Answer to Question 1
Correct Answer: 2
Rationale 1: It is important to know the client's physical characteristics, but these measurements would not help determine the cause of infertility.
Rationale 2: The nurse must discover whether the client understands when conception is most likely to occur before proceeding with other assessments.
Rationale 3: An assessment of the client's job status would not necessarily help determine the cause of infertility.
Rationale 4: This information would not help determine the cause of infertility.
Global Rationale: The nurse must discover whether the client understands when conception is most likely to occur before proceeding with other assessments. It is important to know the client's physical characteristics, but these measurements would not help determine the cause of infertility. An assessment of the client's job status would not necessarily help determine the cause of infertility. Preferred position during sexual intercourse is of no consequence to fertility as long as intercourse is occurring.
Answer to Question 2
Correct Answer: 1
Rationale 1: Clients receiving oxytocin require continuous fetal and maternal monitoring, so the client needs to realize that walking around will not be possible.
Rationale 2: Doses of intravenous oxytocin are increased gradually, every 15 to 60 minutes, until a normal labor pattern is established.
Rationale 3: Vital signs, including blood pressure, should be checked at least every 15 minutes.
Rationale 4: A headache could be a sign of increased blood pressure, which might lead to a need to discontinue the oxytocin.
Global Rationale: Clients receiving oxytocin require continuous fetal and maternal monitoring, so the client needs to realize that walking around will not be possible. Doses of intravenous oxytocin are increased gradually, every 15 to 60 minutes, until a normal labor pattern is established. Vital signs, including blood pressure, should be checked at least every 15 minutes. A headache could be a sign of increased blood pressure, which might lead to a need to discontinue the oxytocin.