Nokea
The nurse is teaching a group of women about fertility awareness methods of contraception. Which of the following would the nurse include as the most reliable indicator that ovulation has occurred?
- A. A slight drop followed by a rise in basal body temperature.
- B. A change in cervical mucus to thin, clear, and stretchy.
- C. The onset of mittelschmerz, or midcycle pelvic pain.
- D. The presence of a thick, cloudy cervical mucus.
Correct Answer: A
Rationale: A slight drop followed by a rise in basal body temperature is the most reliable indicator of ovulation, as it reflects the hormonal shift post-ovulation. Cervical mucus changes and mittelschmerz are less precise, and thick mucus typically occurs post-ovulation.
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A client asks about the side effects of the contraceptive implant. Which of the following would the nurse include?
- A. Regular menstrual cycles are guaranteed.
- B. Irregular bleeding is a common side effect.
- C. It causes significant weight loss.
- D. It increases the risk of ovarian cysts.
Correct Answer: B
Rationale: Irregular bleeding is a common side effect of the contraceptive implant, especially in the first year. It does not guarantee regular cycles, cause significant weight loss, or significantly increase ovarian cyst risk.
While assessing a primigravid client admitted at 36 weeks' gestation, the nurse observes multiple bruises on the client's face, neck, and abdomen. When asked about the bruises, the client admits that her boyfriend beats her now and then and says, 'I want to leave him because I'm afraid he will hurt the baby.' Which of the following actions is the nurse's priority?
- A. Tell the client to leave the boyfriend immediately.
- B. Ask the client when she last felt the baby move.
- C. Refer the client to a social worker for possible options.
- D. Report the incident to the unit nursing supervisor.
Correct Answer: C
Rationale: Suspected domestic violence requires referral to a social worker to provide resources (e.g., shelters, counseling) and ensure maternal-fetal safety. Advising immediate leaving is impractical, fetal movement assessment is secondary, and reporting to the supervisor does not directly help the client.
While the nurse is preparing to assist the primiparous client to the bathroom to void 6 hours after a vaginal delivery under epidural anesthesia, the client says that she feels dizzy when sitting up on the side of the bed. The nurse explains that this is most likely caused by which of the following?
- A. Effects of the anesthetic during labor.
- B. Hemorrhage during the delivery process.
- C. Effects of analgesics used during labor.
- D. Decreased blood volume in the vascular system.
Correct Answer: A
Rationale: Dizziness when sitting up is likely due to residual effects of epidural anesthesia, which can cause orthostatic hypotension.
The nurse is catheterizing a client who cannot void after a normal delivery 8 hours ago. The nurse begins the catheterization process and the client asks the nurse if Betadine was used to clean the meatus for the catheterization. The nurse realizes that the client is allergic to Betadine and the client is reacting to the cleansing agent. The nurse should take the following steps in order of priority from first to last.
- A. Document incident.
- B. Clean Betadine from client's vaginal area.
- C. Notify physician ordering catheterization.
- D. Ask client what her reaction is when exposed to Betadine.
- E. File an incident report.
Correct Answer: B,D,C,A,E
Rationale: First, clean the Betadine to stop the reaction, ask about the reaction to assess severity, notify the physician, document the incident, and file an incident report.
When assessing a 16-year-old primigravid client at 37 weeks' gestation diagnosed with severe preeclampsia, which of the following indicates the client needs continued management for the preeclampsia?
- A. Blood pressure of 138/94 mm Hg.
- B. Severe blurring of vision.
- C. Less than 2 g of protein in a 24-hour sample.
- D. Weight gain of 0.5 lb in 1 week.
Correct Answer: B
Rationale: Severe blurring of vision indicates worsening preeclampsia.