Nokea
The nurse is instructing a preeclamptic client about monitoring the movements of her fetus to determine fetal well-being. Which statement by the client indicates that she needs further instruction about when to call the health care provider concerning fetal movement?
- A. "If the fetus is becoming less active than before."
- B. "If it takes longer each day for the fetus to move 10 times."
- C. "If the fetus stops moving for 12 hours."
- D. "If the fetus moves more often than 3 times an hour."
Correct Answer: D
Rationale: Increased fetal movement can be a sign of distress, so the client should be instructed to report any significant changes in movement.
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A multigravid client diagnosed with a probable ruptured ectopic pregnancy is scheduled for emergency surgery. In addition to monitoring the client's blood pressure before surgery, which of the following would the nurse assess?
- A. Uterine cramping.
- B. Abdominal distention.
- C. Hemoglobin and hematocrit.
- D. Pulse rate.
Correct Answer: D
Rationale: Pulse rate helps assess circulatory status.
A client asks about the disadvantages of the contraceptive sponge. Which of the following would the nurse include?
- A. It is difficult to insert and remove.
- B. It provides protection against STIs.
- C. It can be left in place for up to 48 hours.
- D. It is highly effective for women who have given birth.
Correct Answer: A
Rationale: The contraceptive sponge can be difficult to insert and remove, especially for some users. It does not protect against STIs, can be left in place for up to 24 hours (not 48), and is less effective for women who have given birth due to changes in vaginal anatomy.
While assisting a primiparous client with her first breast-feeding session, which of the following actions should the nurse instruct the mother to do to stimulate the neonate to open the mouth and grasp the nipple?
- A. Pull down gently on the neonate's chin and insert the nipple.
- B. Squeeze both of the neonate's cheeks simultaneously.
- C. Place the nipple into the neonate's mouth on top of the tongue.
- D. Brush the neonate's lips lightly with the nipple.
Correct Answer: D
Rationale: Brushing the neonate's lips with the nipple stimulates the rooting reflex, encouraging the mouth to open.
A male neonate born at 36 weeks' gestation is admitted to the neonatal intensive care nursery with a diagnosis of probable fetal alcohol syndrome (FAS). The mother visits the nursery soon after the neonate is admitted. Which of the following instructions should the nurse expect to include when developing the teaching plan for the mother about FAS?
- A. Withdrawal symptoms usually do not occur until 7 days postpartum.
- B. Large-for-gestational-age size is common with this condition.
- C. Facial deformities associated with FAS can be corrected by plastic surgery.
- D. Symptoms of withdrawal include tremors, sleeplessness, and seizures.
Correct Answer: D
Rationale: Symptoms of withdrawal in FAS include tremors, sleeplessness, and seizures due to neurological effects of alcohol exposure.
At a home visit, the nurse assesses a neonate delivered vaginally at 41 weeks' gestation 5 days ago, noting the following findings: frequent hiccups; loose, watery stool in diaper; red rash on face; and dry, peeling skin; which of these findings warrants further assessment?
- A. Frequent hiccups.
- B. Loose, watery stool in diaper.
- C. Pink papular vesicles on the face.
- D. Dry, peeling skin.
Correct Answer: B
Rationale: Loose, watery stool may indicate diarrhea, which requires further assessment to rule out infection or malabsorption.