Nokea
The nurse is caring for a client with preeclampsia. What is the primary goal of magnesium sulfate therapy?
- A. To reduce blood pressure.
- B. To prevent seizures.
- C. To improve fetal circulation.
- D. To treat headaches.
Correct Answer: B
Rationale: Magnesium sulfate is administered in preeclampsia primarily to prevent eclampsia-related seizures.
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A patient had unprotected sex yesterday. She is interested in emergency contraception. The nurse knows that the patient has how long to take the medication for it to be effective?
- A. 24 hr
- B. 48 hr
- C. 3 days
- D. 5 days
Correct Answer: C
Rationale: Emergency contraception is most effective if taken within 3 days after unprotected sex. The sooner it is taken, the more effective it is. Choice A and B are incorrect because they are too short a time window for emergency contraception to be effective. Choice D is also incorrect because most emergency contraceptive pills are not effective after 5 days.
The nurse is teaching a client about postpartum warning signs. Which symptom should be reported immediately?
- A. Increased lochia on standing.
- B. Breast tenderness and fullness.
- C. Severe headache and blurred vision.
- D. Mild swelling in the feet.
Correct Answer: C
Rationale: Severe headache and blurred vision may indicate postpartum complications such as preeclampsia.
A nurse is caring for a client who is receiving prenatal care and is at her 24- week appointment. Which of the following laboratory tests should the nurse plans to conduct?
- A. Group B strep culture
- B. 1-hr glucose tolerance test
- C. Rubella titer
- D. Blood type and Rh
Correct Answer: D
Rationale: At the 24-week prenatal appointment, it is essential to conduct the blood type and Rh test for the pregnant client. Determining the mother's blood type (A, B, AB, O) and Rh factor (positive or negative) is crucial as it helps identify if the mother is Rh-negative and at risk for Rh incompatibility with her baby. This information is vital for appropriate management to prevent potential complications such as hemolytic disease of the newborn. Conducting the blood type and Rh test at this stage allows healthcare providers to take necessary precautions to protect both the mother and the fetus.
The nurse is caring for a client at 39 weeks' gestation in active labor. The fetal monitor shows late decelerations. What is the priority nursing action?
- A. Reposition the client to her left side.
- B. Increase the oxytocin infusion rate.
- C. Encourage the client to push harder.
- D. Notify the healthcare provider immediately.
Correct Answer: A
Rationale: Repositioning improves uteroplacental blood flow and oxygen delivery to the fetus, addressing late decelerations.
The nurse is teaching a client with a midline episiotomy about perineal care after vaginal birth. Which statement from the client indicates she
- B. I will use the perineal bottle without touching perineum each time going to the bathroom
- C. I will gently pat perineal dry rather than wipe
- D. I will only use the perineal bottle after bowel movements
Correct Answer: C
Rationale: This statement indicates a correct understanding of perineal care after a midline episiotomy. After vaginal birth, it is important to avoid wiping the perineal area to prevent irritation and infection. Instead, gently patting the area dry is recommended to promote healing and prevent discomfort. This approach helps to minimize trauma to the sensitive tissues of the perineum and reduces the risk of introducing bacteria from wiping.