The nurse understands that many patients who experience violence become homeless to escape their situation. How can the nurse help these patients?

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Question 1 of 5

The nurse understands that many patients who experience violence become homeless to escape their situation. How can the nurse help these patients?

Correct Answer: C

Rationale: The correct answer is C: Refer the patient to a shelter. This option is the most appropriate because it addresses the immediate need for a safe place to stay for patients experiencing violence and homelessness. Referring the patient to a shelter provides them with temporary housing, safety, and access to resources and support services. Options A and B are not suitable as they overlook the safety concerns of the patient and may put them at risk of further harm. Option D, referring the patient to the police, may not address the patient's need for shelter and support services. Therefore, option C is the most effective and compassionate way to help patients in this situation.

Question 2 of 5

The nurse is assessing a client in labor and notes persistent late decelerations on the monitor. What is the priority action?

Correct Answer: A

Rationale: The correct answer is A: Reposition the client to her left side. This is the priority action because late decelerations indicate uteroplacental insufficiency, possibly due to compression of the umbilical cord. Repositioning the client to her left side can help improve blood flow to the placenta by reducing pressure on the vena cava, thus optimizing fetal oxygenation. Administering oxygen (B) is important but not the immediate priority. Increasing IV fluids (C) may not directly address the cause of late decelerations. Notifying the healthcare provider (D) is important but should come after immediate interventions.

Question 3 of 5

A client at 34 weeks' gestation reports decreased fetal movements. What should the nurse advise first?

Correct Answer: A

Rationale: The correct answer is A: Drink a glass of juice and lie down. This advice is based on the concept that consuming juice can stimulate fetal movements due to the increase in blood sugar levels. Lying down also helps the client focus on feeling the movements. This initial step is non-invasive and can potentially address the decreased fetal movements promptly. Choices B and D delay action, which can be dangerous if there is a significant issue with the baby. Choice C might lead to unnecessary waiting and potential risks if the fetus is in distress.

Question 4 of 5

The nurse is performing a prenatal assessment. What finding is considered a positive sign of pregnancy?

Correct Answer: B

Rationale: The correct answer is B, auscultation of fetal heart tones, because it is a definitive sign of pregnancy indicating the presence of a fetus. This can be heard around 10-12 weeks of gestation using a Doppler device. It is a positive sign as it directly confirms the existence of a developing fetus. A: A positive pregnancy test is a probable sign and can indicate pregnancy but is not definitive. C: Hegar's sign is a probable sign characterized by softening of the lower uterine segment, not specific to pregnancy. D: Chadwick's sign is a probable sign of pregnancy indicated by bluish discoloration of the cervix, vagina, and labia, not a definitive sign of pregnancy.

Question 5 of 5

The nurse is preparing a client for an amniocentesis. What is the priority nursing action before the procedure?

Correct Answer: C

Rationale: The correct answer is C: Ensure informed consent is signed. Before any invasive procedure like an amniocentesis, it is essential to ensure that the client has full understanding of the risks, benefits, and alternatives. This is crucial for autonomy and ethical practice. Administering IV fluids (choice A) is not a priority before an amniocentesis. Obtaining baseline vital signs (choice B) is important but not the priority over informed consent. Positioning the client in the Trendelenburg position (choice D) is not necessary for an amniocentesis procedure.

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