The nurse is monitoring a client receiving magnesium sulfate for preeclampsia. What finding indicates magnesium toxicity?
- A. Increased urine output.
- B. Deep tendon reflexes +4.
- C. Respiratory rate of 10 breaths per minute.
- D. Blood pressure of 140/90 mmHg.
Correct Answer: C
Rationale: Respiratory depression is a key sign of magnesium sulfate toxicity and requires immediate intervention.
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In what way is the Mongan Method of childbirth education beneficial to birthing people?
- A. It helps people push with great effort in second stage labor.
- B. Birthing people feel confident about the use of an epidural to relax the body.
- C. People are taught how to release fear to decrease pain.
- D. HypnoBirthing is proven to be 100 percent effective in relieving pain in labor.
Correct Answer: C
Rationale: The Mongan Method focuses on releasing fear to reduce pain, promoting a calm birthing experience.
What behavior indicates effective teaching about the temperature rhythm method of fertility control?
- A. The woman takes her basal body temperature before retiring each evening.
- B. The couple charts information from at least six menstrual cycles before using the method.
- C. The couple resumes having intercourse as soon as they see a rise in the basal body temperature.
- D. The woman assesses her vaginal discharge daily for changes in color and odor.
Correct Answer: B
Rationale: Charting multiple cycles helps identify the fertile window accurately.
A neonate is being discharged home with a fiber-optic blanket for treatment of physiologic jaundice. What is important for the nurse to include in the discharge instructions?
- A. Cover the infant's eyes during the treatment.
- B. Reduce the daily number of formula feedings.
- C. Encourage frequent feeding to increase intake.
- D. Expect a constipated stool until jaundice clears.
Correct Answer: C
Rationale: Frequent feeding aids in bilirubin excretion.
Which statement made by a nursing student would best indicate that her education on family-centered care was fully understood?
- A. Childbirth affects the entire family, and relationships will change.
- B. Families are usually not capable of making health care decisions for themselves, especially in stressful situations.
- C. Mothers are the only family member affected by childbirth.
- D. Since childbirth is a medical procedure, it may affect everyone.
Correct Answer: A
Rationale: Childbirth affects the entire family, and relationships will change. Childbirth is viewed as a normal life event, not a medical procedure. Families are very capable of making health care decisions about their own care with proper information and support.
What should the nurse consider when caring for a client who identifies as a lesbian?
- A. Lesbian women are usually less sexually active than straight women.
- B. Lesbian women need not be asked about domestic violence issues.
- C. Lesbian women should be tested for cervical cancer every three to seven years.
- D. Lesbian women are at higher risk for bacterial vaginosis than are straight women.
Correct Answer: C
Rationale: Regular cervical cancer screening is important for all women.