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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After several hours of labor, the fetal heart monitor shows
- A. The nurse would interpret this deceleration to be consistent with which presentation?
- B. Umbilical cord compression
- C. Uteroplacental insufficiency
- D. Compression of fetal head
Correct Answer: B
Rationale: The correct answer is B: Umbilical cord compression. When the fetal heart monitor shows deceleration after several hours of labor, it indicates reduced oxygen supply to the fetus. Umbilical cord compression can restrict blood flow and oxygen delivery to the fetus, leading to decelerations. This is a common cause during labor. Choices A, C, and D do not directly relate to the decreased oxygen supply indicated by decelerations on the fetal heart monitor.
Which intervention should the nurse prioritize for a pregnant client with placenta previa?
- A. Monitor the client for contractions
- B. Prepare for immediate cesarean delivery
- C. Monitor for signs of fetal distress
- D. Encourage the client to remain in bed rest
Correct Answer: B
Rationale: The correct answer is B: Prepare for immediate cesarean delivery. Placenta previa is a condition where the placenta partially or completely covers the cervix, which can lead to life-threatening bleeding during labor. Immediate cesarean delivery is the priority to prevent maternal and fetal complications. Monitoring for contractions (A) is important but not the priority. Monitoring for fetal distress (C) is crucial but not the immediate intervention. Encouraging bed rest (D) may be recommended but is not the priority intervention in placenta previa.
The nurse understands that many patients who experience violence become homeless to escape their situation. How can the nurse help these patients?
- A. Tell the patient to go back home in order to have a place to live.
- B. Tell the patient to get a job in order to have a place to stay.
- C. Refer the patient to a shelter.
- D. Refer the patient to the police.
Correct Answer: C
Rationale: The correct answer is C: Refer the patient to a shelter. This option is the most appropriate because it addresses the immediate need for a safe place to stay for patients experiencing violence and homelessness. Referring the patient to a shelter provides them with temporary housing, safety, and access to resources and support services. Options A and B are not suitable as they overlook the safety concerns of the patient and may put them at risk of further harm. Option D, referring the patient to the police, may not address the patient's need for shelter and support services. Therefore, option C is the most effective and compassionate way to help patients in this situation.
A client at 20 weeks' gestation asks about fetal movements. What is the nurse's best response?
- A. Fetal movements are rarely felt before 24 weeks.
- B. You should feel strong, regular movements at this stage.
- C. You may feel fluttering movements, known as quickening.
- D. It is too early to feel any fetal movements.
Correct Answer: C
Rationale: The correct answer is C because quickening, described as fluttering movements, is typically felt by pregnant individuals around 18-20 weeks of gestation. This indicates fetal movement and is an important milestone in pregnancy. Choices A and D are incorrect as fetal movements can be felt as early as 18-20 weeks. Choice B is incorrect as feeling strong, regular movements is not expected until later in the pregnancy.
The nurse is teaching a client about morning sickness. What recommendation should the nurse provide?
- A. Eat large meals three times a day.
- B. Drink fluids with meals.
- C. Consume dry crackers before getting out of bed.
- D. Avoid eating before bedtime.
Correct Answer: C
Rationale: The correct answer is C: Consume dry crackers before getting out of bed. This recommendation helps alleviate morning sickness by providing a bland and easily digestible snack to settle the stomach before getting up. By consuming dry crackers, the client can avoid an empty stomach, which can contribute to nausea. Eating large meals three times a day (A) can worsen morning sickness due to heavy digestion, while drinking fluids with meals (B) may exacerbate nausea. Avoiding eating before bedtime (D) is generally recommended, but it does not specifically address morning sickness.