Nokea
A woman is planning to become pregnant. Which of the following actions should she be counseled to take before stopping birth control? Select all that apply.
- A. Take a daily multivitamin.
- B. See a medical doctor.
- C. Drink beer instead of vodka.
- D. Stop all over-the-counter medications.
Correct Answer: B
Rationale: Taking a multivitamin, consulting a doctor, and stopping potentially harmful medications are important preconception steps. Alcohol consumption should generally be minimized, but switching from vodka to beer is not a significant improvement.
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The patient who has received a dose of preservative-free morphine (Duramorph) is beginning to experience pruritus. Which medication is used to treat this?
- A. Low-dose naloxone infusion
- B. Diphenhydramine
- C. Dilaudid
- D. Sublimaze
Correct Answer: B
Rationale: The correct answer is B: Diphenhydramine. Pruritus is a common side effect of opioids like morphine. Diphenhydramine, an antihistamine, can help alleviate itching by blocking histamine receptors. Low-dose naloxone infusion (A) is used to reverse opioid overdose, not treat pruritus. Dilaudid (C) and Sublimaze (D) are also opioids and would not be effective in treating pruritus caused by morphine. Diphenhydramine is the most appropriate choice for addressing this specific symptom.
A nurse is caring for a laboring person who is in the third stage of labor. What is the most appropriate nursing intervention during this stage?
- A. assist with the delivery of the placenta
- B. prepare for a vaginal birth
- C. administer oxytocin
- D. apply gentle pressure to the uterus
Correct Answer: A
Rationale: The correct answer is A: assist with the delivery of the placenta. During the third stage of labor, the placenta needs to be delivered. This is done by gently applying traction to the umbilical cord while supporting the uterus to facilitate the expulsion of the placenta. This step is crucial to prevent postpartum hemorrhage.
Choice B (prepare for a vaginal birth) is incorrect because the person is already in the third stage of labor, which means the baby has been delivered and they are now focusing on delivering the placenta.
Choice C (administer oxytocin) is incorrect because while oxytocin may be used to help control bleeding after the placenta is delivered, it is not the most appropriate intervention during the third stage of labor.
Choice D (apply gentle pressure to the uterus) is incorrect because direct pressure to the uterus is not the primary intervention during the third stage of labor; assisting with the delivery of the placenta takes precedence.
Which statement about fetal circulation is correct?
- A. The foramen ovale is between ventricles
- B. Umbilical vein contains oxygen-poor blood
- C. Right atrium contains mixed blood
- D. Ductus venosus lies between aorta and pulmonary artery
Correct Answer: C
Rationale: The right atrium contains both oxygen-rich and oxygen-poor blood due to the unique fetal circulatory system.
The nurse is caring for a pregnant client who is a vegan. Which of the following foods should the nurse suggest the client consume as substitutes for restricted foods?
- A. Tofu, legumes, broccoli.
- B. Corn, yams, green beans.
- C. Potatoes, parsnips, turnips.
- D. Cheese, yogurt, fish.
Correct Answer: A
Rationale: Tofu, legumes, and broccoli provide essential nutrients like protein, iron, and calcium that are often lacking in a vegan diet. Corn, yams, and green beans offer carbohydrates and vitamins but lack sufficient protein sources. Potatoes, parsnips, and turnips are starchy vegetables with limited nutritional variety. Cheese, yogurt, and fish are non-vegan options.
A 36-week pregnant woman is admitted with ruptured membranes and a positive test for Group B Streptococcus (GBS). What is the appropriate nursing action?
- A. Start prophylactic antibiotics for the patient
- B. Perform a cesarean section
- C. Administer IV fluids
- D. Provide patient education on labor progression
Correct Answer: A
Rationale: The correct answer is A: Start prophylactic antibiotics for the patient. In this scenario, the woman is at risk for ascending infection due to ruptured membranes and positive GBS test. Prophylactic antibiotics are necessary to prevent neonatal GBS sepsis. Performing a cesarean section is not indicated unless there are other obstetric indications. Administering IV fluids is important but not the priority in this case. Patient education on labor progression is not the immediate concern when the woman is at risk for infection.