Nokea
A client at 37 weeks' gestation is scheduled for a biophysical profile. Which of the following should the nurse instruct the client to do before the test?
- A. Drink 1 to 2 L of fluid.
- B. Take nothing by mouth after midnight before the test.
- C. Plan to remain in the clinic for 4 hours after the test.
- D. Eat a high-fiber meal after the test.
Correct Answer: A
Rationale: Drinking 1-2 L of fluid ensures adequate amniotic fluid volume, which is assessed during a biophysical profile.
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The nurse should give which medication instructions to the client prescribed quinapril hydrochloride?
- A. Take the medication with food only.
- B. Expect a therapeutic effect immediately.
- C. Discontinue the medication if nausea occurs.
- D. Rise slowly from a lying to a sitting position.
Correct Answer: D
Rationale: Quinapril hydrochloride is an angiotensin-converting enzyme (ACE) inhibitor. It is used in the treatment of hypertension. The client should be instructed to rise slowly from a lying to sitting position and to permit the legs to dangle from the bed momentarily before standing to reduce the hypotensive effect. The medication does not need to be taken with meals. It may be given without regard to food. A full therapeutic effect may be noted in 1 to 2 weeks. If nausea occurs, the client should be instructed to take a noncola carbonated beverage and salted crackers or dry toast.
A primiparous client who is breast-feeding develops endometritis on the third postpartum day. Which of the following instructions should the nurse give to the mother?
- A. The neonate will need to be bottle-fed for the next few days.
- B. The condition typically is treated with I.V. antibiotic therapy.
- C. The client's uterus may become 'boggy,' requiring frequent massage and oxytocics.
- D. The client needs to remain in bed in a side-lying position as much as possible.
Correct Answer: B
Rationale: Endometritis is typically treated with I.V. antibiotics to address the infection.
The nurse asks the client to sign a consent form before undergoing surgery. The client indicates that he was not told about the risks of the surgical procedure. Which of the following statements by the nurse is most appropriate?
- A. What are your concerns? I can answer any questions that you have.'
- B. You can go ahead and sign the form. I will be sure to tell the surgeon you have questions.'
- C. It is important that your questions are answered before you consent to the procedure. I will contact the surgeon.'
- D. I'm sure the risks are minimal, so you don't need to worry.'
Correct Answer: C
Rationale: Ensuring the client's questions about risks are answered before signing consent is critical for informed consent, requiring the nurse to contact the surgeon.
A client develops an irregular heart rate. Which statement made by the client who has developed an irregular heart rate indicates to the nurse that the client is ready for learning?
- A. I feel weak with an irregular pulse.
- B. What is it like to have a pacemaker?
- C. All my medications will be changed now.
- D. How can this heart rate problem affect me?
Correct Answer: D
Rationale: Learning depends on two things: physical and emotional readiness to learn. A good time to teach is when the client indicates an interest in learning, is motivated, and is physically capable of concentrating on learning. Option 4 addresses the client's readiness because the client is directly asking about the disorder. Option 1 indicates that the client is potentially physically incapable of learning at this time. The client indicates wanting to learn about pacemakers in option 2; however, the client has formed a hasty conclusion because the need for a pacemaker has not been determined. In option 3, by assuming that the medications will change, the client is emotionally unprepared for learning because the statement is based on incomplete data.
A client with a history of chronic kidney disease is prescribed sevelamer (Renagel). The nurse should explain that this medication works by:
- A. Reducing blood pressure.
- B. Binding phosphate in the gut.
- C. Increasing urine output.
- D. Decreasing blood glucose.
Correct Answer: B
Rationale: Sevelamer binds phosphate in the gut, reducing serum phosphate levels in chronic kidney disease.