Nokea
A client is a 43-year-old G2 P1 at 16 weeks' gestation that has completed prenatal testing for chromosomal abnormalities. The results reveal the infant is a female with Down syndrome. The nurse should tell the parents which of the following? Check all that apply.
- A. Down syndrome can occur in mothers of any age.
- B. Down syndrome is correlated with autosomal dominant traits carried by the parents.
- C. Down syndrome is a result of autosomal recessive traits carried by the parents.
- D. Down syndrome depends upon maternal prenatal care since pregnancy began.
- E. Down syndrome occurs more frequently with advanced maternal age.
- F. Down syndrome results from a trisomy of chromosome 21.
Correct Answer: A,E,F
Rationale: Down syndrome can occur at any maternal age, is more frequent with advanced maternal age, and results from trisomy 21. It is not related to dominant/recessive traits or prenatal care.
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Which is an intrinsic risk factor that places the client at risk for pressure ulcers?
- A. Pressure
- B. Shearing
- C. Impaired tissue perfusion
- D. Friction
Correct Answer: C
Rationale: Impaired tissue perfusion is an intrinsic risk factor for pressure ulcers, as it reduces oxygen and nutrient delivery to tissues, increasing susceptibility to breakdown.
Your client has an allergy to both penicillin and latex. Which of these pathophysiological facts should you apply when you are providing to this client?
- A. The sensitizing dose of penicillin can lead to anaphylaxis.
- B. The second dose of penicillin can lead to distributive shock.
- C. You should be aware of the fact that about 10% of the population has an allergy to both penicillin and latex.
- D. You should be aware of the fact that about 20% of the population has an allergy to both penicillin and latex.
Correct Answer: A
Rationale: A sensitizing dose of penicillin can lead to anaphylaxis , a life-threatening allergic reaction, which is critical to consider when caring for a client with a penicillin allergy. The prevalence of dual allergies (C, D) is not accurate, and distributive shock is not specific to a second dose.
A client is scheduled for a colonoscopy. Which of the following instructions should the nurse include in the pre-procedure teaching?
- A. Avoid solid foods for 24 hours before the procedure.
- B. Take all regular medications the morning of the procedure.
- C. Expect to be sedated during the procedure.
- D. Plan to stay overnight in the hospital.
Correct Answer: A, C
Rationale: Clear liquid diet for 24 hours prevents residue, and sedation is common during colonoscopy. Regular medications may need adjustment, and overnight stays are not typical.
Which anatomical site and method should the nurse use to administer an injection of iron to a client?
- A. Deltoid muscle using an air lock
- B. Gluteal muscle using Z-track technique
- C. Anterolateral thigh with 5/8-inch needle
- D. Subcutaneous tissue of the abdomen with 5/8-inch needle
Correct Answer: B
Rationale: The correct technique for administering parenteral iron is deep in the gluteal muscle using Z-track technique to minimize the possibility of staining or irritating the tissues. Administering iron subcutaneously or with a short needle and using the deltoid muscle is contraindicated because of iron's irritating nature.
The nurse holds the gauze pledget against an I.M. injection site while removing the needle from the muscle. This technique helps to:
- A. Seal off the track left by the needle in the tissue.
- B. Speed the spread of the medication in the tissue.
- C. Avoid the discomfort of the needle pulling on the skin.
- D. Prevent organisms from entering the body through the skin puncture.
Correct Answer: A
Rationale: Holding gauze against the injection site prevents medication leakage along the needle track, ensuring proper drug absorption.