Which of the following instructions should be included in the nurse’s teaching regarding oral contraceptives?
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Solution
Answer B is correct. When the client is taking oral contraceptives and begins antibiotics, another method of birth control should be used. Antibiotics decrease the effectiveness of oral contraceptives. Approximately 5–10 pounds of weight gain is not unusual in clients taking oral contraceptives, so answer A is incorrect. If the client misses a birth control pill, she should be instructed to take the pill as soon as she remembers the pill. If she missed two, she should take two; if she missed more than two, she should take the missed pills but use another method of birth control for the remainder of the cycle, so answer C is incorrect. Changes in menstrual flow are expected in clients using oral contraceptive. Often these clients have lighter menses and this need not be reported, so answer D is incorrect.
The nurse is caring for a neonate whose mother is diabetic. The nurse will expect the neonate to be:
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Solution
Answer C is correct. The infant of a diabetic mother is usually large for gestational age. After birth, glucose levels fall rapidly due to the absence of glucose from the mother. Answer A is incorrect because the infant will not be small for gestational age. Answer B is incorrect because the infant will not be hyperglycemic. Answer D is incorrect because the infant will have hypoglycemia and will be large for gestational age.
A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:
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Solution
Answer B is correct. The most definitive diagnosis of pregnancy is the presence of fetal heart tones. The other signs are subjective and can be related to other medical conditions. Answers A and C can be related to a hydatidiform mole. Answer D is very subjective and is often present before menses or with use of oral contraceptives.
The client with hyperemesis gravidarum is at risk for developing:
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Solution
Answer B is correct. The client with hyperemesis has persistent nausea and vomiting. With vomiting comes dehydration. When the client is dehydrated, she will have metabolic acidosis. Answers A and C are incorrect because they are respiratory in nature, and answer D is incorrect because the client will not be in alkalosis with persistent vomiting.
The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet the nutritional needs of the pregnant client?
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Solution
Answer C is correct. All of the choices are tasty, but the pregnant client needs a diet that is balanced and has increased amounts of calcium, such as is included in answer C: meat, fruit, potato salad, and yogurt, with about 360mg of calcium. Answer A is lacking in fruits and milk. Answer B contains the potato chips, which contain a large amount of sodium. Answer D is not the best diet because it lacks vegetables and milk products.
The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of ectopic pregnancy?
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Solution
Answer D is correct. The signs of an ectopic pregnancy are vague until the fallopian tube ruptures. The client will complain of sudden, stabbing pain in the lower quadrant that radiates down the leg or up into the chest. Painless vaginal bleeding is a sign of placenta previa, so answer A is incorrect. Abdominal cramping is a sign of labor, so answer B is incorrect. Throbbing pain in the upper quadrant, in answer C, is nonspecific and is not a sign of an ectopic pregnancy.
A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes?
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Solution
Answer C is correct. The best method of birth control for the client with diabetes is the diaphragm. The intrauterine device in answer A prevents implantation by producing an inflammatory response. Clients with diabetes have an increased response to inflammation. Oral contraceptives, in answer B, are not the best method because they tend to elevate blood glucose levels. Contraceptive sponges alone are not best at preventing pregnancy, so answer D is incorrect.
A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the rhythm method depends on the:
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Solution
Answer C is correct. The success of the rhythm method of birth control is dependent on the client’s menses being regular. It is not dependent on the age of the client, as stated in answer A; the frequency of intercourse, as stated in answer B; or the range of the client’s temperature, as stated in answer D.
A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:
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Solution
Answer B is correct. Lutenizing hormone released by the pituitary is responsible for ovulation. At about day 14, the continued increase in estrogen stimulates the release of lutenizing hormone from the anterior pituitary. The LH surge is responsible for ovulation, or the release of the dominant follicle in reparation from conception, which occurs within the next 10–12 hours after the LH levels peak. Answer A is incorrect because estrogen levels are high at the beginning of ovulation. Answer C is incorrect because the endometrial lining is thick, not thin. Answer D is incorrect because the progesterone levels are high, not low
The nurse asks the client with an epidural anesthesia to void every hour during the labor. The rationale for this intervention is:
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Solution
Answer C is correct. Epidural anesthesia decreases the urge to void and sensation of a full bladder. A full bladder will decrease the progression of labor. Answer A is incorrect because the bladder does not fill more rapidly in the client with epidural anesthesia. Answer B is incorrect because the client’s level of consciousness is not altered. Answer D is incorrect because there is no data to indicate that the client is embarrassed to ask for the bedpan.