Nokea
Assessment of a 16-year-old nulligravid client who visits the clinic and asks for information on contraceptives reveals a menstrual cycle of 28 days. The nurse formulates a nursing diagnosis of Deficient knowledge related to ovulation and fertility management. Which of the following would be important to include in the teaching plan for the client?
- A. The ovum survives for 96 hours after ovulation, making conception possible during this time.
- B. The basal body temperature falls at least 0.2°F after ovulation has occurred.
- C. Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the next menstrual cycle.
- D. Most women can tell they have ovulated because of severe pain and thick, scant cervical mucus.
Correct Answer: C
Rationale: Ovulation typically occurs around day 14 (plus or minus 2 days) before the next menstrual cycle in a 28-day cycle, which is critical for understanding fertility windows. The ovum survives for about 12-24 hours, not 96 hours, and basal body temperature rises after ovulation.
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A multigravid client at term is admitted to the hospital for a trial labor and possible vaginal birth. She has a history of previous cesarean delivery because of fetal distress. When the client is 4 cm dilated, she receives nalbuphine (Nubain) intravenously. While monitoring the fetal heart rate, the nurse observes minimal variability and a rate of 120 bpm. The nurse should explain the decreased variability is most likely caused by which of the following?
- A. Maternal fatigue.
- B. Fetal malposition.
- C. Small-for-gestational-age fetus.
- D. Effects of analgesic medication.
Correct Answer: D
Rationale: Nalbuphine, an opioid, can reduce fetal heart rate variability by depressing the central nervous system, a common side effect. Maternal fatigue, malposition, or small-for-gestational-age fetus are less likely causes.
During a shift change, the nurse is assigned a new postpartum client who delivered 6 hours ago. Which task should the nurse prioritize?
- A. Perform a fundal assessment.
- B. Educate the client on newborn care.
- C. Assist with breastfeeding initiation.
- D. Administer a prescribed stool softener.
Correct Answer: A
Rationale: Fundal assessment is critical within the first 24 hours to detect complications like hemorrhage.
Which of the following would the nurse include in the primiparous client's discharge teaching plan about measures to provide visual stimulation for the neonate?
- A. Maintain eye contact while talking to the baby.
- B. Paint the baby's room in bright colors accented with teddy bears.
- C. Use brightly colored animals and cartoon figures on the wall.
- D. Move a brightly colored rattle in front of the baby's eyes.
Correct Answer: A
Rationale: Maintaining eye contact promotes visual stimulation and bonding, suitable for a neonate's developmental stage.
The nurse explains to a newly admitted primigravid client in active labor that, according to the gate-control theory of pain, a closed gate means that the client should experience which of the following?
- A. No pain.
- B. Sharp pain.
- C. Light pain.
- D. Moderate pain.
Correct Answer: A
Rationale: A 'closed gate' in the gate-control theory blocks pain signals in the spinal cord, resulting in no pain or significantly reduced pain perception. Sharp, light, or moderate pain indicates an open or partially open gate.
A laboring client with preeclampsia is prescribed magnesium sulfate 2 g/hour I.V. piggyback. The pharmacy sends the I.V. to the unit labeled magnesium sulfate 20 g/500 mL normal saline. To deliver the correct dose, the nurse should set the pump to deliver how many milliliters per hour?
Correct Answer: 50
Rationale: To calculate the correct dose: (2 g/hour * 500 mL) / 20 g = 50 mL/hour.