A nurse is reinforcing teaching with a client who is using a diaphragm to prevent pregnancy. Which of the following statements should the nurse include in the teaching?

"You should replace your diaphragm every 2 year”

"You should be refitted for your diaphragm if you have a 10 percent weight fluctuation."

"You should insert the diaphragm when your bladder is full."

"You should remove your diaphragm 4 hours after intercourse."

Answer and Explanation

The Correct Answer is B

Rationale:

A. "You should replace your diaphragm every 2 years": Diaphragms generally need to be replaced every 1 to 2 years, depending on the manufacturer’s guidelines and wear and tear. However, it is more important to be aware of refitting needs related to physiological changes.

B. "You should be refitted for your diaphragm if you have a 10 percent weight fluctuation.": Significant weight changes, usually around 10 to 15 percent, can alter pelvic anatomy and affect diaphragm fit, increasing the risk of contraceptive failure. Therefore, refitting is recommended after notable weight fluctuations.

C. "You should insert the diaphragm when your bladder is full.": The bladder should be empty when inserting the diaphragm to avoid discomfort and ensure proper placement over the cervix. A full bladder can cause displacement and increase the risk of failure.

D. "You should remove your diaphragm 4 hours after intercourse.": The diaphragm should be left in place for at least 6 hours after intercourse to ensure adequate sperm immobilization and contraceptive effectiveness. Removing it too early may increase the risk of pregnancy.

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Correct Answer is D

Explanation

Rationale:

A. New onset of hearing loss: Hearing loss is not a typical adverse effect of 0.9% sodium chloride infusion. It may occur with high-dose loop diuretics like furosemide but is unrelated to isotonic fluid administration or hyperparathyroidism management.

B. Kussmaul respirations: These are deep, rapid respirations seen in metabolic acidosis, particularly diabetic ketoacidosis. They are not associated with isotonic fluid infusion or calcium disturbances in hyperparathyroidism.

C. Hyperthermia: Elevated body temperature is not linked to 0.9% sodium chloride infusion. Hyperthermia may occur with infections or neurologic injury, but not as a direct consequence of isotonic fluid therapy.

D. Chvostek's sign: Chvostek's sign is a clinical indicator of hypocalcemia, which can occur as an adverse effect of 0.9% sodium chloride infusion in clients with hyperparathyroidism. Large volumes of saline increase calcium excretion, potentially leading to low serum calcium levels.

A. Use touch to convey acceptance. B. Avoid attempting to distract the client away from the hallucination. C. Encourage group activities. D. Provide low lighting in the client's room.

Correct Answer is D

Explanation

Rationale:

A. Use touch to convey acceptance: Using touch with clients who are actively hallucinating can be misinterpreted and may provoke fear or aggression. Maintaining a safe physical distance and using verbal reassurance is more appropriate during episodes of hallucination.

B. Avoid attempting to distract the client away from the hallucination: Distraction techniques are often helpful in managing hallucinations. Encouraging the client to engage in a different activity or conversation can help shift their focus away from distressing perceptual disturbances.

C. Encourage group activities: Group settings may increase anxiety or overstimulation for a client who is actively hallucinating. Individualized, low-stimulation environments are more therapeutic during acute symptoms.

D. Provide low lighting in the client's room: A calm, low-stimulation environment including dim lighting can reduce sensory overload and help the client feel more secure. Low lighting may also help minimize misinterpretation of visual stimuli that could feed into hallucinations.

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A nurse is reinforcing teaching with a client who is using a diaphragm to prevent pregnancy. Which of the following statements should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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