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Which data must the nurse consider before administering Depo-Provera (medroxyprogesterone acetate) to a postpartum client?
- A. The capsule must be taken at the same time each day.
- B. The client must be taught to use sunscreen whenever in the sunlight.
- C. The medicine is contraindicated if the woman has lung or esophageal cancer.
- D. The client must use an alternate form of birth control for the first two months.
Correct Answer: C
Rationale: Medroxyprogesterone acetate is contraindicated in women with certain cancers.
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The nurse is assessing a postpartum client who is breastfeeding. What finding requires further evaluation?
- A. Engorgement on day 3 postpartum.
- B. Mild nipple tenderness.
- C. Cracked and bleeding nipples.
- D. Colostrum present in the first 48 hours.
Correct Answer: C
Rationale: Cracked and bleeding nipples may indicate poor latch or incorrect breastfeeding technique, requiring intervention.
When teaching parents about mandatory newborn screening, it is important for the nurse to explain that the main purpose is to:
- A. keep the State records updated.
- B. allow accurate statistical information.
- C. document the number of births.
- D. recognize and treat newborn disorders early.
Correct Answer: D
Rationale: Early recognition and treatment can prevent serious health issues.
The nurse is reviewing a copy of the U.S. Surgeon General's Report, Healthy People 2020. Which nursing action best reflects the nurse fostering this health care agenda?
- A. The nurse signs up for classes to obtain an advanced degree in nursing.
- B. The nurse volunteers at a local health care clinic providing free vaccinations for low-income populations.
- C. The nurse performs an in-service on basic hospital equipment for student nurses.
- D. The nurse compiles nursing articles on evidence-based practices in nursing to present at a hospital training seminar.
Correct Answer: B
Rationale: Healthy People 2020 is a comprehensive health promotion and disease prevention agenda that is working toward improving the quantity and quality of life for all Americans.
The nurse is monitoring a client with severe preeclampsia. What assessment finding requires immediate intervention?
- A. Blood pressure of 150/90 mmHg.
- B. Urine output of 25 mL/hr.
- C. Headache relieved by acetaminophen.
- D. Deep tendon reflexes +2.
Correct Answer: B
Rationale: Oliguria (urine output <30 mL/hr) may indicate worsening renal function or severe complications in preeclampsia.
After her baby's birth a patient wishes to begin breastfeeding. The nurse assists the client by:
- A. Positioning the infant to grasp the nipple to express milk.
- B. Giving the infant a bottle first to evaluate the baby's ability to suck
- C. Leaving them alone and allowing the infant to nurse as long as desired
- D. Touching the infant's cheek adjacent to the nipple to elicit the rooting reflex
Correct Answer: D
Rationale: The rooting reflex helps initiate breastfeeding.