Nokea
A client states she thinks she is experiencing premenstrual syndrome (PMS). The nurse should next ask the client about which of the following?
- A. Menstrual cycle irregularity with increased menstrual flow
- B. Mood swings immediately after menses
- C. Tension and fatigue before menses and through the second day of the menstrual cycle
- D. Midcycle spotting and abdominal pain at the time of ovulation
Correct Answer: C
Rationale: PMS symptoms, such as tension and fatigue, typically occur before menses and may persist into the early menstrual phase. Irregular cycles, post-menses mood swings, or midcycle symptoms are less characteristic of PMS.
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Methylergonovine maleate is prescribed for a woman who has just delivered a healthy newborn. Which is the priority assessment to complete before administering the medication?
- A. Lochia
- B. Uterine tone
- C. Blood pressure
- D. Deep tendon reflexes
Correct Answer: C
Rationale: Methylergonovine maleate, an oxytocic, is an agent used to prevent or control postpartum hemorrhage by contracting the uterus. The immediate dose is administered intramuscularly, and then, if still needed, it is administered orally. It causes uterine contractions and may elevate the blood pressure. A priority assessment before administration of methylergonovine maleate is blood pressure. Methylergonovine maleate is to be administered cautiously in the presence of hypertension, and the primary health care provider should be notified if hypertension is present. Options 1 and 2 are general components of care in the postpartum period. Option 4 is most specifically related to the administration of magnesium sulfate.
The nurse assesses a 7-month-old infant's growth and development. Which behavior should the nurse consider unusual?
- A. Drinking from a cup and spilling little of the liquid.
- B. Raising the chest and upper abdomen off the bed with the hands.
- C. Imitating sounds that the nurse makes.
- D. Crying loudly in protest when the mother leaves the room.
Correct Answer: A
Rationale: Drinking from a cup with minimal spilling is advanced for a 7-month-old, who typically lacks such fine motor control.
A client is receiving a tube feeding and has developed diarrhea, cramps, and abdominal distention. Which of the following interventions would be most appropriate? Select all that apply.
- A. Change the feeding apparatus every 24 hours.
- B. Use a higher volume of formula because the normal loss of the blood pressure.
- C. Slow the administration rate.
- D. Use a diluted formula, gradually increasing the volume and concentration.
- E. Anticipate changing to a lactose-free formula.
Correct Answer: A, C, D, E
Rationale: Changing the apparatus, slowing the rate, using diluted formula, and switching to lactose-free formula help manage diarrhea and distention.
The nurse is conducting a prostate screening clinic. Which sign of prostatism should the nurse question each client about?
- A. Absence of postvoid dribbling
- B. Ability to stop voiding quickly
- C. Excessive force in urinary stream
- D. Hesitancy when initiating urinary stream
Correct Answer: D
Rationale: Signs of prostatism that may be reported to the nurse are reduced force and size of urinary stream, intermittent stream, hesitancy in beginning the flow of urine, inability to stop urinating quickly, a sensation of incomplete bladder emptying after voiding, and an increase in episodes of nocturia. These symptoms are the result of pressure of the enlarging prostate on the client's urethra.
A client is prescribed amiloride 10 mg orally daily for the treatment of hypertension. Which instruction should the nurse give the client regarding its administration?
- A. Take the medication in the morning with breakfast.
- B. Withhold the medication if the blood pressure is high.
- C. Eat foods with extra sodium while taking this medication.
- D. Take the medication 2 hours after lunch on an empty stomach.
Correct Answer: A
Rationale: Amiloride is a potassium-retaining diuretic used to treat edema or hypertension. A daily dose should be taken in the morning to avoid nocturia. Increased blood pressure is not a reason to hold the medication, and it may be an indication for its use. Sodium should be restricted if used as an antihypertensive. The dose should be taken with food to increase bioavailability.