Nokea
A 19-year-old G1 P0 is being discharged home after hospitalization for hyperemesis gravidarum and is being referred to home health care. The nurse should develop a discharge plan that includes which of the following? Select all that apply.
- A. Refer client to a nutritionist for the following day.
- B. Ensure that the client has a prescription for an antiemetic.
- C. Ask the health care provider (HCP) for an anxiolytic prescription.
- D. Encourage return to normal routine when client feels ready.
- E. Coordinate follow-up appointment with provider in 6 weeks.
- F. Discuss plan of care and discharge instructions with client.
Correct Answer: A, B, D, F
Rationale: For hyperemesis gravidarum, a nutritionist referral, antiemetic prescription, gradual return to routine, and discussing discharge instructions are essential. Anxiolytics may not be indicated, and a 6-week follow-up is too delayed.
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The nurse is assessing a client with suspected hyperthyroidism. Which of the following symptoms is most likely to be present?
- A. Weight gain.
- B. Cold intolerance.
- C. Tremors.
- D. Constipation.
Correct Answer: C
Rationale: Tremors are a common symptom of hyperthyroidism due to increased metabolic rate and nervous system stimulation.
A client has had sucralfate (Carafate) ordered as treatment for peptic ulcer disease. Which of the following statements indicates that the client understands how to take the medication?
- A. I should take the Carafate every evening at bedtime.'
- B. It is important that I take this drug on an empty stomach.'
- C. I should avoid milk products while taking this drug.'
- D. I should have my hemoglobin checked monthly while taking Carafate.'
Correct Answer: B
Rationale: Sucralfate should be taken on an empty stomach to coat the stomach lining effectively. Bedtime dosing, avoiding milk, or monthly hemoglobin checks are not required.
A 6-year-old client is diagnosed with attention deficit hyperactivity disorder (ADHD). When asking this client to complete a task, what techniques should the nurse use to communicate most effectively with him?
- A. Obtain eye contact before speaking, use simple language, and have him repeat what was said. Praise him if he completes the task.
- B. Fully explain to the client the actions required of him, offer verbal praise and a food reward for task completion.
- C. Explain to the client what he is to do, the consequences if he does not comply, and follow through with praise or consequences as appropriate.
- D. Demonstrate to the client what he is to do, have him imitate the nurse's actions, and give a food reward if he completes the task.
Correct Answer: A
Rationale: Clear, simple instructions with eye contact and repetition enhance communication for a child with ADHD, and praise reinforces positive behavior.
A client reports gas pains after surgery and requests medication. The nurse reviews the medication prescription sheet to see if which medication is prescribed for the relief of gas pains?
- A. Droperidol
- B. Simethicone
- C. Acetaminophen
- D. Magnesium hydroxide
Correct Answer: B
Rationale: Simethicone is an antiflatulent used in the relief of pain caused by excessive gas in the gastrointestinal tract. Droperidol is used to treat postoperative nausea and vomiting. Acetaminophen is a nonopioid analgesic. Magnesium hydroxide is an antacid and laxative.
As you are assessing the fetus during labor you are determining and the fetal lie, presentation, attitude, station and position. Your client asks you what all these assessments are. Among other things, how should you respond to the mother?
- A. You should explain that fetal lie is where the fetus' presenting part is within the birth canal during labor, among other information about the other assessments.
- B. You should explain that fetal presentation is the relationship of the fetus's spine to the mother's spine, among other information about the other assessments.
- C. You should explain that fetal attitude is the relationship of the fetus' presenting part to the anterior, posterior, right or left side of the mother's pelvis, among other information about the other assessments.
- D. You should explain that fetal station is the level of the fetus' presenting part in relationship to the mother's ischial spines, among other information about the other assessments.
Correct Answer: D
Rationale: Fetal station refers to the level of the fetus's presenting part relative to the mother's ischial spines, measured in centimeters above or below the spines. This is the correct definition among the options provided.