The nurse prepares the client for which pain management option during labor?
- A. Epidural anesthesia
- B. Hot baths during active labor
- C. Over-the-counter pain relievers
- D. No pain relief options
Correct Answer: A
Rationale: Epidural anesthesia is a common and effective pain management option during labor, tailored to the client's needs.
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The nurse is reviewing the medication history of the client during preconception counseling. The client reports taking isotretinoin for acne. Which is the nurse’s best response?
- A. “Stop taking isotretinoin now! It can cause serious birth defects if you become pregnant.”
- B. “You need to be on some type of birth control right now. Getting pregnant is not an option.”
- C. “Talk with your HCP about changing isotretinoin before you consider becoming pregnant.”
- D. “Once you are off of isotretinoin for treating acne, you can then safely become pregnant.”
Correct Answer: C
Rationale: The best response is to have the client consult her HCP so another medication can be prescribed. This response indicates that isotretinoin (Accutane) is not safe but that alternative medications can be prescribed. Responding to the client emphatically can create anxiety and fear. Telling the client that getting pregnant is not an option is a paternal response and does not facilitate open communication. Clients must wait one month after cessation of isotretinoin before becoming pregnant.
Which snack is most appropriate for a pregnant client with nausea?
- A. Dry crackers
- B. Ice cream
- C. Spicy chips
- D. Carbonated soda
Correct Answer: A
Rationale: Dry crackers are bland and easy to digest, helping to alleviate nausea without exacerbating symptoms.
The postpartum client, who had a forceps-assisted vaginal birth 4 hours ago, tells the nurse that she is having continuing perineal pain rated at 7 out of 10 and rectal pressure. An oral analgesic was given and ice applied to the perineum earlier. What should the nurse do now?
- A. Call the HCP to report the pain
- B. Closely reinspect the perineum
- C. Help her out of bed to ambulate
- D. Administer a stool softener
Correct Answer: B
Rationale: Reexamination of the perineum should be completed before calling the HCP to report the pain level. A forceps-assisted delivery can increase the risk of hematoma development. Rectal pressure and perineal pain can indicate a hematoma in the posterior vaginal wall. The nurse should closely examine the perineum and the vaginal introitus for ecchymosis and a bulging mass. Ambulation would not help the perineal pain. A stool softener would be appropriate to avoid constipation but would not help the immediate problem.
The nurse recognizes which behavior as a sign of potential depression in a pregnant client?
- A. Occasional fatigue
- B. Persistent sadness and withdrawal
- C. Increased appetite
- D. Excitement about the pregnancy
Correct Answer: B
Rationale: Persistent sadness and withdrawal are hallmark signs of depression, requiring further assessment and intervention.
Which activity should the nurse recommend to prepare for labor?
- A. Practicing relaxation and breathing techniques
- B. Increasing caffeine intake
- C. Avoiding all physical activity
- D. Taking daily hot baths
Correct Answer: A
Rationale: Practicing relaxation and breathing techniques helps manage labor pain and prepares the client for childbirth.