Nokea
A client who had major abdominal surgery is having delayed healing of the wound. Which laboratory test result would most closely correlate with this problem?
- A. Decreased albumin
- B. Decreased creatinine
- C. Increased calcium
- D. Increased sodium
Correct Answer: A
Rationale: Decreased albumin indicates protein deficiency, impairing tissue repair and delaying wound healing. Decreased creatinine (B) reflects renal function, increased calcium (C) affects bones, and increased sodium (D) affects fluid balance, not healing directly.
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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 history of a pleural effusion who is scheduled for a thoracentesis. The nurse should:
- A. Position the client flat in bed
- B. Administer a sedative before the procedure
- C. Place the client in a sitting position
- D. Restrict fluids after the procedure
Correct Answer: C
Rationale: Sitting upright with arms supported facilitates access to the pleural space during thoracentesis and reduces complications. Sedatives and fluid restrictions are not routine.
Which of the following signs might indicate a complication during the labor process with vertex presentation?
- A. Fetal tachycardia to 170 bpm during a contraction
- B. Nausea and vomiting at 8-10 cm dilation
- C. Contraction lasting 60 seconds
- D. Appearance of dark-colored amniotic fluid
Correct Answer: D
Rationale: Fetal tachycardia may indicate fetal hypoxia; however, 170 bpm is only mild tachycardia. Nausea and vomiting occur frequently during transition and are not a complication. Contractions frequently last 60-90 seconds during the transitional phase of labor and are not considered a complication as long as the uterus relaxes completely between contractions. Passage of meconium in a vertex presentation is a sign of fetal distress; this may be normal in a breech presentation owing to pressure on the presenting part.
A client with a history of atrial flutter is admitted with complaints of dizziness. The nurse should give priority to:
- A. Monitoring heart rate
- B. Administering pain medication
- C. Monitoring respiratory rate
- D. Administering diuretics
Correct Answer: A
Rationale: Atrial flutter causes rapid heart rates, which can lead to dizziness due to reduced cardiac output, so monitoring heart rate is the priority.
Which play activity is best suited to the gross motor skills of a toddler?
- A. Coloring book and crayons
- B. Ball
- C. Building cubes
- D. Swing set
Correct Answer: B
Rationale: Playing with a ball encourages gross motor skills like kicking, throwing, and running, suitable for a toddler's developmental stage. The other activities focus more on fine motor skills or require advanced coordination.