Nokea
After surgery to remove a ruptured fallopian tube, a multigravid client receives discharge instructions about potential complications to report to her physician. Which of the following, if stated by the client as a complication, indicates a need for additional teaching?
- A. Pain.
- B. Headache.
- C. Fever.
- D. Bleeding.
Correct Answer: B
Rationale: Headache is not a typical complication of ectopic pregnancy surgery.
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A primigravid client in active labor has had no anesthesia. The client's cervix is 7 cm dilated, and she is starting to feel considerable discomfort during the first 10 cm to the client's sacral client is a left side-lying position. The nurse should encourage which of the following?
- A. Rapid, shallow chest breathing.
- B. Deep chest breathing.
- C. Rapid pant-blow breathing.
- D. Slow abdominal breathing.
Correct Answer: D
Rationale: Slow abdominal breathing promotes relaxation and oxygenation, helping manage discomfort in active labor without anesthesia. Rapid or shallow breathing may lead to hyperventilation, and deep chest breathing is less effective for pain control.
The nurse enlists the aid of an interpreter when caring for a primiparous client from Mexico who speaks very little English and delivered a viable term neonate 8 hours ago. When developing the postpartum dietary plan of care for the client, the nurse would encourage the client's intake of which of the following?
- A. High-fiber foods and adequate fluids.
- B. Low-calorie foods to promote weight loss.
- C. High-protein foods only.
- D. Caffeinated beverages to maintain energy.
Correct Answer: A
Rationale: High-fiber foods and adequate fluids promote bowel function and hydration, which are essential for postpartum recovery.
A male neonate born at 38 weeks' gestation by cesarean delivery after prolonged rupture of the membranes and a maternal oral temperature of 102°F (38.8°C) is being observed for signs and symptoms of infection. Which of the following would alert the nurse to notify the physician?
- A. Leukocytosis.
- B. Apical heart rate of 132 bpm.
- C. Alertness changes.
- D. Warm, moist skin.
Correct Answer: A
Rationale: Leukocytosis is a sign of infection and warrants notifying the physician, especially given the maternal fever and prolonged rupture of membranes.
To determine whether a primigravid client in labor with a fetus in the left occipitoanterior (LOA) position is completely dilated, the nurse performs a vaginal examination. During the examination the nurse should palpate which of the following cranial sutures?
- A. Sagittal.
- B. Lambdoidal.
- C. Coronal.
- D. Frontal.
Correct Answer: A
Rationale: In the LOA position, the fetus's occiput is anterior, and the sagittal suture (running midline along the skull) is most accessible during vaginal examination to assess dilation and fetal position. Other sutures are less prominent in this presentation.
Two hours ago, a neonate at 38 weeks' gestation and weighing 3,175 g (7 lb) was born to a primiparous client who tested positive for beta-hemolytic Streptococcus. Which of the following would alert the nurse to notify the pediatrician?
- A. Alkalosis.
- B. Increased muscle tone.
- C. Temperature instability.
- D. Positive Babinski's reflex.
Correct Answer: C
Rationale: Temperature instability can indicate early sepsis, especially in a neonate at risk due to maternal beta-hemolytic Streptococcus.