Nokea
The nurse is teaching a client and her partner about the technique of counter pressure during labor. Which of the following statements by the nurse is appropriate?
- A. Your partner will apply upward pressure on your lower abdomen between contractions
- B. Your partner will apply continuous from pressure between your thumb and index finger
- C. Your partner will apply pressure to the top of your uterus during contractions
- D. Your partner will apply steady pressure with a tennis ball to your lower back
Correct Answer: D
Rationale: The correct answer is D because applying steady pressure with a tennis ball to the lower back can help relieve lower back pain during labor. This technique targets the sacral area, which can alleviate discomfort and provide comfort. Choice A is incorrect as upward pressure on the lower abdomen may not be effective for pain relief. Choice B is incorrect as applying continuous pressure between the thumb and index finger is not related to counter pressure for labor pain. Choice C is incorrect as pressure on the top of the uterus during contractions is not a recommended technique.
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A nurse is assessing a client during her first prenatal visit the client reports March 20th us her last menstrual.. Use Niagele9s rule to calculate the estimated date of delivery. Use the mmdd format with four numerals and no spaces or punctuation.
- A. 05/11
- B. 5/4
- C. 5/12
- D. 04/27
Correct Answer: A
Rationale: The correct answer is A: 05/11. Using Naegele's rule, add 7 days to the first day of the last menstrual period (March 20), subtract 3 months, and add 1 year. March 20 + 7 days = March 27. Subtracting 3 months gives us December 27. Adding 1 year brings us to December 27 of the following year. However, since we are looking for the estimated date of delivery, we add 7 days to adjust for the 7 days we added at the beginning, which gives us May 4. Therefore, the estimated date of delivery would be May 11. Choice B (5/4) is incorrect because it does not account for the 7-day adjustment. Choice C (5/12) is incorrect as it adds 7 days twice. Choice D (04/27) is incorrect as it doesn't correctly follow Naegele's rule.
A nurse is assessing a client who is 27 weeks of gestation and has pre eclampsia. Which of the following findings should the nurse report to the provider?
- A. Hemoglobin 14.8 g/dL
- B. Platelet count 60,000/ mm
- C. Creatine 0.8 mg/ dL
- D. Urine protein concentration 200 mg/24hr
Correct Answer: B
Rationale: The correct answer is B: Platelet count 60,000/ mm. In pre-eclampsia, a low platelet count indicates thrombocytopenia, a serious complication that can lead to bleeding. This finding should be reported promptly to the provider for further evaluation and management. A: Hemoglobin level is within normal range and not a priority in pre-eclampsia. C: Creatinine level is normal and not directly related to the complications of pre-eclampsia. D: Urine protein concentration is elevated, which is expected in pre-eclampsia and should be monitored, but not as urgent as low platelet count.
A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include?
- A. You should use an oil based vaginal lubricant when inserting your diaphragm
- B. You should store your diaphragm in sterile water after each use
- C. You should keep the diaphragm in place for at least 4 hours after intercourse
- D. You should have your provider refit you for a new diaphragm
Correct Answer: D
Rationale: The correct answer is D: You should have your provider refit you for a new diaphragm. This is important because postpartum changes, such as weight gain or loss, can affect the fit of the diaphragm. A proper fit is crucial for effective contraception. Storing the diaphragm in sterile water (B) is incorrect as it can damage the device. Using oil-based lubricants (A) is not recommended as they can weaken the diaphragm. Keeping the diaphragm in place for 4 hours after intercourse (C) is unnecessary and may increase the risk of infection.
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 plan to conduct?
- A. 1 hour glucose tolerance test
- B. Rubella titer
- C. Group B strep culture
- D. Blood type and Rh
Correct Answer: A
Rationale: The correct answer is A: 1 hour glucose tolerance test. At 24-week prenatal appointment, screening for gestational diabetes is crucial. This test helps identify any glucose intolerance in pregnant women. The other choices are incorrect because: B: Rubella titer is typically done earlier in pregnancy to assess immunity. C: Group B strep culture is usually done around 35-37 weeks to determine if the mother needs antibiotics during labor. D: Blood type and Rh testing are important but are usually done earlier in pregnancy to determine if the mother is Rh negative and needs Rhogam.
A nurse is caring for four enter-partum clients. Which of the following clients should the nurse assess first?
- A. A client who is at 7 weeks of gestation and reports urinary frequency
- B. A client who is at 32 weeks of gestation and reports seeing floating spots
- C. A client who is 38 weeks of gestation and reports leg cramps
- D. A client who is at 20 weeks of gestation and reports periodic numbness in her fingers
Correct Answer: B
Rationale: The correct answer is B. The nurse should assess the client at 32 weeks of gestation reporting seeing floating spots first because it could indicate a serious condition called preeclampsia, characterized by high blood pressure and organ damage. This client's symptom is a sign of visual disturbances, a classic symptom of preeclampsia. Immediate assessment is necessary to prevent complications such as seizures and stroke. The other clients' symptoms, urinary frequency, leg cramps, and periodic numbness in fingers, are common discomforts in pregnancy but do not suggest immediate serious complications like preeclampsia.