Question

The nurse is working with a 36-year-old, married client, G6 P6, who smokes. The woman states, "I don't expect to have any more kids, but I hate the thought of being sterile." Which of the following contraceptive methods would be best for this client?

Answer 1

Correct Answers:

Intrauterine device

Rationale :

🩺An intrauterine device provides highly effective, long-acting, and reversible contraception.

🚭Because the client is older than 35 and smokes, estrogen-containing contraceptives increase her risk of thromboembolism, stroke, and myocardial infarction.

🔄An IUD preserves future fertility, which addresses her concern about permanent sterility.

📅Depending on the type, an IUD can provide reliable contraception for several years without requiring daily adherence.

📌Core Message:

An IUD is the best option because it provides highly effective reversible contraception without the estrogen-related cardiovascular risks associated with smoking after age 35.

Answer 2

Correct Answers:

Extent of cervical dilatation
Cervical effacement
Fetal presentation

Rationale :

🩺A sterile vaginal examination determines cervical dilation, which measures the opening of the cervix in centimeters.

📏The examination evaluates cervical effacement, which describes cervical thinning as a percentage.

👶Palpating the presenting fetal part helps identify the fetal presentation and position.

📉The examination can also provide information about fetal station, membrane status, and labour progression.

📌Core Message:

A sterile vaginal examination evaluates cervical dilation, cervical effacement, and fetal presentation during labour.

Answer 3

Correct Answers:

"You need to be in control of what happens, so you need to discuss contraceptive options before having sex again."

Rationale :

🗣️This response encourages the adolescent to participate actively in reproductive decision-making.

🛡️Discussing contraception before sexual activity helps prevent another unintended pregnancy.

🤝The statement is direct, nonjudgmental, and supportive of the client’s autonomy.

📚The nurse can then provide accurate information about effective contraception and sexually transmitted infection prevention.

📌Core Message:

The nurse should empower the adolescent to make informed contraceptive decisions before resuming sexual activity.

Answer 4

Correct Answers:

The client will be discharged home to await the onset of true labour

Rationale :

⏳The client’s contractions are irregular, brief, and mild, which suggests false or latent labour rather than established active labour.

📏The absence of cervical change over 2 hours confirms that progressive labour has not begun.

💓A Category I fetal heart rate indicates reassuring fetal oxygenation and well-being.

🏠With intact membranes and no complications, the client can safely return home with labour precautions.

📌Core Message:

A term client with mild irregular contractions, no cervical change, intact membranes, and a Category I tracing should be discharged to await true labour.

Answer 5

Correct Answers:

Upon admission to the hospital at the start of labour
When the client feels perineal pressure
With either spontaneous or artificial rupture of membranes

Rationale :

🩺An admission examination establishes baseline cervical dilation, effacement, station, and presentation.

⬇️Perineal pressure may indicate rapid fetal descent or complete cervical dilation, requiring examination.

💧After rupture of membranes, an examination can assess for umbilical cord prolapse, particularly when clinically indicated.

🧤Vaginal examinations should be limited and performed using appropriate aseptic technique to reduce infection risk.

📌Core Message:

Vaginal examination is appropriate upon admission, with perineal pressure, and when membranes rupture to evaluate labour progress and immediate complications.

Answer 6

Correct Answers:

Encouraging clients to keep all prenatal appointments and if one needs to be missed to call and reschedule
Reporting symptoms of urinary frequency and burning to the health-care provider
Coming to the labour triage unit if back pain or cramping persist or become regular

Rationale :

📅Regular prenatal appointments allow early identification and management of risk factors for preterm labour.

🦠Urinary frequency and burning can indicate a urinary tract infection, which may trigger uterine contractions.

⚠️Persistent back pain or regular cramping can be early manifestations of preterm labour.

🏥Prompt evaluation allows timely interventions that may delay birth and improve neonatal outcomes.

📌Core Message:

Preventing preterm birth involves consistent prenatal care, prompt treatment of possible infection, and immediate evaluation of persistent back pain or regular cramping.

Answer 7

Correct Answers:

Increased vaginal bleeding
Cord lengthens

Rationale :

🩸A sudden gush or increased amount of blood indicates placental separation from the uterine wall.

📏The umbilical cord appears to lengthen as the separated placenta descends toward the vaginal opening.

🔵Another expected sign is a firm, globular uterus that rises in the abdomen.

⚠️These findings indicate readiness for controlled delivery of the placenta during the third stage of labour.

📌Core Message:

Increased vaginal bleeding and apparent umbilical cord lengthening are classic signs that the placenta has separated.

Answer 8

Correct Answers:

Prepare to assist the mother with the birth and call for assistance.

Rationale :

👶Crowning indicates that birth is imminent and the nurse must remain with the client.

🧤The nurse should prepare to control the delivery of the head and support a safe emergency birth.

📣The nurse should call for assistance without leaving the mother unattended during this critical event.

🛡️Immediate preparation reduces the risk of newborn injury, maternal trauma, and other birth complications.

📌Core Message:

When crowning occurs and birth is imminent, the nurse must remain with the client, prepare to assist with delivery, and summon help.

Answer 9

Correct Answers:

Chronic diabetes, post term, history of rapid labor

Rationale :

🩺Maternal chronic diabetes can justify induction when continuing the pregnancy creates greater maternal or fetal risk.

📅A post-term pregnancy increases the risk of placental insufficiency, oligohydramnios, meconium aspiration, and fetal compromise.

⚡A history of rapid labour may support a planned induction in selected circumstances because of the risk of precipitous out-of-hospital birth.

✅Among the options, this group contains conditions that may be appropriate indications for induction rather than contraindications.

📌Core Message:

Chronic diabetes, post-term pregnancy, and selected cases involving previous precipitous labour may support labour induction when benefits exceed risks.

Answer 10

Correct Answers:

100

Rationale :

🧮2 g/hr × 1,000 mL ÷ 20 g = 100 mL/hr

💊The prescribed magnesium sulfate dose is 2 g each hour.

🧴The available solution contains 20 g in 1,000 mL of normal saline.

🧮Using dimensional analysis converts the ordered grams per hour into the required milliliters per hour.

⚙️The infusion pump should therefore be programmed to deliver 100 mL/hr.

📌Core Message:

A magnesium sulfate solution containing 20 g in 1,000 mL must infuse at 100 mL/hr to deliver 2 g each hour.

1 :
The nurse is working with a 36-year-old, married client, G6 P6, who smokes. The woman states, "I don't expect to have any more kids, but I hate the thought of being sterile." Which of the following contraceptive methods would be best for this client?

2 :
The perinatal nurse knows that a sterile vaginal examination provides what information? Select all that apply.

3 :
A postpartum teenage mother tells the nurse that she "will not get pregnant again." Which is the nurse's best response to this statement?

5 :
Vaginal examination should be performed in which of these circumstances? Select all that apply.

6 :
The perinatal nurse provides a hospital tour for couples and families preparing for labour and birth. Teaching is an important component of the tour. What information would be provided about preterm labour and birth prevention? Select the three (3) that apply.

7 :
Which two (2) are signs of placental separation in the 3rd Stage of Labour? Select the two (2) that apply.

8 :
After assisting the client to a comfortable position for birth, the nurse begins cleansing the woman's perineal area. With the next contraction, the baby's head crowns and birth is imminent. What should the nurse do?

9 :
The nurse understands which of the following are appropriate indications for induction of labour?

10 :
Your patient is being started on Magnesium Sulfate. The order states administer Magnesium Sulfate at continuous rate of 2g/hr. Magnesium Sulfate is supplied as 20g/1000ml NS. What would you set your pump at for the continuous infusion? ml/hr

1 : The nurse is working with a 36-year-old, married client, G6 P6, who smokes. The woman states, "I don't expect to have any more kids, but I hate the thought of being sterile." Which of the following contraceptive methods would be best for this client?

2 : The perinatal nurse knows that a sterile vaginal examination provides what information? Select all that apply.

3 : A postpartum teenage mother tells the nurse that she "will not get pregnant again." Which is the nurse's best response to this statement?

5 : Vaginal examination should be performed in which of these circumstances? Select all that apply.

6 : The perinatal nurse provides a hospital tour for couples and families preparing for labour and birth. Teaching is an important component of the tour. What information would be provided about preterm labour and birth prevention? Select the three (3) that apply.

7 : Which two (2) are signs of placental separation in the 3rd Stage of Labour? Select the two (2) that apply.

8 : After assisting the client to a comfortable position for birth, the nurse begins cleansing the woman's perineal area. With the next contraction, the baby's head crowns and birth is imminent. What should the nurse do?

9 : The nurse understands which of the following are appropriate indications for induction of labour?

10 : Your patient is being started on Magnesium Sulfate. The order states administer Magnesium Sulfate at continuous rate of 2g/hr. Magnesium Sulfate is supplied as 20g/1000ml NS. What would you set your pump at for the continuous infusion? ml/hr

1 :
The nurse is working with a 36-year-old, married client, G6 P6, who smokes. The woman states, "I don't expect to have any more kids, but I hate the thought of being sterile." Which of the following contraceptive methods would be best for this client?

2 :
The perinatal nurse knows that a sterile vaginal examination provides what information? Select all that apply.

3 :
A postpartum teenage mother tells the nurse that she "will not get pregnant again." Which is the nurse's best response to this statement?

5 :
Vaginal examination should be performed in which of these circumstances? Select all that apply.

6 :
The perinatal nurse provides a hospital tour for couples and families preparing for labour and birth. Teaching is an important component of the tour. What information would be provided about preterm labour and birth prevention? Select the three (3) that apply.

7 :
Which two (2) are signs of placental separation in the 3rd Stage of Labour? Select the two (2) that apply.

8 :
After assisting the client to a comfortable position for birth, the nurse begins cleansing the woman's perineal area. With the next contraction, the baby's head crowns and birth is imminent. What should the nurse do?

9 :
The nurse understands which of the following are appropriate indications for induction of labour?

10 :
Your patient is being started on Magnesium Sulfate. The order states administer Magnesium Sulfate at continuous rate of 2g/hr. Magnesium Sulfate is supplied as 20g/1000ml NS. What would you set your pump at for the continuous infusion? ml/hr