Nokea
While the nurse is preparing to assist the primiparous client to the bathroom to void 6 hours after a vaginal delivery under epidural anesthesia, the client says that she feels dizzy when sitting up on the side of the bed. The nurse explains that this is most likely caused by which of the following?
- A. Effects of the anesthetic during labor.
- B. Hemorrhage during the delivery process.
- C. Effects of analgesics used during labor.
- D. Decreased blood volume in the vascular system.
Correct Answer: A
Rationale: Dizziness when sitting up is likely due to residual effects of epidural anesthesia, which can cause orthostatic hypotension.
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A nurse is discussing the contraceptive ring with a client. Which of the following client statements indicates understanding?
- A. I can remove the ring for up to 3 hours if needed.
- B. The ring is replaced every week.
- C. The ring requires daily insertion.
- D. The ring provides long-term contraception for 5 years.
Correct Answer: A
Rationale: The vaginal contraceptive ring can be removed for up to 3 hours if needed without losing effectiveness. It is replaced every 3 weeks (not weekly), not inserted daily, and provides contraception for one cycle, not 5 years.
Assessment of a term neonate at 8 hours after birth reveals tachypnea, dyspnea, sternal retractions, diminished femoral pulses, poor lower body perfusion, and cyanosis of the lower body and extremities, with a pink upper body. The nurse notifies the pediatrician based on the interpretation that these symptoms are associated with which of the following:
- A. Coarctation of the aorta.
- B. Atrioventricular septal defect.
- C. Pulmonary atresia.
- D. Transposition of the great arteries.
Correct Answer: A
Rationale: These symptoms are characteristic of coarctation of the aorta, which causes reduced blood flow to the lower body.
A client has just had a cesarean section for a prolapsed cord. In reviewing the client's history, which of the following factors places a client at risk for cord prolapse? Select all that apply.
- A. -2 station.
- B. Low birth weight infant.
- C. Rupture of membranes.
- D. Breech presentation.
- E. Prior abortion.
- F. Low lying placenta.
Correct Answer: A,B,C,D,F
Rationale: These factors increase the risk of cord prolapse.
When assessing a 34-year-old multigravid client at 34 weeks' gestation experiencing moderate vaginal bleeding, which of the following would most likely alert the nurse that placenta previa is present?
- A. Painless vaginal bleeding.
- B. Uterine tetany.
- C. Intermittent pain with spotting.
- D. Dull lower back pain.
Correct Answer: A
Rationale: Painless vaginal bleeding is characteristic of placenta previa.
Which of the following should the nurse include in the discharge teaching for a primiparous client about preventing postpartum infections?
- A. Change perineal pads every 8 hours.
- B. Take warm sitz baths twice daily.
- C. Wash hands before and after perineal care.
- D. Use a hairdryer to dry the perineal area.
Correct Answer: C
Rationale: Hand washing before and after perineal care reduces the risk of introducing pathogens, preventing infections.