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."
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. "Placement of the catheter is confirmed by a CT scan.": Catheter placement is typically confirmed by a chest X-ray, not a CT scan, to verify correct positioning and rule out complications such as pneumothorax. CT imaging is not routine for this purpose.
B. "You will be under general anesthesia for this procedure.": Placement of a nontunneled percutaneous central line is usually done under local anesthesia with possible mild sedation. General anesthesia is not required for this relatively short and minimally invasive procedure.
C. "The provider will wear a mask while performing the procedure.": A mask, along with sterile gloves, gown, and drape, is worn to maintain sterile technique and reduce the risk of catheter-related bloodstream infections. This is standard protocol during central line insertion.
D. "Your head will be elevated as high as possible while the catheter is inserted.": The client is usually placed in the Trendelenburg position (head down) during catheter insertion to distend neck veins and reduce the risk of air embolism—not in a high head-elevated position.
Correct Answer is A
Explanation
Rationale:
A. Ask an experienced nurse to assist with the procedure: Seeking guidance from an experienced nurse supports safe practice and skill development. It ensures the procedure is performed correctly while providing an opportunity for supervised learning, which is appropriate for a newly licensed nurse.
B. Delegate the task to an assistive personnel: Tracheal suctioning is a sterile and invasive procedure that requires the clinical judgment and skills of a registered nurse. It should not be delegated to assistive personnel who are not trained or licensed to perform such procedures.
C. Refuse to take the assignment: Refusing the assignment without attempting to seek help or learn is not a constructive or professional approach. Nurses are expected to seek support when performing unfamiliar but appropriate tasks within their role.
D. Identify that the task is in the scope of RN practice and perform the suctioning: While it is within the RN scope, performing a skill without training or supervision may compromise patient safety. Competence must be demonstrated or developed with supervision before performing independently.
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