Nokea
A client suspects that she is pregnant. She reports two missed menstrual periods. The first day of her last menstrual period was August 3. Her estimated date of confinement would be:
- A. 7-Nov
- B. 10-Nov
- C. 7-May
- D. 10-May
Correct Answer: D
Rationale: Using Nägele's rule (LMP - 3 months + 7 days + 1 year), August 3 leads to an estimated delivery date of May 10.
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A client with a history of atrial fibrillation is receiving warfarin (Coumadin). Which laboratory value should the nurse monitor closely?
- A. Platelet count
- B. Prothrombin time (PT/INR)
- C. Hemoglobin
- D. Serum potassium
Correct Answer: B
Rationale: Warfarin affects clotting, requiring monitoring of PT/INR to ensure therapeutic anticoagulation. Platelets (A), hemoglobin (C), and potassium (D) are not directly affected.
A client is pleased about being pregnant, yet states, 'It is really not the best time, but I guess it will be OK.' The nurse's assessment of this response is:
- A. Initial maternal-infant bonding may be poor.
- B. Client may have a poor relationship with her husband.
- C. This response is normal in the first trimester.
- D. This response is abnormal, to be re-evaluated at the next visit.
Correct Answer: C
Rationale: Ambivalence is normal during the first trimester. Reva Rubin addresses the issue of 'not now' in the first trimester. The statement still leaves room for exploration. There are no data to support this. This statement by the mother still leaves room for exploration. Ambivalence is normal during the first trimester. Reva Rubin addresses the issue of 'not now.' This fact should be shared with the mother during further exploration of the comment. It is not abnormal. If it were, another month would also be too long to wait.
A client with a history of hypertension is receiving Aldactone (spironolactone). The nurse should teach the client to avoid:
- A. Potassium-rich foods
- B. Calcium supplements
- C. High-fiber foods
- D. Iron supplements
Correct Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic, and consuming potassium-rich foods can lead to hyperkalemia. Calcium, fiber, and iron supplements are not contraindicated.
The nurse is caring for a client with a diagnosis of gestational hypertension. Which complication is most likely to occur?
- A. Preeclampsia
- B. Preterm labor
- C. Fetal macrosomia
- D. All of the above
Correct Answer: A
Rationale: Gestational hypertension can progress to preeclampsia characterized by proteinuria and other systemic symptoms and is the most likely complication. Preterm labor and macrosomia are less directly related.
Place in sequence from 1-5 the proper order for introducing items to the infant's diet.
- A. Strained meats
- B. Whole milk
- C. Rice cereal
- D. Fruits
- E. Vegetables
Correct Answer: C, D, E, A, B
Rationale: Infant diet sequence: rice cereal (C) at 6 months, then fruits (D) and vegetables (E), strained meats (A) around 7-8 months, and whole milk (B) after 12 months.