Nokea
The nurse is reviewing a prenatal client's record and notes a diagnosis of oligohydramnios. What complication is associated with this condition?
- A. Preterm labor.
- B. Fetal growth restriction.
- C. Cord prolapse.
- D. Placenta previa.
Correct Answer: B
Rationale: Oligohydramnios, or low amniotic fluid levels, is often associated with fetal growth restriction.
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Whose theoretical model describes how clinical judgment evolves with experience?
- A. Benner
- B. Tanner
- C. Lasater
- D. Nightingale
Correct Answer: A
Rationale: Patricia Benner developed the theoretical model known as the Novice to Expert Theory, which describes how clinical judgment evolves with experience. According to this theory, individuals progress through five levels of proficiency in a skill: novice, advanced beginner, competent, proficient, and expert. Benner's model emphasizes the importance of experiential learning and highlights how nurses develop expertise over time through practical experience and reflection.
The nurse is caring for a client whose labor is being augmented with Pitocin. He or she recognizes that Pitocin should be stopped immediately if there is evidence of what?
- A. Fetal HR 180 without sense of variability
- B. Rupture of amniotic membrane
- C. Client needs to void
- D. Uterine contractions q8-10 minutes
Correct Answer: A
Rationale: Pitocin is a medication commonly used to induce or augment labor by stimulating uterine contractions. It is critical for the nurse to monitor the client closely for potential adverse effects. Fetal distress is a serious concern when Pitocin is being administered. A fetal heart rate of 180 beats per minute without variability may indicate fetal distress due to uteroplacental insufficiency. This is a sign of fetal hypoxia and warrants immediate intervention, including stopping the infusion of Pitocin, repositioning the mother, administering oxygen, and notifying the healthcare provider. It is crucial for the nurse to act promptly to ensure the safety and well-being of both the fetus and the mother.
Which postpartum client requires further assessment?
- A. G1P1 with class II heart disease and complains of frequent coughing and has crackles
- B. G3P2 post c/s client who has active herpes on the labia
- C. G4P4 who had 4 saturated pads during the last 12 hours
- D. G2P2 diabetic whose fasting blood sugar is 100
Correct Answer: C
Rationale: The postpartum client who requires further assessment is the G4P4 who had 4 saturated pads during the last 12 hours. This indicates excessive postpartum bleeding, which is abnormal and could potentially be a sign of postpartum hemorrhage. It is crucial to closely monitor and assess the client's vital signs, uterine tone, and overall well-being to prevent any complications related to excessive bleeding. Prompt intervention and medical attention may be necessary to address the postpartum hemorrhage and ensure the client's safety and well-being.
A patient calls the clinic Monday morning. She had condomless sex Friday night and is interested in emergency contraception. What should the nurse tell this patient?
- A. Emergency contraception pills are very effective for medically induced abortions early in pregnancy.
- B. If she is not midcycle when she had sex, she does not need emergency contraception.
- C. It is too late for her to use emergency contraceptive pills, but she can come in for placement of a copper IUD.
- D. She can use emergency contraceptive pills, even if she has had other condomless sex since the Friday night event.
Correct Answer: D
Rationale: The correct advice for the patient in this scenario is to inform her that she can still use emergency contraceptive pills, even if she has had other condomless sex since the Friday night event. Emergency contraceptive pills are most effective when taken as soon as possible after unprotected sex, but they can still be used within a certain window of time depending on the type of pill used. It is important to inform the patient that she can take emergency contraception in this situation to reduce the risk of an unintended pregnancy.
Which client would be at greatest risk for developing
- A. Thick breast cancer?
- B. Wet/slippery with egg white consistency
- C. Client who had her first baby at the age of 24
- D. Client who did not breastfeed
Correct Answer: D
Rationale: Not breastfeeding has been identified as a risk factor for developing breast cancer. Breastfeeding has been shown to have a protective effect against breast cancer due to its impact on hormonal levels and breast tissue changes that occur during lactation. Therefore, compared to other options, the client who did not breastfeed would be at greater risk for developing breast cancer.