Nokea
During a home visit to a breast-feeding primiparous client at 1 week postpartum, the client tells the nurse that her nipples have become sore and cracked from the feedings. Which of the following should the nurse instruct the client to do?
- A. Wipe off any lanolin creams from the nipple before each feeding.
- B. Position the baby with the entire areola in the baby's mouth.
- C. Feed the baby less often for the next several days.
- D. Use a mild soap while in the shower to prevent an infection.
Correct Answer: B
Rationale: Proper positioning with the areola in the baby's mouth prevents and heals sore nipples.
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Four days after a vaginal delivery, the client visits the clinic complaining of excessive lochia rubra with clots. The physician orders methylergonovine maleate (Methergine), 0.2 mg intramuscularly. Before administering this drug, the nurse should assess:
- A. Blood pressure.
- B. Pulse rate.
- C. Breath sounds.
- D. Bowel sounds.
Correct Answer: A
Rationale: Methylergonovine can cause hypertension, so blood pressure assessment is essential before administration.
Before placing the fetal monitoring device on a primigravid client's fundus, the nurse performs Leopold's maneuvers. When performing the third maneuver, the nurse explains that this maneuver is done for which of the following reasons?
- A. To determine whether the fetal presenting part is engaged.
- B. To locate the fetal cephalic prominence.
- C. To distinguish between a breech and a cephalic presentation.
- D. To locate the position of the fetal arms and legs.
Correct Answer: A
Rationale: The third Leopold's maneuver assesses the presenting part's engagement in the pelvis, helping determine labor progression. Other maneuvers address cephalic prominence, presentation type, or fetal positioning.
A client asks about the effectiveness of emergency contraception. Which of the following responses by the nurse is accurate?
- A. Emergency contraception is 100% effective if taken within 24 hours.
- B. Emergency contraception is most effective when taken within 72 hours of unprotected intercourse.
- C. Emergency contraception can be used as a regular contraceptive method.
- D. Emergency contraception requires a surgical procedure.
Correct Answer: B
Rationale: Emergency contraception is most effective when taken within 72 hours of unprotected intercourse, with efficacy decreasing over time. It is not 100% effective, not suitable for regular use, and does not require surgery.
The health care provider has determined that a preterm labor client at 34 weeks' gestation has no fetal fibronectin present. The nurse should assess the client for which of the following outcomes in the next week?
- A. The client will develop preeclampsia.
- B. The fetus will develop mature lungs.
- C. The client will not likely develop preterm labor.
- D. The fetus will not develop gestational diabetes.
Correct Answer: C
Rationale: Absence of fetal fibronectin indicates reduced likelihood of preterm labor.
Several pregnant clients are waiting to be seen in the triage area of the obstetrical unit. Which client should the nurse see first?
- A. A client at 13 weeks' gestation experiencing nausea and vomiting three times a day with +1 ketones in her urine.
- B. A client at 37 weeks' gestation who is an insulin-dependent diabetic and experiencing 3 to 4 fetal movements per day.
- C. A client at 32 weeks' gestation who has preeclampsia and +3 proteinuria who is returning for evaluation of epigastric pain.
- D. A primigravida at 17 weeks' gestation complaining of not feeling fetal movement at this point in her pregnancy.
Correct Answer: C
Rationale: Epigastric pain in a preeclamptic client can indicate impending eclampsia.