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Which of the following indicates whether the adolescent understands the teaching on requires further education?
- A. I should continue taking all my medications even if I don't show any symptoms.
- B. If I continue to get this type of infection, it can affect my ability to have kids in the future.
- C. I should go to the emergency department if my urine turns dark.
- D. As long as I keep my IUD, I don't need to use condoms.
- E. I'm more likely to get a sunburn while taking these medications.
Correct Answer: D
Rationale: [0, 0, 0]
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A nurse is teaching a client who is at 37 weeks of gestation and has a prescription for a nonstress test. Which of the following instructions should the nurse include?
- A. The test should take 10 to 15 minutes to complete.
- B. You will lie in a supine position throughout the test.
- C. You should not eat or drink for hours before the test.
- D. You should press the handheld button when you feel your baby move.
Correct Answer: D
Rationale: Rationale: Option D is the correct answer because in a nonstress test, the client is required to press a handheld button every time they feel their baby move. This action helps to monitor the baby's heart rate in response to its movements, providing valuable information about the baby's well-being. This is essential at 37 weeks of gestation to ensure the baby is healthy and responding appropriately.
Summary of other choices:
A: Incorrect - The test duration can vary, but it typically takes longer than 10 to 15 minutes.
B: Incorrect - The client may need to change positions during the test to optimize fetal monitoring.
C: Incorrect - It is important for the client to eat and stay hydrated before the test to encourage fetal movement.
E, F, G: Choices not provided, thus irrelevant.
A nurse is developing a plan of care for a newborn who is to undergo phototherapy for hyperbilirubinemia. Which of the following actions should the nurse include in the plan?
- A. Feed the newborn 1 oz of water every 4 hr.
- B. Apply lotion to the newborn's skin three times per day.
- C. Remove all clothing from the newborn except the diaper.
- D. Discontinue therapy if the newborn develops a rash.
Correct Answer: C
Rationale: The correct answer is C. Removing all clothing from the newborn except the diaper during phototherapy is essential as it helps maximize the skin surface area exposed to the light, thus enhancing the effectiveness of the treatment. This allows for better absorption of the light by the skin, aiding in the breakdown of bilirubin.
A: Feeding the newborn water every 4 hours is not directly related to phototherapy for hyperbilirubinemia.
B: Applying lotion to the newborn's skin may interfere with the effectiveness of phototherapy and should be avoided.
D: Discontinuing therapy if a rash develops is not advisable, as a rash is a common side effect of phototherapy and does not necessarily require therapy cessation.
A nurse is teaching a client who is at 10 weeks of gestation about nutrition during pregnancy. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should increase my protein intake to 60 grams each day.
- B. I should drink 2 liters of water each day.
- C. I should increase my overall daily caloric intake by 300 calories.
- D. I should take 600 micrograms of folic acid each day.
Correct Answer: D
Rationale: The correct answer is D because folic acid is crucial during pregnancy to prevent birth defects like spina bifida. It is recommended to take 600 micrograms daily. Choice A is incorrect as the recommended protein intake is 71 grams/day. Choice B is important but doesn't address nutrition specifically. Choice C is unnecessary and could lead to excessive weight gain.
A nurse is preparing to perform Leopold maneuvers for a client. Identify the sequence the nurse should follow. (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
- A. Identify the attitude of the head.
- B. Palpate the fundus to identify the fetal part.
- C. Determine the location of the fetal back.
- D. Palpate for the fetal part presenting at the inlet.
Correct Answer: B, C, D, A
Rationale: The correct order for performing Leopold maneuvers is B, C, D, A. Firstly, palpating the fundus (B) helps determine the fetal part. Next, determining the location of the fetal back (C) guides the nurse to find the fetal back. Palpating for the fetal part at the inlet (D) helps identify its presentation. Lastly, identifying the attitude of the head (A) completes the assessment. Other choices are not relevant to the sequential assessment in Leopold maneuvers.
A nurse is assessing a client who is postpartum and has idiopathic thrombocytopenia purpura (ITP). Which of the following findings should the nurse expect?
- A. Decreased platelet count.
- B. Increased erythrocyte sedimentation rate (ESR).
- C. Decreased megakaryocytes.
- D. Increased WBC.
Correct Answer: A
Rationale: The correct answer is A: Decreased platelet count. In idiopathic thrombocytopenic purpura (ITP), there is a decrease in platelet count due to immune-mediated destruction of platelets. This can lead to bleeding tendencies. Other choices are incorrect because in ITP, there is no significant change in ESR (B), megakaryocytes may be increased or normal (C), and WBC count is usually normal or slightly elevated (D).