Nokea
During a scheduled cesarean delivery of a primigravid client with a fetus at 39 weeks' gestation in a breech presentation, a neonatologist is present in the operating room. The nurse explains to the client that the neonatologist is present because neonates born by cesarean delivery tend to have an increased incidence of which of the following?
- A. Congenital anomalies.
- B. Pulmonary hypertension.
- C. Meconium aspiration syndrome.
- D. Respiratory distress syndrome.
Correct Answer: D
Rationale: Cesarean delivery, especially without labor, increases the risk of respiratory distress syndrome due to retained lung fluid. Breech presentation may exacerbate this. Congenital anomalies, pulmonary hypertension, and meconium aspiration are less directly related.
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While caring for a primigravid client with class II heart disease at 28 weeks' gestation, the nurse would instruct the client to contact her physician immediately if the client experiences which of the following?
- A. Mild ankle edema.
- B. Emotional stress on the job.
- C. Weight gain of 1 lb in 1 week.
- D. Increased dyspnea at rest.
Correct Answer: D
Rationale: Increased dyspnea at rest can indicate worsening heart function.
While changing the neonate's diaper, the client asks the nurse about some red-tinged drainage from the neonate's vagina. Which of the following responses would be most appropriate?
- A. It's of no concern because it is such a small amount.
- B. The cause is usually related to swallowing blood during the delivery.
- C. Sometimes baby girls have this from hormones received from the mother.
- D. This vaginal spotting is caused by hemorrhagic disease of the newborn.
Correct Answer: C
Rationale: Pseudo-menstruation in female newborns is due to maternal hormone withdrawal.
A nurse is counseling a client about the vaginal contraceptive ring. Which of the following client statements indicates a need for further teaching?
- A. I will leave the ring in place for three weeks.
- B. I may experience nausea or breast tenderness.
- C. I can remove the ring for up to 3 hours if needed.
- D. The ring will make my periods heavier.
Correct Answer: D
Rationale: The vaginal contraceptive ring typically reduces menstrual flow or causes lighter periods, not heavier ones. The other statements are correct, indicating a need for further teaching about menstrual effects.
When developing the plan of care for a primiparous client during the first 12 hours after vaginal delivery, which of the following concerns of the client should be the nurse's primary focus of care?
- A. The neonate.
- B. The family.
- C. The client's own comfort.
- D. The client's significant other.
Correct Answer: C
Rationale: In the first 12 hours postpartum, the nurse's primary focus is the client's physical and emotional comfort to promote recovery and prevent complications.
A nurse is teaching a client about the use of female condoms. Which of the following instructions should the nurse include?
- A. Insert the female condom up to 8 hours before intercourse.
- B. Reuse the female condom if it is undamaged.
- C. Apply spermicide to the female condom for added protection.
- D. Store female condoms in a hot environment.
Correct Answer: A
Rationale: The female condom can be inserted up to 8 hours before intercourse, providing flexibility. It cannot be reused, does not require spermicide for effectiveness, and should be stored in a cool, dry place.