A patient calls the clinic Monday morning. She had condomless sex Friday night and is interested in emergency contraception. What should the nurse tell this patient?

Correct Answer: D

Rationale: The correct advice for the patient in this scenario is to inform her that she can still use emergency contraceptive pills, even if she has had other condomless sex since the Friday night event. Emergency contraceptive pills are most effective when taken as soon as possible after unprotected sex, but they can still be used within a certain window of time depending on the type of pill used. It is important to inform the patient that she can take emergency contraception in this situation to reduce the risk of an unintended pregnancy.

Correct Answer: B

Rationale: Late decelerations of the fetal heart rate can indicate uteroplacental insufficiency, which may be a result of decreased oxygen supply to the fetus. Placing the client in a lateral position can help enhance uteroplacental perfusion by relieving pressure on the vena cava and improving maternal blood flow to the placenta. This position change can help improve fetal oxygenation and decrease the occurrence of late decelerations. Other actions such as administering oxygen and assessing for other contributing factors should also be done, but placing the client in a lateral position is the most appropriate immediate intervention in this scenario.

Correct Answer: A

Rationale: In this situation, it is important for the nurse to provide the client with options for how they would like to proceed. By offering the option to bathe and dress the baby, the nurse is allowing the client to make decisions about their care and how they would like to cope with the loss. This empowers the client and respects their individual grieving process. It is crucial to encourage the client to make choices that align with their feelings and provide them with support and sensitivity during this difficult time.

Correct Answer: B

Rationale: Ensuring the newborn's mouth is wide open before latching to the breast is the correct action to take when caring for a client experiencing sore nipples from breastfeeding. When the newborn latches onto the breast correctly with a wide open mouth, it helps to prevent nipple soreness and discomfort by allowing proper positioning and attachment, which reduces pressure on the nipple. This action can promote effective and comfortable breastfeeding for both the client and the newborn. Placing a snug dressing on the nipple when not breastfeeding (Choice A) could hinder air circulation, leading to moisture, which may increase the risk of nipple soreness. Limiting the newborn's feeding to 10 minutes on each breast (Choice C) can be insufficient for adequate milk intake and can lead to feeding issues. Instructing the client to begin the feeding with the nipple that is most tender (Choice D) may exacerbate the issue and cause further discomfort.

Correct Answer: B

Rationale: Neonatal opioid withdrawal syndrome, also known as neonatal abstinence syndrome (NAS), can occur in newborns who were exposed to opioids in utero. Symptoms of NAS can include tremors, irritability, high-pitched crying, poor feeding, vomiting, diarrhea, sweating, and sneezing. The severity of symptoms can vary depending on the type of opioid exposure, dosage, and duration of exposure. In this case, the nurse should expect to see moderate tremors of the extremities in the newborn experiencing opioid withdrawals at 48 hours old. It is important for the nurse to monitor and manage the newborn's withdrawal symptoms closely to ensure their safety and well-being.