Nokea
The physician orders docusate sodium (Colace) 100 mg at bedtime for a primiparous client after vaginal delivery of a term neonate after a midline episiotomy. The nurse instructs the client to expect which of the following results from taking the medication?
- A. Relief from episiotomy pain.
- B. Contraction of the uterus.
- C. Softening of the stool.
- D. Aid in sleeping.
Correct Answer: C
Rationale: Docusate sodium is a stool softener, which helps prevent straining during bowel movements, especially important after an episiotomy.
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A woman who is Rh-negative has delivered an Rh-positive infant. The nurse explains to the client that she will receive RhoGAM. The nurse determines that the client understands the purpose of RhoGAM when she states:
- A. "RhoGAM will protect my next baby if it is Rh-negative."
- B. "RhoGAM will prevent antibody formation in my blood."
- C. "RhoGAM will be given to prevent German measles."
- D. "RhoGAM will be used to prevent bleeding in my newborn."
Correct Answer: B
Rationale: RhoGAM prevents maternal antibody formation against Rh-positive blood.
Which of the following would be most important for the nurse to encourage in a primiparous client diagnosed with endometritis who is receiving intravenous antibiotic therapy?
- A. Ambulate to the bathroom frequently.
- B. Discontinue breast-feeding temporarily.
- C. Maintain bed rest in Fowler's position.
- D. Restrict visitors to prevent contamination.
Correct Answer: C
Rationale: Fowler's position promotes drainage of uterine secretions, aiding recovery from endometritis.
A nurse is discussing the withdrawal method with a client. Which of the following client statements indicates a need for further teaching?
- A. I understand it has a high failure rate.
- B. My partner needs to withdraw before ejaculation.
- C. It provides some protection against STIs.
- D. It requires careful timing and control.
Correct Answer: C
Rationale: The withdrawal method does not provide protection against STIs, indicating a need for further teaching. The other statements are correct regarding its high failure rate, need for withdrawal before ejaculation, and requirement for timing and control.
The nurse is caring for a multigravid client who speaks little English. As the nurse enters the client's room, the nurse observes the client panting on the bed and the fetal head crowning. After calling for assistance and helping the client lie down, which of the following actions should the nurse do next?
- A. Tell the client to push between contractions.
- B. Provide gentle support to the fetal head.
- C. Apply gentle upward traction on the neonate's anterior shoulder.
- D. Massage the perineum to stretch the perineal tissues.
Correct Answer: B
Rationale: With the fetal head crowning, providing gentle support prevents rapid expulsion and perineal trauma. Pushing between contractions is incorrect, traction is for shoulder dystocia, and perineal massage is less urgent.
A neonate born at 38 weeks' gestation is admitted to the neonatal nursery for observation. The neonate's mother, who is positive for human immunodeficiency virus (HIV) infection, has received no prenatal care. The mother asks the nurse if her neonate is positive for HIV. The nurse can tell the mother which of the following?
- A. More than $50 \%$ of neonates born to mothers who are positive for HIV will be positive at 18 months of age.'
- B. An enlarged liver at birth generally means the neonate is HIV positive.'
- C. A complete blood count analysis is the primary method for determining whether the neonate is HIV positive.'
- D. Most neonates are asymptomatic at birth and usually test positive for the HIV antibody at this time.'
Correct Answer: D
Rationale: Most neonates born to HIV-positive mothers test positive for HIV antibodies at birth due to maternal antibody transfer but are asymptomatic, with true infection status determined later.