A nurse is caring for a client who is taking an oral contraceptive. The nurse should instruct the client to report which of the following findings to the provider immediately?

Painful intercourse

Vaginal itching

Persistent headaches

Breast tenderness

Answer and Explanation

The Correct Answer is C

A. Painful intercourse: Painful intercourse can have various causes, but it is not typically associated with serious complications related to oral contraceptives. It may be addressed with the healthcare provider during a routine follow-up.

B. Vaginal itching: Vaginal itching may be due to various reasons, including infections, but it is not typically a direct side effect of oral contraceptives. However, if the itching is persistent or severe, the client should report it to the provider for appropriate evaluation.

C. Persistent headaches: Persistent headaches can be a concerning side effect associated with the use of oral contraceptives. It may indicate an increased risk of vascular events, such as stroke or thrombosis. Clients experiencing persistent headaches while on oral contraceptives should report this symptom to the healthcare provider immediately for further evaluation.

D. Breast tenderness: Breast tenderness is a common side effect of hormonal contraceptives, and it is not typically an emergency or a sign of serious complications. However, if the breast tenderness is severe or associated with other concerning symptoms, the client should contact the provider for guidance.

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Correct Answer is B

Explanation

A. Place a witch hazel pad on the client's perineal pad after each voiding: Witch hazel pads can provide relief from perineal discomfort, but they are typically used in the immediate postpartum period for general comfort rather than specifically for third-degree perineal lacerations.

B. Apply hydrogel pads to the perineum every 4 hr: Hydrogel pads can help soothe and cool the perineal area, providing relief from pain and discomfort. This intervention is appropriate for third-degree perineal lacerations.

C. Prepare the client for a pudendal nerve block: Pudendal nerve blocks are typically used for pain relief during the second stage of labor and delivery. They are not a standard intervention for managing third-degree perineal lacerations postpartum.

D. Encourage the client to apply a warm pack to the perineum for discomfort: While warm packs can provide comfort, they are generally not recommended for third-degree perineal lacerations. Cold packs or hydrogel pads are often more appropriate for reducing swelling and providing relief in this situation.

A. Select a 21-gauge needle to perform the procedure B. Puncture the lateral side of the heel for the procedure C. Apply an alcohol pad to the site after the procedure D. Place a cool cloth at the site for 15 min before the procedure

Correct Answer is B

Explanation

A. Select a 21-gauge needle to perform the procedure: The size of the needle used for a heel stick typically ranges between 23 and 25 gauge. A 21-gauge needle is larger and may cause more discomfort to the newborn.

B. Puncture the lateral side of the heel for the procedure: The lateral (outer) side of the heel is the recommended site for a heel stick in a newborn. This area is less sensitive, and puncturing the lateral side helps avoid injury to the medial (inner) side where important structures are located.

C. Apply an alcohol pad to the site after the procedure: Applying an alcohol pad after the procedure is not necessary and may cause unnecessary discomfort to the newborn. The puncture site can be gently blotted with a gauze pad if needed.

D. Place a cool cloth at the site for 15 minutes before the procedure: Placing a cool cloth before the procedure is not recommended. Cooling the site may cause vasoconstriction, making it more difficult to obtain an adequate blood sample. It's generally better to warm the heel, for example, by using a warm cloth, to promote blood flow.

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A nurse is caring for a client who is taking an oral contraceptive. The nurse should instruct the client to report which of the following findings to the provider immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is 12 hr postpartum and has a third-degree perineal laceration. Which of the following interventions should the nurse include in the plan?

Correct Answer is B

Explanation

A nurse is preparing to perform a heel stick on a newborn who has a prescription for a total serum bilirubin. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is assessing the results of a nonstress test for an antepartal client at 35 weeks of gestation. Which of the following findings should indicate to the nurse the need for further diagnostic testing?

A nurse is caring for a client who delivered by cesarean birth 6 hr ago. The nurse notes a steady trickle of vaginal bleeding that does not stop with fundal message. Which of the following actions should the nurse take?

A nurse is caring for a postpartum client who recently had an indwelling urinary catheter removed. Which of the following findings indicates that the client is able to void effectively?

A nurse is reviewing the history of a client who is pregnant. Which of the following clinical data indicates the client is at risk for preterm delivery?

A surer is caring for a client who is experiencing infertility and is requesting in vitro fertilization. Which of the following information should the nurse provide to the client?

A nurse is planning care for a client in the postpartum unit. Which of the following goals should the nurse identify for the client to accomplish during the taking in phase of postpartum adjustment?

A nurse is providing instructions to a client who has chosen a diaphragm for birth control. Which of the following instructions should the nurse include?

A nurse in a provider's office is caring for a 20-year-old client who is at 12 weeks of gestation and requests an amniocentesis to determine the sex of the fetus. Which of the following responses should the nurse make?