is expected at this stage postpartum.
3. Breasts: Hard and warm breasts are indicative of engorgement, a common issue in breastfeeding mothers.
Summary:
A: Early indications of mastitis would include redness, warmth, and tenderness in the breasts, along with flu-like symptoms.
C: Application of a heating pad to the breasts can worsen engorgement and increase the risk of mastitis.
D: Removing a nursing bra may offer some relief for engorgement, but it is not the priority intervention at this time.