A client in a family planning clinic requests oral contraceptives. Which of the following findings in the client's history should be recognized as contraindications to oral contraceptives? (Select all that apply.)

Correct Answer: D

Rationale: The correct answer is D. Cholecystitis, hypertension, and migraine headaches are contraindications to oral contraceptives due to increased risks of complications. Cholecystitis can worsen with oral contraceptives, hypertension increases cardiovascular risks, and migraines with aura can increase stroke risk. Other choices are incorrect because they do not pose significant risks with oral contraceptives.

Correct Answer: D

Rationale: The correct answer is D: Decreased urine output. At 26 weeks of gestation, decreased urine output can indicate a potential problem with kidney function or dehydration, which are concerning during pregnancy. This should be reported to the provider immediately to prevent complications such as preterm labor or preeclampsia. A: Leukorrhea is a common vaginal discharge during pregnancy and not typically a cause for concern at 26 weeks. B: Supine hypotension can occur due to pressure on the vena cava when lying on the back, but it is more common in the third trimester and can usually be resolved by changing position. C: Periodic numbness of the fingers may be related to carpal tunnel syndrome, which is common in pregnancy but is not typically an urgent concern at 26 weeks.

Correct Answer: A

Rationale: The correct answer is A: The client's room number. Using the room number as a secondary identifier is not recommended as it can lead to errors if multiple clients share the same room or if clients are moved to different rooms. It is important to use unique identifiers like the client's birth date or medical record number to ensure accurate identification. The client's telephone number is also not a recommended identifier as it may change frequently. Birth date and medical record number are more reliable and specific identifiers for accurate client identification.

Correct Answer: D

Rationale: The correct answer is D: Pregestational diabetes mellitus. Preeclampsia is a condition characterized by high blood pressure and proteinuria during pregnancy. Pregestational diabetes is a known risk factor for developing preeclampsia due to underlying vascular changes. Women with diabetes have compromised blood vessel function, increasing the likelihood of developing preeclampsia. Choices A, B, and C are not risk factors for preeclampsia. A singleton pregnancy, a BMI of 20, and maternal age of 32 years are not directly associated with an increased risk of preeclampsia.

Correct Answer: C

Rationale: Correct Answer: C Rationale: 1. Giving a gift from the newborn to the sibling promotes positive feelings and acceptance. 2. It allows the sibling to feel included and valued in the new family dynamic. 3. The act of giving a gift fosters a sense of connection and bonding between the siblings. Summary: A: Allowing the sibling to hold the newborn during a bath may pose safety concerns and should be supervised. B: Forcing physical affection like kissing may not be appropriate and could lead to negative feelings. D: Switching rooms may cause confusion and disrupt the sibling's sense of stability.

Correct Answer: B

Rationale: The correct answer is B because a normal respiratory rate for a newborn is 30-60 breaths per minute. A rate of 18/min is below the expected range and may indicate respiratory distress, requiring immediate intervention. Choice A is within the normal range (120-160/min) for newborn heart rate. Tremors (Choice C) are common in newborns and usually do not require immediate intervention. Fine crackles (Choice D) can be normal due to fluid in the lungs after birth and typically resolve on their own without intervention.

Correct Answer: C

Rationale: The correct answer is C: Weight gain of 2.2 kg (4.8 lb). This finding should be reported to the provider because sudden or excessive weight gain in late pregnancy may indicate conditions like preeclampsia or gestational hypertension, which can be harmful to the mother and baby. Weight gain should be monitored closely during pregnancy. Incorrect choices: A: Blood pressure 136/88 mm Hg - This blood pressure reading is within normal limits for pregnancy and does not raise immediate concern. B: Report of insomnia - Insomnia is a common complaint during pregnancy and typically does not require immediate medical intervention. D: Report of Braxton-Hicks contractions - Braxton-Hicks contractions are common in the third trimester and are usually not a cause for alarm unless they become frequent or regular.

Correct Answer: D

Rationale: The correct answer is D: Begin FHR monitoring. This is the priority intervention because it helps assess the well-being of the fetus and ensures timely detection of any distress. Monitoring the fetal heart rate (FHR) is crucial in cases of ruptured membranes to identify any signs of fetal distress. Nitrazine testing (A) assesses for the presence of amniotic fluid but does not provide immediate information on fetal well-being. Assessing the fluid (B) is important but not as critical as monitoring the FHR. Checking cervical dilation (C) is important but not the priority when the client's water has just broken.

Correct Answer: D

Rationale: The correct answer is D: Respiratory distress. Hypoglycemia in newborns can manifest as respiratory distress due to inadequate glucose supply to the brain, leading to altered respiratory drive. Hypertonia (choice A) is not a typical sign of hypoglycemia. Increased feeding (choice B) is a compensatory mechanism to raise blood sugar levels. Hyperthermia (choice C) is not directly related to hypoglycemia. In summary, respiratory distress is a crucial sign of hypoglycemia in late preterm newborns, while the other choices are not specific indicators of low blood sugar levels.