Nokea
A client indicates to the nurse a desire to become pregnant. The client drinks 1-2 glasses of wine on weekends. BMI is 32 kg/m². Which teachings should the nurse reinforce as part of proper preconception health care for this client? Select all that apply.
- A. Avoid eating undercooked hamburgers
- B. Do not have more than 1 alcoholic drink per week
- C. Maintain current BMI
- D. Receive a rubella vaccine at least 3 months before attempting pregnancy
- E. Take 0.4 mg folic acid supplementation daily
Correct Answer: A,B,D,E
Rationale: To optimize preconception health: Avoid undercooked meat to prevent toxoplasmosis; limit alcohol to minimal or none to avoid fetal alcohol syndrome; rubella vaccine prevents congenital rubella syndrome; and folic acid reduces neural tube defects. A BMI of 32 is obese and should be reduced for healthier pregnancy outcomes.
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Which client condition is concerning and requires further nursing observation and intervention? Select all that apply.
- A. Client with asthma exacerbation and blood pressure is 150/90 mm Hg
- B. Client with spinal cord injury and blood pressure is 50/60 mm Hg
- C. Client with coronary artery disease on metoprolol, pulse is 62/min
- D. Elderly client with black stool; pulse is 112/min
- E. Neonate crying inconsolably at feeding time; pulse is 160/min
Correct Answer: B,D,E
Rationale: Concerning conditions include: spinal cord injury with hypotension suggesting neurogenic shock; black stool and tachycardia indicating possible GI bleeding; and inconsolable neonate with tachycardia suggesting distress. Asthma with hypertension and stable pulse on metoprolol are less urgent.
The nurse is assessing a 1-month-old infant with atrial septal defect. Which of the following findings would be consistent with the condition?
- A. cyanosis
- B. muffled heart tones
- C. murmur
- D. weak femoral pulses
Correct Answer: C
Rationale: An atrial septal defect often presents with a heart murmur due to abnormal blood flow. Cyanosis is rare unless severe, muffled tones are not typical, and weak femoral pulses suggest coarctation of the aorta.
A client is scheduled for a percutaneous transluminal coronary angioplasty (PTCA). The nurse knows that a PTCA is the
- A. Surgical repair of a diseased coronary artery
- B. Placement of an automatic internal cardiac defibrillator
- C. Procedure that compresses plaque against the wall of the diseased coronary artery to improve blood flow
- D. Non-invasive radiographic examination of the heart
Correct Answer: C
Rationale: PTCA is performed to improve coronary artery blood flow in a diseased artery. It is performed during a cardiac catheterization.
The nurse is assessing a 55 year-old female client who is scheduled for abdominal surgery. Which of the following information would indicate that the client is at risk for thrombus formation in the post-operative period?
- A. Estrogen replacement therapy
- B. 10% less than ideal body weight
- C. Hypersensitivity to heparin
- D. History of hepatitis
Correct Answer: A
Rationale: Estrogen increases the hypercoagulability of the blood and increases the risk for development of thrombophlebitis.
A nurse is caring for a child who is receiving oxygen at 2 L/min by nasal cannula and observes the current oxygen saturation and pulse plethysmographic waveform on the pulse oximeter. Which intervention should be the nurse's initial action?
- A. Auscultate the child's lung fields
- B. Have the child take slow, deep breaths
- C. Increase the oxygen flow rate to 3 L/min
- D. Verify the position and integrity of the finger probe
Correct Answer: D
Rationale: An inaccurate pulse oximeter reading may result from a poorly positioned probe. Verifying the probe's position is the initial action. Auscultation , deep breaths , or increasing oxygen are secondary without confirming the reading.