Nokea
A primiparous client has just delivered a healthy male infant. The client and her husband are Muslim and the husband begins chanting a song in Arabic while holding the neonate. The nurse interprets the father's actions as indicative of which of the following?
- A. Thanking Allah for giving him a male heir.
- B. Singing to his son from the Koran in praise of Allah.
- C. Expressing appreciation that his wife and son are healthy.
- D. Performing a ritual similar to baptism in other religions.
Correct Answer: D
Rationale: The chanting is likely the Adhan, a Muslim ritual where the call to prayer is recited to the newborn, similar to a baptismal rite.
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A multiparous client at 24 hours postpartum demonstrates a positive Homan's sign with discomfort. The nurse should:
- A. Place a cold pack on the client's perineal area.
- B. Place the client in a semi-Fowler's position.
- C. Notify the client's physician immediately.
- D. Ask the client to ambulate around the room.
Correct Answer: C
Rationale: A positive Homan's sign suggests possible deep vein thrombosis, requiring immediate physician notification.
A nurse is preparing a change-of-shift report and has been caring for a multigravid client with a normally progressing labor. Which of the following information should be part of this report? Select all that apply.
- A. Interpretation of the fetal monitor strip.
- B. Analgesia or anesthesia being used.
- C. Anticipated method of birth control.
- D. Amount of vaginal bleeding or discharge.
- E. Support persons with the client.
- F. Prior delivery history.
Correct Answer: A,B,D,E,F
Rationale: A comprehensive shift report includes fetal monitor interpretation, analgesia/anesthesia use, vaginal bleeding/discharge, support persons, and prior delivery history to ensure continuity of care. Anticipated birth control is not relevant during labor.
A nurse is discussing the withdrawal method with a client. Which of the following client statements indicates a need for further teaching?
- A. I understand it has a high failure rate.
- B. My partner needs to withdraw before ejaculation.
- C. It provides some protection against STIs.
- D. It requires careful timing and control.
Correct Answer: C
Rationale: The withdrawal method does not provide protection against STIs, indicating a need for further teaching. The other statements are correct regarding its high failure rate, need for withdrawal before ejaculation, and requirement for timing and control.
A primigravida is admitted to the labor area with ruptured membranes and contractions occurring every 2 to 3 minutes, lasting 45 seconds. After 3 hours of labor, the client's contractions are now every 7 to 10 minutes, lasting 30 seconds. The nurse administers oxytocin (Pitocin) as ordered. The expected outcome of this drug is:
- A. The cervix will begin to dilate 2 centimeters per hour.
- B. Contractions will occur every 2 to 3 minutes, lasting 40 to 60 seconds, moderate intensity, resting tone between contractions.
- C. The cervix will change from firm to soft, efface to 40% to 50%, and move from a posterior to anterior position.
- D. Contractions will be every 2 minutes, lasting 60 to 90 seconds, with intrauterine pressure of 70 mm Hg.
Correct Answer: B
Rationale: Oxytocin is used to augment labor by increasing contraction frequency, duration, and intensity. The expected outcome is regular contractions every 2–3 minutes, lasting 40–60 seconds, with moderate intensity and adequate resting tone, promoting effective labor progression. The other options describe unrealistic or unrelated effects.
A client has obtained Plan B (levonorgestrel 0.75 mg, 2 tablets) as emergency contraception. After unprotected intercourse, the client calls the clinic to ask questions about taking the contraceptives. The nurse realizes the client needs further explanation when she makes which of the following responses?
- A. I can wait 3 to 4 days after intercourse to start taking these to prevent pregnancy.
- B. My boyfriend can buy Plan B from the pharmacy if he is over 18 years old.
- C. The birth control works by preventing ovulation or fertilization of the egg.
- D. I can be discussed and have breast tenderness or a headache after using the contraceptive.
Correct Answer: A
Rationale: Plan B is most effective when taken within 72 hours of unprotected intercourse, ideally as soon as possible. Waiting 3 to 4 days reduces its efficacy, indicating a need for further explanation.