Nokea
A woman asks about the side effects of the contraceptive implant. Which of the following should the nurse include in the discussion?
- A. The implant will cause heavy menstrual bleeding.
- B. The implant may cause irregular bleeding patterns, including light spotting.
- C. The implant can cause weight gain.
- D. The implant may cause hair loss.
Correct Answer: B
Rationale: The correct answer is B because irregular bleeding patterns, including light spotting, are a common side effect of the contraceptive implant due to hormonal changes. This is important for the woman to be aware of to manage her expectations. Choice A is incorrect as the implant typically leads to lighter periods or no periods at all. Choice C is incorrect as weight gain is not a common side effect of the implant. Choice D is also incorrect as hair loss is not typically associated with the contraceptive implant.
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The nurse is preparing a postpartum client for discharge. Which instruction is most important?
- A. Avoid breastfeeding if you feel tired.
- B. Report foul-smelling lochia to your doctor.
- C. Resume all physical activity immediately.
- D. Stop taking your prenatal vitamins after discharge.
Correct Answer: B
Rationale: The correct answer is B: Report foul-smelling lochia to your doctor. This instruction is crucial because foul-smelling lochia can indicate an infection, which requires immediate medical attention to prevent complications. Reporting this to the doctor promptly ensures timely treatment.
A: Avoid breastfeeding if you feel tired - Incorrect. Breastfeeding is important for the baby's nutrition and bonding, regardless of the mother's fatigue.
C: Resume all physical activity immediately - Incorrect. Gradual resumption of physical activity is recommended to allow the body to heal properly.
D: Stop taking your prenatal vitamins after discharge - Incorrect. Prenatal vitamins are beneficial for postpartum recovery and breastfeeding, so stopping them abruptly is not advisable.
In what stage does the corpus luteum form?
- A. Luteal phase
- B. Follicular phase
- C. Proliferative phase
- D. Shedding of endometrium phase
Correct Answer: A
Rationale: The corpus luteum forms during the luteal phase of the menstrual cycle. After ovulation, the ruptured follicle transforms into the corpus luteum, which secretes progesterone to prepare the uterus for potential pregnancy. If fertilization doesn't occur, the corpus luteum degenerates, leading to a drop in progesterone levels and the start of menstruation. The other choices, such as the follicular phase (B) where the follicles develop, proliferative phase (C) where the endometrium thickens, and shedding of endometrium phase (D) where menstruation occurs, do not involve the formation of the corpus luteum.
The nurse is assessing a client in active labor with variable decelerations on the fetal monitor. What is the priority intervention?
- A. Increase oxytocin infusion.
- B. Reposition the client.
- C. Administer oxygen at 10 L/min.
- D. Perform a vaginal examination.
Correct Answer: B
Rationale: The correct answer is B: Reposition the client. Variable decelerations can indicate umbilical cord compression. Repositioning the client can help relieve the compression, improving fetal oxygenation. Increasing oxytocin (A) could worsen the situation. Administering oxygen (C) may be needed but repositioning is the priority. Performing a vaginal examination (D) is not indicated for variable decelerations.
A patient has delivered twins. The first twin was stillborn, and the second is in the intensive care nursery, recovering quickly from respiratory distress. The patient is crying softly and says, "wish my baby could have lived." What is the most therapeutic response?
- A. "How soon do you plan to have another baby?"
- B. "Don't be sad. At least you have one healthy baby."
- C. "have a friend who lost a twin and she's doing just fine now."
- D. "am so sorry about your loss. Would you like to talk about it?"
Correct Answer: D
Rationale: The correct answer is D because it shows empathy, acknowledges the patient's loss, and invites further discussion if the patient wishes to talk. It validates the patient's feelings and offers support. Choice A is inappropriate as it disregards the patient's current emotional state. Choice B diminishes the patient's grief and may come off as insensitive. Choice C redirects the focus to someone else's experience, which may not be helpful in addressing the patient's emotions.
A client with a history of hypertension is at 28 weeks' gestation. What complication is she at greatest risk for?
- A. Placenta previa.
- B. Gestational diabetes.
- C. Abruptio placentae.
- D. Preterm labor.
Correct Answer: C
Rationale: The correct answer is C: Abruptio placentae. At 28 weeks, the client with hypertension is at greater risk for abruptio placentae due to increased vascular resistance, leading to potential placental detachment. Placenta previa (A) is more common in the third trimester. Gestational diabetes (B) is more common in later pregnancy and not directly related to hypertension. Preterm labor (D) can be a risk with chronic hypertension but is not the greatest risk at 28 weeks.