A woman asks the nurse about the 'new vaginal ring everyone is talking about for birth control.' When counseling the woman about this method of contraception, the nurse should assess for the woman's:

Correct Answer: C

Rationale: C: Comfort level about self-insertion of the ring every 3 weeks. The correct answer is C because the vaginal ring is a form of birth control that is inserted into the vagina and left in place for three weeks before being removed for a week-long break. This method requires self-insertion, so it is important for the nurse to assess the woman's comfort level with this aspect of the contraceptive method. This ensures that the woman is able to properly use the vaginal ring and adhere to the recommended schedule for insertion and removal. A: Ability to remember to insert the device every morning. This statement is incorrect because the vaginal ring is not inserted daily like some other forms of birth control. The vaginal ring is typically inserted once every three weeks and removed after that period, which is a different schedule compared to daily insertion. Therefore, the woman's ability to remember to insert the device every morning is not relevant to using the vaginal ring. B: Feelings about having to insert the device before sexual intercourse. This statement is incorrect because the vaginal ring does not need to be inserted immediately before sexual intercourse. The vaginal ring is inserted once every three weeks and does not require insertion right before sexual activity. Therefore, the woman's feelings about inserting the device before intercourse are not relevant to using the vaginal ring. D: Ability to return to the clinic once a month for reinsertion. This statement is incorrect because the vaginal ring does not need to be reinserted monthly. The vaginal ring is typically inserted once every three weeks by the woman herself and does not require monthly reinsertion at a clinic. Therefore, the woman's ability to return to the clinic once a month for reinsertion is not relevant to using the vaginal ring.

Correct Answer: B

Rationale: B: The nurse should provide further information to the client when she states, "I heard that for doctors to deliver babies safely, it is essential to have the mother's legs up in stirrups." This statement is incorrect because the use of leg stirrups during delivery is not necessary for all women, and it is not the only safe way to deliver a baby. It is important for the nurse to educate the client that there are various positions for giving birth, and the use of stirrups is not always required. Providing this information will help the client make informed decisions about her delivery. A: The client stating, "I am glad that deliveries can take place in a variety of places, including a Jacuzzi bathtub," does not require further information from the nurse. While water births in Jacuzzi bathtubs are an option for some women, it is essential for the nurse to ensure that the client has accurate information about the safety and appropriateness of this delivery method. C: When the client mentions, "During difficult deliveries it is sometimes necessary to put a woman's legs up in stirrups," the nurse does not need to provide further information. This statement acknowledges that there are situations where using leg stirrups may be necessary, such as during a difficult delivery. However, it is still important for the nurse to discuss other potential positions and options with the client. D: The client stating, "I heard that midwives often deliver their patients either in the side-lying or squatting position," does not require further information from the nurse. This statement demonstrates that the client is aware of alternative birthing positions besides using leg stirrups. It is valuable for the nurse to affirm this knowledge and provide additional information if needed to support the client's understanding of birthing positions.

Correct Answer: B

Rationale: During the transition phase of labor, which is the most intense phase before pushing, the woman is likely to experience significant pain and discomfort due to strong and frequent contractions. Choice B, "I can't stand this pain any longer," is the correct answer because it reflects the expected response during this phase. The woman is likely to express feelings of being overwhelmed by the pain and may find it difficult to cope. Choice A, "I am so excited to be in labor," is incorrect because the transition phase is typically not a time of excitement but rather a time of intense focus and discomfort as the body prepares for the final stage of labor. Choice C, "I need ice chips because I'm so hot," is incorrect because the need for ice chips to cool down is not typically associated with the transition phase of labor. The focus during this phase is more on managing the pain and preparing for delivery. Choice D, "I have to push the baby out right now," is incorrect because the urge to push usually comes later in the labor process during the second stage, after the cervix is fully dilated. In the transition phase, the woman may feel an intense pressure but may not be fully dilated yet, so pushing prematurely can be harmful. In conclusion, the correct answer is B because it accurately reflects the expected experience of intense pain and discomfort during the transition phase of labor.

Correct Answer: A

Rationale: During the latent phase of labor, contractions are typically mild to moderate in intensity and occur at regular intervals. Choice A is correct because if the woman is able to talk and laugh during contractions, it indicates that her contractions are not yet intense or close enough together to signify active labor. This aligns with the characteristics of the latent phase. Choice B is incorrect because complaining about severe back labor is more indicative of active labor, where contractions are stronger and more frequent. This symptom is not typically associated with the latent phase of labor. Choice C is incorrect because performing effleurage (light circular stroking of the abdomen) during a contraction is a coping mechanism often used in active labor to help manage pain. In the latent phase, contractions are usually not intense enough to necessitate coping techniques like effleurage. Choice D is incorrect because the urge to defecate is more commonly associated with the later stages of labor as the baby descends and puts pressure on the rectum. In the latent phase, the woman is typically still able to walk around and may not yet feel the urge to bear down. In summary, the ability to talk and laugh during contractions is a key characteristic of the latent phase of labor, making choice A the correct answer. Choices B, C, and D are all more indicative of active labor or the later stages of labor, making them incorrect in this context.

Correct Answer: D

Rationale: Before a woman undergoes regional anesthesia, it is crucial for the nurse to monitor her blood pressure every 5 minutes for the first 15 minutes after the anesthesia is administered. This is because regional anesthesia can cause a sudden drop in blood pressure, known as hypotension, which can be dangerous for both the mother and the fetus. By monitoring blood pressure closely, the nurse can quickly identify any signs of hypotension and take appropriate action to prevent any complications. Assessing the fetal heart rate (Choice A) is important during labor and delivery, but it is not a necessary step immediately before regional anesthesia. Infusing 1000 cc of Ringer's lactate (Choice B) is also not a standard pre-anesthesia procedure and may not be indicated for every patient. Having the woman empty her bladder (Choice C) is a common pre-anesthesia step to prevent discomfort during the procedure, but it is not as critical as monitoring blood pressure in this situation. Overall, monitoring blood pressure every 5 minutes for the first 15 minutes after regional anesthesia is the most important action to ensure the safety and well-being of the mother and fetus during the procedure.