Nokea
A primigravid client at 38 weeks' gestation is admitted to the labor suite in active labor. The client's physical assessment reveals a chlamydial infection. The nurse explains that if the infection is left untreated, the neonate may develop which of the following?
- A. Conjunctivitis.
- B. Heart disease.
- C. Skin lesions.
- D. Hepatitis.
Correct Answer: A
Rationale: Untreated chlamydia during delivery can cause neonatal conjunctivitis (ophthalmia neonatorum) via transmission through the birth canal. Heart disease, skin lesions, and hepatitis are not associated with chlamydia.
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Which of the following anticoagulants would the nurse expect to administer when caring for a primigravid client at 12 weeks' gestation who has class II cardiac disease due to mitral valve stenosis?
- A. Heparin.
- B. Warfarin(Coumadin).
- C. Enoxaparin(Lovenox).
- D. Ardeparin(Normiflo).
Correct Answer: A
Rationale: Heparin is safe during pregnancy and does not cross the placenta.
The nurse managing the admission nursery is beginning the shift. There are 2 infants under the care of a primary staff nurse and are remaining in the nursery while their mothers sleep. One newborn is waiting to be transferred to the special care nursery (SCN) with a diagnosis of possible sepsis. The SCN cannot accept a transfer for 30 minutes. The nurse has been notified that another infant has been born and is breathing at a rate of 80 bpm and needs to be admitted to the nursery. There are also two infants who are waiting for social services to determine discharge plans. There can be no other additions to the nursery until at least one newborn leaves the area. How should the nurse manage this situation?
- A. Ask the nurses in SCN if they can take the newborn with possible sepsis now.
- B. Ask the primary staff nurses to take their babies back to the sleeping mothers' rooms.
- C. Call social services to determine if either of the babies who are waiting to be discharged are ready to leave.
- D. Ask the nurse with the infant who is breathing at 80 bpm to wait ½ hour.
Correct Answer: C
Rationale: Calling social services to expedite discharge of one of the waiting infants allows space for the new admission with a high respiratory rate, which requires urgent assessment.
The nurse is working on a busy labor and delivery unit with other nurses and a licensed practical nurse. Which of the following labor clients would the nurse assign to the licensed practical nurse?
- A. A G 4, P 3 client with a history of gestational diabetes.
- B. A G 3, P 1, Ab 1 client at 35 weeks' gestation.
- C. A G 1, P 0 client with leaking green amniotic fluid.
- D. A G 2, P 1 client with a history of hyperemesis gravidarum.
Correct Answer: D
Rationale: A G 2, P 1 client with a history of hyperemesis gravidarum is low-risk, suitable for an LPN's scope (e.g., vital signs, basic care). Clients with gestational diabetes, preterm labor (35 weeks), or meconium-stained fluid (G 1, P 0) require RN assessment due to higher risk.
A nurse is discussing sterilization with a male client. Which of the following statements by the nurse is accurate?
- A. A vasectomy is effective immediately.
- B. A vasectomy requires a follow-up sperm count to confirm sterility.
- C. A vasectomy prevents testosterone production.
- D. A vasectomy is reversible in all cases.
Correct Answer: B
Rationale: A vasectomy requires a follow-up sperm count to confirm sterility, as sperm may remain in the vas deferens initially. It is not effective immediately, does not affect testosterone production, and reversal is not always successful.
One-half hour after vaginal delivery of a term neonate, the nurse palpates the fundus of a primigravid client, noting several large clots and a small trickle of bright red vaginal bleeding. The client's blood pressure is 136/92 mm Hg. Which of the following would the nurse do first?
- A. Continue to monitor the client's fundus every 15 minutes.
- B. Ask the physician for an order for methylergonovine (Methergine).
- C. Immediately notify the physician of the client's symptoms.
- D. Change the client's perineal pads every 15 minutes.
Correct Answer: C
Rationale: Large clots and bright red bleeding post-delivery suggest possible uterine atony or retained placental fragments, requiring immediate physician notification for intervention. Monitoring, requesting medication, or changing pads are secondary actions.