Nokea
In a prenatal clinic, a client in the first trimester of pregnancy has a health record that includes this data: G3 T1 P0 A1 L1. How should the nurse interpret this information? (Select all that apply)
- A. Client has delivered one newborn at term
- B. Client has experienced no preterm labor
- C. Client has had two prior pregnancies
- D. ALL OF THE ABOVE - has one living child
Correct Answer: D
Rationale: The data "G3 T1 P0 A1 L1" indicates the client has had 3 pregnancies (G3), 1 term delivery (T1), 0 preterm deliveries (P0), 1 living child (A1), and 1 living child currently (L1). Therefore, the correct interpretation is that the client has one living child (A1) from one term delivery (T1). Choice D ("ALL OF THE ABOVE - has one living child") is correct as it summarizes the information accurately. Choices A, B, and C are incorrect because they do not encompass all the aspects of the data provided in the client's health record.
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During a teaching session with a client in labor, a nurse is explaining episiotomy. Which of the following information should the nurse include?
- A. An episiotomy is a perineal incision made by the provider to facilitate delivery of the fetus
- B. A fourth-degree episiotomy extends into the rectal area and is not recommended
- C. An episiotomy is an incision made by the provider to facilitate delivery of the fetus
- D. A mediolateral episiotomy is preferred over a median episiotomy for most deliveries
Correct Answer: C
Rationale: The correct answer is C because it accurately describes an episiotomy as an incision made by the provider to facilitate delivery of the fetus. This information is crucial for the client to understand the purpose and potential benefits of the procedure.
A: While choice A is similar to the correct answer, it includes unnecessary detail about who makes the incision, which may confuse the client.
B: Choice B is incorrect as it provides inaccurate information about a fourth-degree episiotomy extending into the rectal area, which is not recommended as it would involve cutting through the anal sphincter.
D: Choice D is incorrect because it introduces unnecessary information about the types of episiotomies without providing the basic understanding of what an episiotomy is.
A client in active labor at 39 weeks of gestation is receiving continuous IV oxytocin and has early decelerations in the FHR on the monitor tracing. What action should the nurse take?
- A. Discontinue the oxytocin infusion.
- B. Continue monitoring the client.
- C. Request that the provider assess the client.
- D. Increase the infusion rate of the maintenance IV fluid.
Correct Answer: B
Rationale: The correct action for the nurse to take when a client in active labor at 39 weeks of gestation has early decelerations in the FHR on the monitor tracing is to continue monitoring the client. Early decelerations are typically benign and are associated with head compression during contractions, which is a normal response to labor. There is no need to discontinue the oxytocin infusion as early decelerations do not indicate fetal distress. Requesting the provider to assess the client may not be necessary at this point unless other concerning signs are present. Increasing the infusion rate of the maintenance IV fluid is not indicated as it would not address the early decelerations. Therefore, the best course of action is to continue monitoring the client for any changes in the FHR pattern.
A healthcare provider is reinforcing teaching with a client about a new prescription for medroxyprogesterone. Which of the following information should the provider include in the teaching? (Select all that apply)
- A. Weight fluctuations can occur.
- B. Irregular vaginal spotting can occur.
- C. You should increase your intake of calcium.
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because all options are relevant when teaching a client about medroxyprogesterone. A, weight fluctuations can occur due to hormonal changes. B, irregular vaginal spotting is a common side effect of medroxyprogesterone. C, increasing calcium intake is important to prevent bone density loss associated with long-term medroxyprogesterone use. Therefore, all options are essential for comprehensive client education. Other choices are incorrect because excluding any of these key points could lead to incomplete information and potential misunderstandings regarding the medication's effects and management.
A charge nurse on the postpartum unit is observing a newly licensed nurse who is preparing to administer pain medication to a client. The charge nurse should intervene when the newly licensed nurse uses which of the following secondary identifiers to identify the client?
- A. The client's room number
- B. The client's telephone number
- C. The client's birth date
- D. The client's medical record number
Correct Answer: A
Rationale: The correct answer is A: The client's room number. Using the client's room number as a secondary identifier is not appropriate as it does not uniquely identify the client and can lead to errors. The room number may change, or there could be multiple clients in the same room. Telephone number, birth date, and medical record number are more reliable secondary identifiers as they are unique to the client and less likely to be confused with another individual. It is essential to use accurate and reliable identifiers to ensure patient safety and prevent medication errors.
A healthcare provider is assisting with the care for a client who has a prescription for magnesium sulfate. The provider should recognize that which of the following are contraindications for the use of this medication? (Select all that apply)
- A. Fetal distress
- B. Cervical dilation greater than 6 cm
- C. Vaginal bleeding
- D. All of the Above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Magnesium sulfate is contraindicated in cases of fetal distress, cervical dilation greater than 6 cm, and vaginal bleeding. Fetal distress can be worsened by magnesium sulfate, and it can lead to respiratory depression in the newborn. Cervical dilation greater than 6 cm indicates advanced labor, where the risk of uterine atony and postpartum hemorrhage is increased with magnesium sulfate use. Vaginal bleeding may be a sign of placental abruption or other complications, which can be exacerbated by magnesium sulfate. Therefore, all three options are contraindications for the use of magnesium sulfate in this scenario.