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Certified Professional Midwife
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A client in labor is administered with an anesthetic through the spinal subarachnoid space. Which of the following actions by the nurse is the least appropriate when managing the client?
The midwife maintains the client flat on bed for 8 to 12 hours.
Inform the client that headaches may occur.
Monitor the client for hypertension.
Administer IV fluids.
The midwife should monitor the client for hypotension, not hypertension Subarachnoid or spinal block relieves uterine and perineal pain and numbs the lower extremities, vagina and perineum. The anesthetic may cause headaches. The client should be flat on the bed for 8 to 12 hours. Administration of IV fluids is also appropriate.
A midwife is teaching a 14-year-old girl about contraceptives. The client gave
birth to a healthy baby girl three days ago. The midwife is correct when she says that the most effective way to protect against conception is through:
Natural family planning.
Abstinence.
Oral contraception.
Surgical methods.
Abstinence is the most effective way to protect against conception. Natural family planning has a failure rate of about 20%. Oral contraception has a failure rate of about 3%. If used correctly, oral contraceptives are 99.5% effective. Surgical methods have a failure rate between 0.1 and 0.4%.
A midwife is assessing four female clients with signs and symptoms involving the
reproductive system. All clients are engaging in heterosexual sexual relationships. The midwife requires identification and treatment of sexual partners of all of the following clients except:
A client diagnosed with genital herpes.
A client diagnosed with chlamydia.
A client diagnosed with bacterial vaginosis.
A client with hepatitis B.
A client diagnosed with bacterial vaginosis is not required to identify her sexual partners for treatment. Engaging in unprotected sex increases the risk for bacterial vaginosis for women only, and it is believed that bacterial vaginosis can be transmitted between women. Therefore, only women who engage in sexual relationships with other women need to identify their sexual partners for treatment of bacterial vaginosis.
A midwife is assessing the fertility of couples who have been trying to conceive
for a period of time without success. Which of the following couples has primary infertility?
A couple engaging in unprotected sex for half a year. No previous conceptions are reported.
A couple engaging in unprotected sex for one year. A previous conception is reported.
A couple engaging in unprotected sex for one year. No previous conceptions are reported.
A couple engaging in unprotected sex for half a year. A previous conception is reported.
Infertility is engaging in unprotected sex for one year without an occurring pregnancy. If the couple has no previous conceptions, it is called primary infertility. If the couple reported a previous conception, it is called secondary infertility.
A couple is considering artificial insemination after the man fails to respond to
medications that intend to increase his sperm count. Which of the following statements about artificial insemination is false?
A donor’s sperm can be used.
The sperm is instilled into the female reproductive tract one day after ovulation.
It involves selective termination of gestational sacs.
The sperm is instilled into the cervix or uterus.
Artificial insemination does not involve selective termination of gestational sacs. Selective termination is performed in in vitro fertilization. Artificial insemination may be considered if the man has inadequate sperm count or if the woman has a condition that interferes with sperm motility.