Nokea
The primiparous patient that's 40 weeks' gestation reports to the nurse that she has increased pelvic pressure and increased urinary frequency. Which response by the nurse is best?
- A. This symptom usually means the baby's head has descended further
- B. Unless you have pain with urination, we don't need to worry it
- C. Come in for an appointment today and we'll check out everything
- D. This might indicate that the baby is no longer in a head down position
Correct Answer: A
Rationale: The best response by the nurse is to reassure the primiparous patient that her increased pelvic pressure and urinary frequency could mean that the baby's head has descended further into the pelvis. This can indicate that labor is approaching, as the baby is getting into position for birth. It is important for the nurse to provide this information to ease the patient's concerns and help her understand the potential significance of these symptoms at 40 weeks' gestation.
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A nurse is caring for several clients. The nurse should recognize that it is safe to administer tocolytic therapy to which of the following clients?
- A. A client who is experiencing fetal death at 32 weeks of gestation
- B. A client who is experiencing preterm labor at 26 weeks of gestation
- C. A client who is experiencing Braxton-Hicks contractions at 36 weeks of gestation
- D. A client who has a post-term pregnancy at 42 weeks of gestation
Correct Answer: B
Rationale: Tocolytic therapy is a medication given to delay preterm labor and prolong the pregnancy. It is safe and appropriate to administer tocolytic therapy to a client who is experiencing preterm labor at 26 weeks of gestation (option B) to help delay delivery and give time for other interventions to be initiated, such as administration of corticosteroids for fetal lung maturation and transfer to a facility with a NICU if necessary. The goal is to prevent premature birth and its associated complications.
Why is it important for nurses to approach the topic of sexual history with sensitivity and create a nonjudgmental and confidential environment?
- A. to increase patient satisfaction with the health-care provider
- B. to ensure that patients feel comfortable and supported during the assessment
- C. to promote healthy sexual behaviors among patients
- D. to comply with health-care regulations and standards
Correct Answer: B
Rationale:
Which assessment finding indicates a complication in a client attempting a VBAC?
- A. Complaint of pain between the scapula (could be uterine
- C. Contraction every 3 minutes lasting 70 seconds
- D. Pain level 6 at acme of
Correct Answer: C
Rationale: A client attempting a Vaginal Birth After Cesarean (VBAC) is at higher risk for uterine rupture. A concerning assessment finding in this scenario would be the occurrence of contractions every 3 minutes that are lasting 70 seconds. This pattern of contractions could potentially indicate uterine hyperstimulation, which increases the risk of uterine rupture. It is essential to closely monitor these contractions and address any signs of distress or complications promptly to ensure the safety of both the mother and the baby.
What is the nurse's role in supporting breastfeeding for a first-time mother?
- A. Provide formula supplements
- B. Demonstrate proper latching techniques
- C. Recommend stopping breastfeeding
- D. Provide pacifiers to prevent overfeeding
Correct Answer: A
Rationale: Proper latching techniques help establish successful breastfeeding and prevent complications.
The nurse notes that an older adult client receives only one visitor and asks the client if family members could be called. The client states, 'I consider her to be all of my family.' What would the nurse consider in responding to the client?
- A. The nurse could encourage the client to reconnect with other family members.
- B. The client defines who is and who is not part of the family without undue influence.
- C. The nurse realizes individuals exist without a family and do not often adopt substitutes.
- D. Family is more important to those individuals with a large number of family members.
Correct Answer: B
Rationale: It is important for nurses to remain neutral to all they hear and see in order to enhance trust and maintain open communication lines with all family members. Nurses need to remember that clients are experts of their own health and can define their own family.