Nokea
Four days after delivery, a client develops complications of postpartal hemorrhage. The most common cause of late postpartal hemorrhage is:
- A. Uterine atony
- B. Retained placental fragments
- C. Cervical laceration
- D. Perineal tears
Correct Answer: B
Rationale: Retained placental fragments are the most common cause of late postpartum hemorrhage, as they prevent proper uterine contraction and hemostasis.
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The nurse is caring for a client who is 14 weeks pregnant. The client is asking about vaccinations that can be given during pregnancy. Which of the following vaccines does the nurse tell the client that are safe during pregnancy?
- A. mumps
- B. measles
- C. smallpox
- D. influenza
Correct Answer: D
Rationale: The influenza vaccine is safe and recommended during pregnancy. Mumps, measles, and smallpox vaccines are contraindicated.
A client at a psychiatric hospital tells the nurse that he does not want to join the others for dinner in the dining room because he already ate. The nurse is aware this client has been diagnosed with avoidant personality disorder. The best response from the nurse is to
- A. ask the client what would make group dinners more enjoyable so he will participate in the future.
- B. allow the client to skip the group dinner this time only.
- C. ask the client why he ate dinner so early.
- D. state clearly that the client is expected in the dining room and then walk with the client to the dining room.
Correct Answer: D
Rationale: Avoidant personality disorder involves social withdrawal due to fear of rejection. Gently encouraging participation while providing support (walking with the client) promotes socialization without confrontation.
The nurse is caring for a client after an open reduction to the left ulna. The client's left arm is in a plaster cast with an Ace wrap for reinforcement. Which intervention by the nurse can offer nonpharmacological comfort to this client?
- A. elevate the left arm on a pillow and apply an ice pack over the approximate location of the surgical incision
- B. call the physician and obtain an order for acetaminophen (Tylenol) 650 mg PO PRN q6 hours as needed for pain
- C. advise the client that if he starts to itch under the cast, he can use a wire coat hanger or an ink pen to gently scratch up under the cast
- D. perform range-of-motion exercises twice a shift, including bending the fingers, opening and closing the hand, and lifting the arm up to shoulder level
Correct Answer: A
Rationale: Elevation and ice reduce swelling and pain nonpharmacologically. Scratching under the cast risks skin damage, and excessive movement may disrupt healing.
The nurse is caring for a first-time mother who is asking how to help her baby sleep through the night as the baby gets older. Which recommendation should the nurse tell the mother?
- A. Rock her to sleep every night until she is in a deep sleep.
- B. Give diphenhydramine 12.5 mg orally to put the baby to sleep.
- C. If she starts waking up a lot in the middle of the night, put her in the bed with you.
- D. Give the last feeding as late as possible, and put her in the bed awake without a bottle.
Correct Answer: D
Rationale: Placing the baby in bed awake after a late feeding promotes self-soothing and healthy sleep habits, unlike the other options, which may create dependencies or safety risks.
Which of the following ethnic groups has the highest risk of developing diabetes mellitus type 2 and should be routinely screened for diabetes?
- A. Hispanics
- B. Asians
- C. Caucasians
- D. African-Americans
Correct Answer: A
Rationale: Hispanics (A) have the highest risk for type 2 diabetes due to genetic and socioeconomic factors, requiring routine screening.