A nurse is caring for a client who is postpartum and requests information about contraception. Which of the following instructions should the nurse include?

"You should avoid vaginal spermicides while breastfeeding."

"The lactation amenorrhea method is effective for your first year postpartum."

"Place the transdermal birth control patch on your upper outer arm."

"You can continue to use the diaphragm you used before your pregnancy."

Answer and Explanation

The Correct Answer is C

Rationale:

A. "You should avoid vaginal spermicides while breastfeeding.": Vaginal spermicides are generally considered safe during breastfeeding. They do not contain hormones and do not affect milk production, so avoidance is not typically necessary unless the client has specific contraindications.

B. "The lactation amenorrhea method is effective for your first year postpartum.": This method is only effective during the first 6 months postpartum, provided the mother is exclusively breastfeeding and menstruation has not resumed. Beyond that period, the risk of ovulation increases and it becomes unreliable.

C. "Place the transdermal birth control patch on your upper outer arm.": The patch can be applied to several sites, including the upper outer arm, abdomen, buttock, or upper torso. This is an appropriate instruction and part of standard patient teaching for transdermal contraceptive use.

D. "You can continue to use the diaphragm you used before your pregnancy.": The diaphragm often requires refitting postpartum due to changes in vaginal tone and cervix position. Using the same diaphragm without evaluation could reduce effectiveness and increase risk of unintended pregnancy.

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Correct Answer is B

Explanation

Rationale:

A. Canned black beans: While black beans are a healthy source of protein and fiber, canned varieties are often high in sodium unless labeled low-sodium. High sodium intake can worsen hypertension, so these should be limited or thoroughly rinsed before use.

B. Fish: Fish, particularly those high in omega-3 fatty acids like salmon and mackerel, can help lower blood pressure and reduce cardiovascular risk. They are a heart-healthy protein source recommended in hypertension management.

C. Red meat: Red meat is often high in saturated fat and cholesterol, which can contribute to elevated blood pressure and heart disease. It should be limited in a diet designed to control hypertension.

D. Cheese: Many cheeses are high in sodium and saturated fat, which can increase blood pressure and cardiovascular strain. Even small portions may contain significant sodium, making them less ideal for clients with hypertension.

A. Drop the sterile gauze from 25.4 cm (10 in) above the sterile field. B. Hold the sterile package in his dominant hand and open the top flap of the package toward his body. C. Place objects 1.27 cm (0.5 in) inside the border of the sterile field. D. Position the bottle outside the edge of the sterile field when pouring solution into a sterile container.

Correct Answer is A

Explanation

Rationale:

A. Drop the sterile gauze from 25.4 cm (10 in) above the sterile field: Dropping sterile items from a height of about 6 to 12 inches prevents contamination by keeping hands outside the sterile field and ensuring the item lands safely without touching nonsterile surfaces.

B. Hold the sterile package in his dominant hand and open the top flap of the package toward his body: The top flap should be opened away from the nurse’s body to maintain sterility and prevent the arm from crossing over the sterile field, which would risk contamination.

C. Place objects 1.27 cm (0.5 in) inside the border of the sterile field: The outer 2.5 cm (1 inch) of the sterile field is considered contaminated. Placing items only 0.5 inches inside this border would place them within the contaminated zone, risking sterile field compromise.

D. Position the bottle outside the edge of the sterile field when pouring solution into a sterile container: While the bottle should not touch the sterile field, it must be close enough to pour without splashing, and the sterile container must be inside the sterile field.

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Finding	Nursing Intervention
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A nurse is caring for a client who is postpartum and requests information about contraception. Which of the following instructions should the nurse include?

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