A nurse in a prenatal clinic is teaching a client about non pharmacological pain management during labor. Which of the following statements by the client indicates an understanding of the teaching?
"The nurse will initiate acupuncture when I arrive at the unit."
"I can use my ultrasound picture as a focal point during contractions."
"A transcutaneous electrical nerve stimulator will help with pelvic pressure."
"My nurse can teach me biofeedback at the beginning of labor."
The Correct Answer is B
A. "The nurse will initiate acupuncture when I arrive at the unit.": Acupuncture must be performed by a trained and licensed practitioner, not a bedside nurse. While it can be used for labor pain, it is not typically initiated by nursing staff upon admission.
B. "I can use my ultrasound picture as a focal point during contractions.": Focal point techniques, such as concentrating on a meaningful object like an ultrasound picture, help distract from pain and promote relaxation.
C. "A transcutaneous electrical nerve stimulator will help with pelvic pressure.": TENS units are primarily effective for back pain in early labor rather than pelvic pressure. They work by stimulating sensory nerves to reduce pain perception but are less effective for deep pelvic discomfort.
D. "My nurse can teach me biofeedback at the beginning of labor.": Biofeedback requires prior training and practice before labor begins to be effective. Learning it for the first time during active labor is impractical and unlikely to yield good results.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","F","H","I","L"]
Explanation
Rationale for correct choices:
- Temperature 38.2° C (100.8° F): An elevated temperature in the postpartum period may indicate infection, particularly given the prolonged rupture of membranes and cesarean birth. Early recognition is essential to prevent progression to sepsis.
- Heart rate 104/min: Tachycardia can be an early sign of infection or postpartum hemorrhage. In combination with fever and elevated WBC, this warrants prompt evaluation.
- Client reports feeling unwell: The client’s report of illness is the first indicator of an ongoing disease process which warrants further evaluation, coupled by other findings, this indicates that there is something wrong.
- WBC count 33,000/mm³: This is markedly elevated beyond the normal postpartum range and indicates a possible systemic infection. This finding requires immediate intervention and notification of the provider.
- Fundus boggy but firmed with massage: A boggy uterus suggests uterine atony, which increases the risk of postpartum hemorrhage. Continuous monitoring is needed to prevent excessive blood loss.
- Moderate amount of dark brown, foul-smelling lochia: Foul-smelling lochia is a sign of endometritis or uterine infection. Early identification and treatment reduce the risk of sepsis and further complications.
Rationale for incorrect choices:
- Vital Signs Respiratory rate 18/min, BP 108/70 mm Hg, SaO₂ 97% on room air: This is within normal limits and does not indicate respiratory compromise at this time. Blood pressure is within normal postpartum range; no immediate intervention is needed. Oxygen saturation is adequate and does not require urgent follow-up.
- Breast firmness with moderate nipple discomfort: These findings are consistent with normal lactation and engorgement, and do not indicate an immediate complication.
- Surgical incision well-approximated with slight edema: Mild edema without redness or drainage is expected postoperatively and does not require immediate intervention.
- No bowel movement since birth, hypoactive bowel sounds: While monitoring is necessary for constipation, this is a common postpartum finding, especially after surgery and opioid use, and does not require urgent intervention.
Correct Answer is B
Explanation
Rationale:
A. Educate clients who are at risk for Parkinson's disease about maintaining a low-cholesterol diet: This is an example of primary prevention, aimed at reducing risk factors before the onset of disease, rather than tertiary prevention.
B. Provide daily exercise classes to improve ambulation for patients who have Parkinson's disease: Tertiary prevention focuses on managing disease, minimizing complications, and improving quality of life for those already diagnosed. Exercise programs help maintain mobility and prevent further functional decline.
C. Educate clients about common techniques used to diagnose Parkinson's disease: Teaching about diagnostic techniques is related to secondary prevention, which focuses on early detection and timely intervention.
D. Provide screenings for community members to identify early manifestations of Parkinson's disease: Screening is a secondary prevention strategy intended to detect disease early in asymptomatic individuals, not tertiary prevention.
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