Nokea
A 27-year-old primigravida at 32 weeks' gestation has been diagnosed with complete placenta previa. Conservative management including bed rest is the proper medical management. The goal for fetal survival is based on fetal lung maturity. The test used to determine fetal lung maturity is:
- A. Dinitrophenylhydrazine
- B. Metachromatic stain
- C. Blood serum phenylalanine test
- D. Lecithin-sphingomyelin ratio
Correct Answer: D
Rationale: Dinitrophenylhydrazine is a laboratory test used to detect phenylketonuria, maple syrup urine disease, and Lowe's syndrome. Metachromatic stain is a laboratory test that may be used to diagnose Tay-Sachs and other lipid diseases of the central nervous system. The blood serum phenylalanine test is diagnostic of phenylketonuria and can be used for wide-scale screening. A lecithin-sphingomyelin ratio of at least 2:1 is indicative of fetal lung maturity, and survival of the fetus is likely.
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A client with severe PIH receiving MgSO4 is placed in a quiet, darkened room. The nurse bases this action on the following understanding:
- A. The client is restless.
- B. The elevated blood pressure causes photophobia.
- C. Noise or bright lights may precipitate a convulsion.
- D. External stimuli are annoying to the client with PIH.
Correct Answer: C
Rationale: The client may be anxious and hyperresponsive to stimuli but not necessarily restless. This is not a physiological response to an elevated blood pressure in PIH. The nurse must know the nursing measures that decrease the potential for convulsions. A quiet, darkened room decreases stimuli and promotes rest. External stimuli might induce a convulsion but are not annoying to the client with PIH.
The home care nurse is preparing a teaching plan for a client with deficiencies in folic acid. Which foods will increase the clients' folic acid level?
- A. Broccoli
- B. Cabbage
- C. Chicken
- D. Dried fruit
- E. White bread
- F. Milk
Correct Answer: A, B, D
Rationale: Folic acid-rich foods include broccoli (A), cabbage (B), and dried fruit (D). Chicken (C), white bread (E), and milk (F) are low in folate.
The nurse observes a client crying quietly. She has just experienced a spontaneous abortion at nine weeks' gestation. An appropriate response by the nurse would be:
- A. It must be God's will and probably is for the best.'
- B. This must be a difficult time for you. Would you like to talk about it?'
- C. I'm sure your other children will be a comfort for you.'
- D. Don't worry, you're still young. If I were you I'd just try again.'
Correct Answer: B
Rationale: This response is nontherapeutic because it belittles the client's response and gives a meaningless rationalization. This response acknowledges the client's feelings and demonstrates the therapeutic offering of self by the nurse. This response is nontherapeutic because it does not focus on the client's feelings and offers false reassurance. This response is nontherapeutic because it belittles the client's feelings and offers her advice.
A client with a history of a pituitary tumor is receiving Bromocriptine (Parlodel). The nurse should monitor the client for:
- A. Hypotension
- B. Hyperglycemia
- C. Weight gain
- D. Hair loss
Correct Answer: A
Rationale: Bromocriptine, a dopamine agonist, can cause hypotension due to vasodilation. Hyperglycemia, weight gain, and hair loss are not primary side effects.
A client with AIDS has impaired nutrition due to diarrhea. The nurse teaches the client about the need to avoid certain foods.
- A. Tossed salad
- B. Baked chicken
- C. Broiled fish
- D. Steamed rice
Correct Answer: A
Rationale: Raw foods like tossed salad (A) can harbor pathogens, risky for AIDS patients with diarrhea. Baked chicken (B), broiled fish (C), and steamed rice (D) are cooked and safer, indicating further teaching is needed for A.