What is the best position for a laboring mother with a suspected occiput posterior position?
- A. Encourage side-lying position
- B. Place the mother in lithotomy position
- C. Encourage ambulation to facilitate descent
- D. Use a peanut ball to widen the pelvis
Correct Answer: D
Rationale: The correct answer is D. Using a peanut ball widens the pelvis, which can help rotate the baby into an optimal position for birth. This position can aid in reducing the likelihood of prolonged labor and the need for interventions. Encouraging side-lying position (A) may not provide the necessary pelvic widening. Placing the mother in lithotomy position (B) can impede the baby's descent. Encouraging ambulation (C) may not specifically address the occiput posterior position and may not provide enough pelvic opening.
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A patient is seen in the primary care clinic for a sinus infection and is prescribed antibiotics. The only other medication that this patient currently takes is an oral contraceptive. What is the most important education the nurse must give to the patient regarding her medications?
- A. If you have nausea with this combination of medication, make sure to take them with food.
- B. You must use a backup method for contraception while taking antibiotics.
- C. Oral contraceptives are contraindicated with many antibiotics.
- D. No education is necessary; these medications do not interact.
Correct Answer: B
Rationale: Step 1: Antibiotics can reduce the effectiveness of oral contraceptives by altering gut flora.
Step 2: Failure to use a backup method can lead to unintended pregnancy.
Step 3: Therefore, it is crucial for the nurse to educate the patient on using a backup method to prevent pregnancy.
Summary: Choice A is incorrect as nausea is not the main concern. Choice C is incorrect as not all antibiotics interact with oral contraceptives. Choice D is incorrect as there is a potential interaction between antibiotics and oral contraceptives.
A nurse in a prenatal clinic is teaching a client who has a new prescription for dinoprostone gel. Which of the following statements should the nurse include in the teaching?
- A. "This medication promotes softening of the cervix."
- B. "This medication is used to treat preeclampsia."
- C. "It causes relaxation of the uterine muscles."
- D. "It is used to treat genital herpes simplex virus."
Correct Answer: A
Rationale: The correct answer is A: "This medication promotes softening of the cervix." Dinoprostone gel is a prostaglandin used to ripen the cervix in preparation for labor induction. This explanation is crucial for the client to understand the purpose of the medication. Option B is incorrect because dinoprostone is not used to treat preeclampsia. Option C is incorrect as dinoprostone causes uterine contractions rather than relaxation. Option D is incorrect as dinoprostone is not used to treat genital herpes simplex virus.
The nurse is educating a client about folic acid during pregnancy. What food should the nurse recommend?
- A. Citrus fruits.
- B. Leafy green vegetables.
- C. Dairy products.
- D. Lean meats.
Correct Answer: B
Rationale: The correct answer is B: Leafy green vegetables. Folic acid is essential during pregnancy for proper fetal development. Leafy green vegetables like spinach, kale, and broccoli are rich sources of folic acid. Citrus fruits (Choice A) contain vitamin C but not as much folic acid as leafy greens. Dairy products (Choice C) provide calcium but are not significant sources of folic acid. Lean meats (Choice D) are good sources of protein but do not contain as much folic acid as leafy green vegetables. Therefore, recommending leafy green vegetables ensures the client gets an adequate intake of folic acid during pregnancy.
The nurse is monitoring a client with hypertonic uterine contractions. What is the priority nursing action?
- A. Administer pain relief as prescribed.
- B. Prepare for an amniotomy.
- C. Encourage ambulation.
- D. Increase oxytocin infusion.
Correct Answer: A
Rationale: The correct answer is A: Administer pain relief as prescribed. The priority is to address the client's discomfort and pain caused by hypertonic uterine contractions. Pain management is crucial to ensure the client's comfort and well-being. Administering pain relief can help prevent complications such as increased stress on the mother and fetus.
Choice B: Prepare for an amniotomy is incorrect because it involves artificial rupturing of the amniotic sac, which is not indicated for hypertonic contractions.
Choice C: Encourage ambulation is incorrect because it may exacerbate the pain and discomfort experienced by the client with hypertonic uterine contractions.
Choice D: Increase oxytocin infusion is incorrect because it can further intensify the uterine contractions and worsen the client's pain.
A preterm neonate develops physiologic jaundice and phototherapy is ordered. The nurse understands that this therapy:
- A. Activates the liver to dispose the bilirubin
- B. Breaks down the unconjugated bilirubin in the skin to conjugated form permitting excretion
- C. Activates Vit. K to facilitate excretion of the bilirubin
- D. Dissolves the bilirubin and allows it to be excreted from the skin
Correct Answer: B
Rationale: The correct answer is B because phototherapy works by breaking down unconjugated bilirubin in the skin to a water-soluble form, allowing it to be excreted from the body. This process does not activate the liver (choice A), nor does it activate Vitamin K (choice C) or dissolve the bilirubin for excretion from the skin (choice D). Phototherapy specifically targets the unconjugated bilirubin in the skin, converting it to a form that can be eliminated through the urine and stool.