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A school nurse is providing teaching to an adolescent about levonorgestrel contraception. Which of the following information should the nurse include in the teaching?
- A. You should take the medication within 72 hours following unprotected sexual intercourse.
- B. You should avoid taking this medication if you are on an oral contraceptive.
- C. If you don't start your period within 5 days of taking this medication, you will need a pregnancy test.
- D. One dose of this medication will prevent you from becoming pregnant for 14 days after taking it.
Correct Answer: A
Rationale: The correct answer is A: You should take the medication within 72 hours following unprotected sexual intercourse. Levonorgestrel is a type of emergency contraception that is most effective when taken within 72 hours of unprotected sex. Taking it as soon as possible maximizes its effectiveness in preventing pregnancy by delaying or inhibiting ovulation. Choice B is incorrect as levonorgestrel can be used even if the person is on an oral contraceptive. Choice C is incorrect because a delayed period does not necessarily indicate pregnancy; a pregnancy test should be taken if there are other signs of pregnancy. Choice D is incorrect because levonorgestrel is only effective for a short period after taking it and does not provide long-term protection against pregnancy.
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A nurse is caring for a client who has hyperemesis gravidarum and is receiving IV fluid replacement. Which of the following findings should the nurse report to the provider?
- A. Blood pressure 105/64 mm Hg.
- B. Heart rate 98/min.
- C. Urine output of 280 mL within 8 hr.
- D. Urine negative for ketones.
Correct Answer: C
Rationale: The correct answer is C: Urine output of 280 mL within 8 hr. In hyperemesis gravidarum, decreased urine output can indicate dehydration, a serious complication. The nurse should report this finding to the provider to ensure prompt intervention. A: Blood pressure 105/64 mm Hg is within normal range for pregnancy. B: Heart rate 98/min may be slightly elevated but not concerning. D: Urine negative for ketones is expected with IV fluid replacement.
A nurse is teaching a client who has pregestational type 1 diabetes mellitus about management during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will need to increase my insulin doses during the first trimester.
- B. I should engage in moderate exercise for 30 minutes if my blood glucose is 250 or greater.
- C. I will continue taking my insulin if I experience nausea and vomiting.
- D. I will ensure that my bedtime snack is high in refined sugar.
Correct Answer: C
Rationale: The correct answer is C. Continuing to take insulin even if experiencing nausea and vomiting is crucial in managing blood glucose levels in type 1 diabetes during pregnancy. Nausea and vomiting can lead to decreased food intake, potentially causing hypoglycemia if insulin is not adjusted. Increasing insulin doses in the first trimester (choice A) is not recommended without healthcare provider guidance. Engaging in moderate exercise with high blood glucose (choice B) could worsen hyperglycemia. Ensuring a bedtime snack high in refined sugar (choice D) may lead to unstable blood glucose levels.
A nurse is caring for a client who is at 38 weeks of gestation. Which of the following actions should the nurse take prior to applying an external transducer for fetal monitoring?
- A. Determine progression of dilatation and effacement.
- B. Perform Leopold maneuvers.
- C. Complete a sterile speculum exam.
- D. Prepare a Nitrazine paper test.
Correct Answer: B
Rationale: The correct answer is B: Perform Leopold maneuvers. Before applying an external transducer for fetal monitoring at 38 weeks of gestation, the nurse should perform Leopold maneuvers to determine the fetal position, presentation, and lie. This helps in correctly placing the transducer over the fetal heart for accurate monitoring. Progression of dilatation and effacement (A) is not necessary prior to applying the external transducer. Completing a sterile speculum exam (C) and preparing a Nitrazine paper test (D) are unrelated to fetal monitoring and are not indicated in this situation.
A nurse is caring for a client who is in labor and reports increasing rectal pressure. They are experiencing contractions 2 to 3 min apart, each lasting 80 to 90 seconds, and a vaginal examination reveals that their cervix is dilated to 9 cm. The nurse should identify that the client is in which of the following phases of labor?
- A. Passive descent
- B. Active
- C. Early
- D. Descent
Correct Answer: B
Rationale: The correct answer is B: Active phase. At 9 cm dilation, the client is in the active phase of the first stage of labor. This phase is characterized by more rapid cervical dilation (6-10 cm) and increased contractions with shorter intervals. The client's symptoms align with this phase as they are experiencing strong contractions close together, along with increased rectal pressure indicating descent of the fetus. Other choices are incorrect as: A (Passive descent) occurs during the second stage of labor; C (Early phase) is typically before 6 cm dilation; D (Descent) is not a recognized phase of labor.
A nurse is caring for a client who has preeclampsia and is receiving a continuous infusion of magnesium sulfate IV. Which of the following actions should the nurse take?
- A. Restrict hourly fluid intake to 150 mL/hr.
- B. Have calcium gluconate readily available.
- C. Assess deep tendon reflexes every 6 hr.
- D. Monitor intake and output every 4 hr.
Correct Answer: B
Rationale: The correct answer is B: Have calcium gluconate readily available. Magnesium sulfate can lead to magnesium toxicity, causing respiratory depression and cardiac arrest. Calcium gluconate is the antidote for magnesium toxicity, so having it readily available is crucial for immediate administration if toxicity occurs. Option A is incorrect as fluid intake should not be restricted in preeclampsia. Option C is incorrect as deep tendon reflexes should be assessed more frequently (every 1-2 hours) due to the risk of hypermagnesemia. Option D is incorrect as intake and output should be monitored hourly to detect any changes in renal function.