A nurse is instructing a female client on how to check her basal body temperature to determine if she is ovulating. The nurse should instruct the client to check her temperature at which of the following times?

1 hour following intercourse

Every morning before arising

Before going to bed every night

On days 13 to 17 of her menstrual cycle

Answer and Explanation

The Correct Answer is B

Choice A reason:
Checking basal body temperature 1 hour following intercourse is not recommended as a method to determine ovulation. Intercourse and physical activity can increase body temperature, which may lead to inaccurate readings. Basal body temperature should be measured after a period of rest, not after physical activity.

Choice B reason:
The basal body temperature method involves measuring the body's at-rest temperature to identify slight changes that occur around the time of ovulation. It is most accurate when taken every morning before getting out of bed, after at least 3 hours of uninterrupted sleep, and before any physical activity, including eating or drinking. A slight increase in basal body temperature typically occurs after ovulation and remains elevated until the next menstrual period. This method requires consistency and precise timing to be effective.

Choice C reason:
Measuring basal body temperature before going to bed every night is not an effective way to track ovulation. The body's temperature fluctuates throughout the day due to various factors, including activity levels, meals, and external temperatures. Therefore, nighttime measurements would not provide the consistent, resting temperature needed to accurately detect ovulation.

Choice D reason:
While it is true that ovulation typically occurs around the middle of the menstrual cycle, which for many women is between days 13 to 17, limiting temperature checks to these days only may miss the initial rise in temperature that indicates ovulation. Ovulation can vary from cycle to cycle, and it is important to measure basal body temperature daily to detect the pattern over time.

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Correct Answer is B

Explanation

Choice A reason:
Magnesium sulfate is used in the management of severe preeclampsia primarily for seizure prophylaxis. One of the key side effects of magnesium sulfate is its impact on neuromuscular transmission, leading to diminished deep-tendon reflexes as serum magnesium levels rise. The therapeutic range for anticonvulsant prophylaxis is typically between 5-8 mg/dL. Reflexes may begin to diminish when serum levels reach 8-12 mg/dL, indicating potential magnesium toxicity. Therefore, diminished reflexes are a warning sign to reassess the infusion rate and possibly reduce or discontinue the medication.

Choice B reason:
A respiratory rate of 16 breaths per minute falls within the normal adult range and suggests that the client's respiratory system is not being adversely affected by the magnesium sulfate infusion. Respiratory rate is a critical parameter to monitor during magnesium sulfate therapy, as respiratory depression is a serious side effect of magnesium toxicity. Maintaining a normal respiratory rate indicates that it is safe to continue the infusion at the current rate.

Choice C reason:
While a urine output of 50 mL/hr is on the lower end of the normal range, it is still considered adequate for most adults. In the setting of magnesium sulfate therapy for severe preeclampsia, maintaining adequate urine output is essential for ensuring that the kidneys can excrete the magnesium to prevent accumulation and toxicity. If urine output decreases significantly, it may necessitate reevaluation of the infusion rate or additional interventions to support renal function.

Choice D reason:
A heart rate of 56 beats per minute is slightly bradycardic but may not be clinically significant if the client is asymptomatic. However, magnesium has a direct effect on cardiac function, and high levels can lead to bradycardia and other cardiac conduction abnormalities. It is important to monitor the client's heart rate and rhythm during magnesium sulfate therapy to detect any early signs of cardiac involvement due to magnesium toxicity.

A. Mongolian spots can be found on the skin of many newborns. B. Caput succedaneum occurs due to compression of blood vessels. C. This is erythema toxicum, which is a transient condition. D. This is a cephalohematoma, which can occur spontaneously.

Correct Answer is B

Explanation

Choice a reason:
Mongolian spots are a type of pigmented birthmark commonly found in newborns, often appearing as blue or grayish areas on the skin. They are not related to swelling and do not result from vacuum-assisted deliveries. Mongolian spots are usually located on the buttocks or lower back and are not associated with the type of swelling described by the mother.

Choice b reason:
Caput succedaneum is a condition where the newborn's scalp swells due to pressure during delivery. It is characterized by a soft, spongy mass that crosses suture lines and is most apparent on the part of the skull that was first to enter the birth canal. This condition is common in vacuum-assisted deliveries and is the correct explanation for the swelling observed on the newborn's head.

Choice c reason:
Erythema toxicum is a common and benign skin condition in newborns, presenting as red patches or small, fluid-filled bumps. It is not related to the swelling described and does not result from vacuum-assisted deliveries. Erythema toxicum typically resolves on its own and does not cause the type of swelling that crosses suture lines.

Choice d reason:
Cephalohematoma is a collection of blood between a newborn's scalp and the skull bone that results from ruptured blood vessels, which can be a result of birth trauma or pressure. However, it is typically confined to one area and does not cross suture lines. Since the swelling described by the mother crosses the suture lines, cephalohematoma is less likely to be the correct diagnosis.

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A nurse is instructing a female client on how to check her basal body temperature to determine if she is ovulating. The nurse should instruct the client to check her temperature at which of the following times?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?

Correct Answer is B

Explanation

A nurse is caring for a newborn delivered by vaginal birth with vacuum assist. The newborn's mother asks about the swollen area on her son's head. After palpation to identify that the swelling crosses the suture line, which of the following is an appropriate response by the nurse?

Correct Answer is B

Explanation

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