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Which of the following would the nurse include in the primiparous client's discharge teaching plan about measures to provide visual stimulation for the neonate?
- A. Maintain eye contact while talking to the baby.
- B. Paint the baby's room in bright colors accented with teddy bears.
- C. Use brightly colored animals and cartoon figures on the wall.
- D. Move a brightly colored rattle in front of the baby's eyes.
Correct Answer: A
Rationale: Maintaining eye contact promotes visual stimulation and bonding, suitable for a neonate's developmental stage.
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During a home visit on the fourth postpartum day, a primiparous client tells the nurse that she has been experiencing breast engorgement. To relieve engorgement, the nurse teaches the client that before nursing her baby, the client should do which of the following?
- A. Apply an ice cube to the nipples.
- B. Rub her nipples gently with lanolin cream.
- C. Express a small amount of breast milk.
- D. Offer the neonate a small amount of formula.
Correct Answer: C
Rationale: Expressing a small amount of milk softens the breast, making it easier for the neonate to latch.
A nurse is counseling a client about the use of spermicides. Which of the following instructions should the nurse include?
- A. Apply spermicide 10-30 minutes before intercourse.
- B. Use spermicide alone for maximum effectiveness.
- C. Leave spermicide in place for at least 24 hours.
- D. Apply spermicide after intercourse.
Correct Answer: A
Rationale: Spermicide should be applied 10-30 minutes before intercourse for optimal effectiveness. It is not most effective alone, should not be left for 24 hours, and is applied before, not after, intercourse.
A 19-year-old primigravid client at 38 weeks' gestation is admitted to the hospital in active labor that began 8 hours ago. When the client's cervix is 7 cm dilated and the presenting part is at +1 station, the client tells the nurse, 'I need to push!' Which of the following would the nurse do next?
- A. Use the McDonald procedure to widen the pelvic opening.
- B. Increase the rate of oxygen and intravenous fluids.
- C. Tell the client to use a pant-blow pattern of breathing.
- D. Tell the client to push only when absolutely necessary.
Correct Answer: C
Rationale: At 7 cm dilation, the client is not fully dilated, and pushing can cause cervical trauma. A pant-blow breathing pattern helps manage the urge to push until full dilation. The McDonald procedure is for cervical cerclage, and increasing oxygen/fluids or encouraging pushing is inappropriate.
A breast-feeding primiparous client reports leaking breasts between feedings on day 3 postpartum. The nurse explains this is due to:
- A. Overproduction of milk.
- B. Poor latch technique.
- C. Milk supply adjusting to demand.
- D. Inadequate feeding frequency.
Correct Answer: C
Rationale: Leaking breasts on day 3 indicate the milk supply is adjusting to the neonate's demand as lactation establishes.
Carboprost (Hemabate) was injected into the uterus of a client to treat uterine atony during a cesarean section. In preparing to care for this client postpartum, the nurse should assess the client for which of the following common adverse effects of the medication?
- A. Vertigo and confusion.
- B. Nausea and diarrhea.
- C. Restlessness and increased vaginal bleeding.
- D. Headache and hypertension.
Correct Answer: B
Rationale: Carboprost commonly causes nausea and diarrhea as side effects.