ob eaq1 level 1
A nurse is teaching a client about the oral contraceptive prescribed by the primary health care provider. Which condition identified by the client indicates understanding of when the drug should be stopped immediately and the health care provider notified?
Chest pain Incorrect2 Menorrhagia 3 Mittelschmerz 4 Increased leukorrhea Oral contraceptives should be discontinued with the presence of any symptom related to a pulmonary embolus. Menorrhagia, extremely heavy menstrual flow, is a side effect related to excessive amounts of estrogen; immediate discontinuation of the oral contraceptive is unnecessary. Mittelschmerz, pain at the time of ovulation, does not occur when the client is taking an oral contraceptive. Increased leukorrhea may be a sign of Infection, not a side effect of oral contraceptives.
A client is admitted to the birthing unit because fluid is leaking from her vagina. She is unsure whether her "bag of water" has broken. What should the nurse do to help determine whether the fluid is amniotic fluid? Correct1 Test the fluid with nitrazine paper 2 Inspect the fluid for its characteristics 3 Assess the fluid for the presence of protein 4 Send the fluid to the laboratory for analysis
Amniotic fluid is slightly alkaline, and urine is acidic; when moistened with amniotic fluid, nitrazine will turn dark blue, indicating an alkaline substance. Inspecting the fluid is a subjective assessment and may be inaccurate. Protein is not a discriminating factor, because it may be present in urine and amniotic fluid, especially in the urine, if the client shows signs of preeclampsia. The fluid need not be sent to the laboratory; it can be tested immediately for alkalinity with nitrazine paper.
Although a client in labor is prepared and plans to participate in the labor and birth process, she states that she is in severe discomfort. The nurse administers the prescribed butorphanol (Stadol). Which phase of labor is the safest time for the nurse to administer this medication?
Early phase Correct2 Active phase 3 Transition phase 4 Expulsion phase Respiratory depression of the newborn will not occur if the medication is given during the active phase; it should not be given when birth is expected to occur within 2 hours. The level of pain during the early phase can usually be managed with other strategies such as breathing techniques or diversion; giving an opioid early in labor may slow the progress of labor. An opioid should be avoided in the 2 hours preceding birth; giving it to a client in the transition phase can cause respiratory depression in the newborn. Giving the medication when birth is imminent is contraindicated because it may cause respiratory depression in the newborn; the mother's level of consciousness will be altered as well, making it difficult for her to cooperate with requests for her to push.
What nursing intervention should be implemented routinely after a client has a vacuum aspiration abortion?
Giving the client the prescribed oxytocic medication 2 Preparing the client for discharge within 30 minutes 3 Teaching the client about the various methods of birth control Correct4 Encouraging the client to take the prescribed antibiotic medication Prophylactic antibiotics after a vacuum extraction abortion decrease the incidence of infection. Oxytocics are not used routinely after an abortion unless there is excessive vaginal bleeding. The client is usually observed for 1 to 3 hours before being discharged. Birth control instructions should be given before the abortion; a client is not receptive to teaching immediately after the procedure.
A 31-year-old client is seeking contraceptive information. Before responding to the client's questions about contraceptives, the nurse obtains a health history. What factor in the client's history indicates to the nurse that oral contraceptives are contraindicated?
Older than 30 years 2 Current hypothyroidism 3 Two multiple pregnancies Correct4 History of borderline hypertension Oral contraceptives may cause or exacerbate hypertension; borderline hypertension places the client at risk for a brain attack. Oral contraceptives are not contraindicated for women older than 30 years of age if there are no known risk factors. There is no relationship between oral contraceptives and multiple births. Contraceptives are not contraindicated in clients who have hypothyroidism.
A primigravida in the first trimester tells a nurse that she has heard that hormones play an important role in pregnancy. Which hormone should the nurse tell the client maintains pregnancy?
1 Prolactin 2 Estrogen Correct3 Progesterone 4 Somatotropin Progesterone is a female sex hormone, produced by the ovaries and placenta, that prepares the endometrium for implantation of the fertilized ovum, maintains pregnancy, and plays a role in the development of the mammary glands. Prolactin is secreted by the anterior lobe of the pituitary gland; it is responsible for initiating and maintaining milk secretion from the mammary glands. Estrogen is a female sex hormone that starts to prepare the endometrium for implantation and promotes development of secondary sex characteristics. Somatotropin is a growth hormone secreted by the anterior pituitary gland.
At 6 weeks' gestation a client is found to have gonorrhea. What medication does a nurse expect the health care provider to prescribe?
1, correct Ceftriaxone (Rocephin) 2 Levofloxacin (Levaquin) 3 Sulfasalazine (Azulfidine) 4 Trimethoprim/sulfamethoxazole (Bactrim) Ceftriaxone (Rocephin, a broad-spectrum antibiotic, is preferred during pregnancy. Levofloxacin (Levaquin), although listed as for unlabeled use against gonococcal Infection, should not be prescribed during pregnancy. Sulfonamides may cause hemolysis in the fetus. Trimethoprim/sulfamethoxazole (Bactrim) contains a sulfonamide and is contraindicated during pregnancy.
A hysterectomy is scheduled for a client with endometrial cancer. Before the surgery, what should the nurse prepare the client to expect? 1 Nasogastric tube Correct2 Indwelling urinary catheter Incorrect3 Vaginal packing for 10 days 4 Jackson-Pratt drain in the abdominal incision
A catheter decompresses the bladder and limits trauma to the surgical site; it eliminates the need for repeated straight catheterizations after surgery. The gastrointestinal tract does not need to be decompressed for this type of surgery. Packing is usually not necessary; if it is used after a hysterectomy, 10 days is an excessively long time. Drains usually are not necessary after a hysterectomy.
A client seeking family planning information asks the nurse during which phase of the menstrual cycle an intrauterine device (IUD) should be inserted. Before responding the nurse recalls that the insertion usually is done:
Between the first and fourth days of the cycle Incorrect2 Between fifth and 11th days 3 Between the 14th and 16th days 4 Between the 25th and 28th days An IUD should be inserted during menstruation because the cervical os is slightly dilated at this time; also, there is little chance of the woman's being pregnant. The IUD should not be inserted between the fifth and 11th days of the menstrual cycle; this is the proliferative phase of the cycle. The IUD should not be inserted between the 14th and 16th days or between the 25th and 28th days because the client may be pregnant.
A nurse is assessing a client who is being admitted for surgical repair of a rectocele. What signs or symptoms does the nurse expect the client to report? (Select all that apply.)
Correct1 Painful intercourse 2 Crampy abdominal pain Correct3 Bearing-down sensations 4 Urinary stress incontinence Incorrect5 Recurrent urinary tract infections The posterior vaginal wall is pushed forward by the herniation of the rectum; this protrusion causes painful intercourse. The posterior vaginal wall is pushed forward by the herniation of the rectum; this protrusion increases rectal pressure and causes the bearing-down sensation. A rectocele is not accompanied by abdominal pain. Urinary stress incontinence is the primary sign of a cystocele. A cystocele, not a rectocele, is associated with urinary tract infections.