Nokea
A nurse on the labor and delivery unit is assessing four clients. Which of the following clients is a candidate for an induction of labor with misoprostol?
- A. A client who has active genital herpes
- B. A client who has gestational diabetes mellitus
- C. A client who has a previous uterine incision
- D. A client who has placenta previa
Correct Answer: C
Rationale: Misoprostol is a prostaglandin E1 analog that is commonly used for labor induction. It is particularly useful in clients with a previous uterine incision, such as a cesarean section scar, because it helps soften the cervix and promote uterine contractions, which can lead to successful vaginal birth after cesarean (VBAC). Misoprostol can be an effective method for inducing labor in these clients while minimizing the risk of uterine rupture. However, it is important to closely monitor clients for signs of uterine hyperstimulation when using misoprostol for labor induction.
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Which interpretation of the data from Table 3-1 is correct?
- A. When one considers those who "read/heard" about the vaccine, there is no significant difference between the percentage of students who received the immunization and those who did not receive the immunization.
- B. The likelihood of students who receive the vaccine when they learned about it from the "health history form" was about 1.6 times that of the "health history form" students who did not receive the vaccine.
- C. 44.4% of those who were not vaccinated received their information from "Letters."
- D. The largest percentage of students who received the vaccine learned about it from the "University Health Service (UHS) providers."
Correct Answer: D
Rationale: According to the table, the largest percentage of vaccinated students learned about the vaccine from UHS providers.
Most newborns receive a prophylactic injection of vitamin K soon after birth. Which site is appropriate for the newborn?
- A. Gluteal muscles
- B. Rectus femoris muscle
- C. Deltoid muscle
- D. Vastus lateralis muscle
Correct Answer: D
Rationale: Vastus lateralis muscle is the recommended site due to its size and safety.
A newborn's birth was prolonged because the shoulders were very wide. The nurse performing the assessment would be particularly observant for a problem with the:
- A. Moro reflex
- B. Plantar reflex
- C. Babinski reflex
- D. Stepping reflex
Correct Answer: A
Rationale: The Moro reflex is a normal infantile reflex that is typically present at birth and disappears around 4-6 months of age. This reflex is triggered by a sudden loss of support or a loud noise, causing the infant to throw back the head and extend the arms in a gesture as if trying to grab something. In a situation where the newborn's birth was prolonged due to wide shoulders, there is a higher risk of injury to the brachial plexus (nerves that control arm movement) during delivery. Damage to the brachial plexus can result in weakness or paralysis of the affected arm, and this may impact the Moro reflex as it involves the arms' movement. Therefore, the nurse would be particularly observant for any abnormality or lack of response in the Moro reflex as it may indicate potential nerve injury related to the difficult birth.
What information should the nurse include in a standard care plan for Mifeprex (misepristone/misoprostol)?
- A. Women should be evaluated by their health care practitioners 2 weeks after taking the medicine.
- B. This is the preferred method for terminating an ectopic pregnancy when an intrauterine device is in place.
- C. The only symptom clients should experience is bleeding 2 to 3 days after taking the medicine.
- D. Women who experience no bleeding within 3 days should immediately take a home pregnancy test.
Correct Answer: A
Rationale: Follow-up evaluation ensures completion of abortion.
What should be included in teaching a client undergoing a bilateral tubal ligation?
- A. The surgical procedure is easily reversible.
- B. Menstruation usually ceases after the procedure.
- C. Libido should remain the same after the procedure.
- D. The incision will be made endocervically.
Correct Answer: C
Rationale: Tubal ligation does not affect libido.