Nokea
A woman asks the nurse to recommend the best douche for use after menstruation. Which of the following responses by the nurse is appropriate?
- A. Tap water with white vinegar is most refreshing and least allergenic.'
- B. It is really best for women not to douche.'
- C. Any of the over-the-counter douches is satisfactory.'
- D. It is best to douche during menstruation rather than after it is over.'
Correct Answer: B
Rationale: Douching can disrupt the natural vaginal flora and increase the risk of infections, so it is generally not recommended.
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A 1-week-postpartum client calls her obstetrician’s office and states, 'I am a breastfeeding mother and my nipples are cracked and bleeding.' Which of the following comments by the nurse is appropriate at this time?
- A. You will need to be seen by the doctor today.'
- B. The blood will make the baby very sick. You should pump and dump your milk for at least 1 week.'
- C. You are very high risk for infection. You should cleanse your nipples with dilute hydrogen peroxide twice every day.'
- D. Lanolin cream applied after each feeding will help you to heal.'
Correct Answer: D
Rationale: Lanolin cream helps soothe and heal cracked nipples without harming the baby.
Which technique would provide the best pain relief for a pregnant woman with an occiput posterior position?
- A. Neuromuscular disassociation
- B. Effleurage
- C. Psychoprophylaxis
- D. Sacral pressure
Correct Answer: D
Rationale: The correct answer is D: Sacral pressure. This technique involves applying pressure to the sacrum to alleviate back pain associated with an occiput posterior position. The pressure helps relieve tension and discomfort in the lower back, providing effective pain relief for the pregnant woman.
A: Neuromuscular disassociation is not specific to addressing the pain associated with the occiput posterior position in pregnancy.
B: Effleurage is a gentle massage technique that may provide some relaxation but may not be as effective as sacral pressure for pain relief in this specific scenario.
C: Psychoprophylaxis is a method of preparing for childbirth through education and relaxation techniques, but it may not directly target the pain caused by the occiput posterior position.
In summary, sacral pressure is the most appropriate technique as it directly addresses the specific pain associated with the occiput posterior position in pregnancy, unlike the other choices.
The nurse is reviewing the procedure for alpha-fetoprotein (AFP) screening with a patient at 16 weeks' gestation. The nurse determines that the patient understands the teaching when she states that will be collected for the initial screening process?
- A. Urine
- B. Blood
- C. Saliva
- D. Amniotic fluid
Correct Answer: B
Rationale: The correct answer is B: Blood. Alpha-fetoprotein (AFP) screening is a test that measures the level of AFP in the mother's blood to screen for certain fetal abnormalities. AFP is a protein produced by the fetus and can be detected in the mother's blood. Blood is the most appropriate sample for this screening as it directly reflects the fetal AFP levels. Urine (A), saliva (C), and amniotic fluid (D) do not contain AFP in levels that can be accurately measured for this screening, making them incorrect choices. Blood is the standard and most reliable sample for AFP screening due to its direct correlation with fetal AFP levels.
Which of the following features would the nurse expect to be absent in an 8-week-gestation embryo?
- A. Four-chambered heart.
- B. Fingers and toes.
- C. Fully formed genitalia.
- D. Facial features.
Correct Answer: C
Rationale: At 8 weeks, the embryo’s genitalia are not fully formed, though other features like the heart and facial structures are developing.
An infant of a diabetic mother, 40 weeks’ gestation, weight 4,500 grams, has just been admitted to the neonatal nursery. The neonatal intensive care nurse will monitor this baby for which of the following? Select all that apply.
- A. Hyperreflexia.
- B. Hypoglycemia.
- C. Respiratory distress.
- D. Opisthotonus.
Correct Answer: C
Rationale: Infants of diabetic mothers are at risk for hypoglycemia due to maternal hyperglycemia and respiratory distress due to delayed lung maturity.