Nokea
A 25-year-old client believes she may be pregnant with her first child. She schedules an obstetric examination with the nurse practitioner to determine the status of her possible pregnancy. Her last menstrual period began May 20, and her estimated date of confinement using Nägele's rule is:
- A. 27-Mar
- B. 1-Feb
- C. 27-Feb
- D. 3-Jan
Correct Answer: C
Rationale: March 27 is a miscalculation. February 1 is a miscalculation. February 27 is the correct answer. To calculate the estimated date of confinement using Nagele's rule, subtract 3 months from the date that the last menstrual cycle began and then add 7 days to the result. January 3 is a miscalculation.
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The mother of a child with chickenpox wants to know if there is a medication that will shorten the course of the illness. Which medication is sometimes used to speed healing of the lesions and shorten the duration of fever and itching?
- A. Zovirax (acyclovir)
- B. Varivax (varicella vaccine)
- C. VZIG (varicella-zoster immune globulin)
- D. Periactin (cyproheptadine)
Correct Answer: A
Rationale: Acyclovir (Zovirax) is an antiviral that can reduce the severity and duration of chickenpox symptoms, including lesions, fever, and itching.
Which nursing intervention would be of highest priority when caring for a patient admitted in sickle cell vaso-occlusive crisis?
- A. Starting intravenous normal saline
- B. Applying oxygen
- C. Applying heat to the affected joints
- D. Administering pain medication
Correct Answer: D
Rationale: In sickle cell vaso-occlusive crisis severe pain results from blocked blood vessels. Administering pain medication is the highest priority to relieve acute discomfort and improve patient comfort. While IV fluids and oxygen are important pain management is the most urgent need.
A client is being admitted with syndrome of inappropriate diuretic hormone. Which does the nurse expect to observe?
- A. Increased thirst
- B. Tachycardia
- C. Polyuria
- D. Hostility
- E. Muscle weakness
Correct Answer: B,D,E
Rationale: SIADH causes water retention, leading to hyponatremia, which can cause tachycardia (B), hostility (D), and muscle weakness (E). Increased thirst (A) and polyuria (C) are more associated with diabetes insipidus.
A client with rheumatoid arthritis is beginning to develop flexion contractures of the knees. The nurse should tell the client to:
- A. Lie prone and let her feet hang over the mattress edge
- B. Lie supine, with her feet rotated inward
- C. Lie on her right side and point her toes downward
- D. Lie on her left side and allow her feet to remain in a neutral position
Correct Answer: A
Rationale: Lying prone with feet hanging over the mattress edge helps stretch the knee joints and prevent flexion contractures in rheumatoid arthritis. The other positions do not address knee extension.
A client had a myocardial infarction 5 days ago. His physician has ordered an echocardiogram to determine how his myocardial infarction has affected his ventricular wall motion. When the client asks if this test is painful, an appropriate response is:
- A. No, but you must be able to ride on a stationary bicycle while the test is being performed.
- B. No, but you will have to lie still and the gel that is used may be cool.
- C. Yes, but your physician will be there and will order pain medicine for you.
- D. Your physician has ordered medicine, which you will be given before you go for the test, which will make you sleepy.
Correct Answer: B
Rationale: An echocardiogram is non-invasive, requiring the client to lie still while cool gel is applied for ultrasound imaging, with no pain involved.