Nokea
After the physician explains the prognosis and medical management for atrial septal defect to a primiparous client whose 2-day-old female neonate was diagnosed with this condition, the nurse determines that the mother needs further instructions when she says which of the following?
- A. As my child grows, she may have increased fatigue and difficulty breathing.'
- B. My child may need to have antibiotics if she develops an infection.'
- C. This condition occurs more commonly in females than in males.'
- D. About half of the children born with this defect heal spontaneously.'
Correct Answer: C
Rationale: Atrial septal defects are not significantly more common in females, indicating a need for further instruction.
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A client is considering the cervical cap. Which of the following client statements indicates understanding?
- A. I need a prescription for the cervical cap.
- B. The cervical cap can be left in place for up to 72 hours.
- C. The cervical cap does not require spermicide.
- D. The cervical cap is more effective after childbirth.
Correct Answer: A
Rationale: The cervical cap requires a prescription and fitting by a healthcare provider. It can be left in place for up to 48 hours, requires spermicide, and is less effective after childbirth.
The nurse is caring for a multiparous client 48 hours after cesarean delivery. Which finding indicates a potential complication?
- A. Clear urine output via catheter.
- B. Incisional pain relieved by medication.
- C. Scant lochia serosa.
- D. Homan's sign negative bilaterally.
Correct Answer: C
Rationale: Scant lochia serosa at 48 hours may indicate retained clots or infection, requiring further assessment.
Two hours ago, a multigravid client was admitted in active labor with her cervix dilated at 5 cm and completely effaced and the fetus at 0 station. Currently, the client is experiencing nausea and vomiting, a slight chill with perspiration beads on her lip, and extreme irritability. The nurse should first:
- A. Warm the temperature of the room by a few degrees.
- B. Increase the rate of intravenous fluid administration.
- C. Obtain an order for an intramuscular antiemetic medication.
- D. Assess the client's cervical dilation and station.
Correct Answer: D
Rationale: Nausea, chills, perspiration, and irritability are signs of the transition phase (8–10 cm dilation). Assessing cervical dilation and station confirms progression and guides care. Warming the room, increasing fluids, or administering antiemetics are secondary.
After the delivery of a neonate, a quick assessment is completed. The neonate is found to be apneic. After quickly drying the neonate, what should the nurse do next?
- A. Assign the first Apgar score.
- B. Place the head in a 'sniff' position.
- C. Administer oxygen.
- D. Start cardiac compressions.
Correct Answer: B
Rationale: Placing the head in a 'sniff' position opens the airway, which is critical for an apneic neonate before further interventions.
A client asks about the effectiveness of the contraceptive patch. Which of the following responses by the nurse is accurate?
- A. The patch is less effective than oral contraceptives.
- B. The patch is highly effective when used correctly.
- C. The patch is 100% effective in preventing pregnancy.
- D. The patch does not require a prescription.
Correct Answer: B
Rationale: The contraceptive patch is highly effective when used correctly, with a failure rate similar to oral contraceptives (about 1% with perfect use). It is not 100% effective, requires a prescription, and is not less effective than pills.