Nokea
Which procedure should be avoided for the client known to have a placenta previa?
- A. A non-stress test
- B. A urinary catheterization
- C. A sterile vaginal exam
- D. An abdominal ultrasound
Correct Answer: C
Rationale: The correct answer is C: A sterile vaginal exam. Placenta previa involves the placenta partially or fully covering the cervix, making a vaginal exam risky due to potential disruption of the placenta and causing severe bleeding. This procedure should be avoided to prevent harm to the client and the baby. A: A non-stress test, D: An abdominal ultrasound, and B: A urinary catheterization are safe procedures that do not pose a risk to the client with placenta previa.
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A nurse is caring for a client who is in active labor and has had no cervical change in the last 4 hr. Which of the following statements should the nurse make?
- A. Let me help you into a comfortable pushing position so you can begin bearing down.
- B. I am going to call the doctor to get a prescription for medication to ripen your cervix.
- C. I will give you some IV pain medicine to strengthen your contractions.
- D. Your provider will insert an intrauterine pressure catheter to monitor the strength of your contractions.
Correct Answer: D
Rationale: The correct answer is D. The nurse should inform the client about the provider inserting an intrauterine pressure catheter to monitor contraction strength. This is appropriate because lack of cervical change in active labor could indicate inadequate contractions. Monitoring contraction strength with an intrauterine pressure catheter can help determine if the contractions are effective in progressing labor. It allows for more accurate assessment and timely interventions if needed.
Choice A is incorrect because pushing without adequate cervical dilation can lead to complications. Choice B is incorrect as medication to ripen the cervix is not indicated in this scenario. Choice C is incorrect as IV pain medicine does not address the issue of inadequate cervical change.
A client delivered two days ago and is suspected of having postpartum 'blues.' Which symptoms confirm the diagnosis?
- A. Uncontrollable crying and insecurity
- B. Depression and suicidal thoughts
- C. Sense of the inability to care for the family and extreme anxiety
- D. Nausea and vomiting
Correct Answer: A
Rationale: The correct answer is A because uncontrollable crying and insecurity are classic symptoms of postpartum blues, also known as baby blues. This condition is characterized by mood swings, tearfulness, and feelings of vulnerability. Choices B, C, and D are incorrect as they suggest more severe symptoms associated with postpartum depression or other mental health disorders, which require immediate intervention. Nausea and vomiting (choice D) are not typically associated with postpartum blues. It is essential to differentiate between postpartum blues and more serious conditions to provide appropriate support and treatment to the client.
A woman in the transition stage of labor is using paced breathing to relieve pain. She complains of blurred vision, numbness, and tingling of her hands and mouth. Which condition is indicated by these signs and symptoms?
- A. Anoxia
- B. Hyperventilation
- C. Anxiety
- D. Hypertension
Correct Answer: B
Rationale: The correct answer is B: Hyperventilation. The symptoms of blurred vision, numbness, and tingling in the hands and mouth are indicative of hyperventilation. During paced breathing, if the woman breathes too quickly or deeply, it can lead to a decrease in carbon dioxide levels in the blood, causing these symptoms. To address this, the woman should be guided to slow down her breathing and breathe into a paper bag to rebreathe some carbon dioxide. Anoxia (A) is a severe lack of oxygen, which would present with different symptoms. Anxiety (C) may cause similar symptoms but is not the primary issue here. Hypertension (D) does not typically lead to these specific symptoms.
A 1-year-old receives routine health maintenance care at the pediatric clinic. The child receives an MMR immunization. The mother asks the nurse, 'When will my child get the next dose of MMR vaccine?' Which is the correct response by the nurse?
- A. In six months with the next DPT
- B. No further vaccination needed
- C. With the Hepatitis B series
- D. After the child is 10 years of age
Correct Answer: D
Rationale: A second MMR, often called a booster, will be needed when the child enters middle school at age eleven or twelve years of age. This ensures full immunity from the diseases covered by the MMR vaccine.
A woman in the first trimester comes to the clinic with vaginal bleeding. The physician determines that the fetus has died and that the placenta, fetus, and tissues still remain in the uterus. How should the findings be documented?
- A. Complete abortion
- B. Stillborn abortion
- C. Missed abortion
- D. Incomplete abortion
Correct Answer: C
Rationale: The correct answer is C: Missed abortion. In a missed abortion, the fetus has died but has not been expelled from the uterus yet. The findings should be documented as a missed abortion because the fetus has not been passed naturally. This is different from a complete abortion (A) where all products of conception have been expelled, a stillborn abortion (B) which is not a recognized medical term, and an incomplete abortion (D) where some products of conception remain in the uterus. Therefore, based on the scenario described, the most appropriate term to document the findings is missed abortion.