Nokea
A client who is pregnant comes to the clinic for a first visit. The nurse gathers data about her obstetric history, which includes 3 year-old twins at home and a miscarriage 10 years ago. She is 8 weeks pregnant. Which description of her obstetric history is written correctly?
- A. Gravida 4 para 2
- B. Gravida 2 para 1
- C. Gravida 3 para 1
- D. Gravida 3 para 2
Correct Answer: C
Rationale: Gravida 3 para 1. Gravida is the number of pregnancies and Parity is the number of pregnancies that reach viability (not the number of fetuses). Thus, for this woman, she is now pregnant, had 2 prior pregnancies, and 1 viable birth (twins).
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The nurse reinforces teaching about the use of the peak flow meter to evaluate airflow to a client newly diagnosed with asthma. Which statement by the client indicates an understanding of the nurse's teaching?
- A. I will exhale a complete breath as quickly as possible through the mouthpiece of the device to obtain a peak flow reading
- B. I will move the indicator to the desired reading on the numbered scale before using the device
- C. I will record the lowest of 3 consecutive peak flow readings in my asthma journal every day.
- D. I will remember to use the device after taking my fluticasone via metered-dose inhaler.
Correct Answer: A
Rationale: Exhaling quickly is the correct technique for peak flow. Setting the indicator , recording the lowest reading , and using post-inhaler are incorrect.
The nurse is caring for an adult who had a cerebrovascular accident. The nurse gives the client a washcloth and encourages the client to wash her face. The client looks at the washcloth as though she does not know what to do with it. The nurse knows that this indicates that the client has which of the following?
- A. Apraxia
- B. Aphasia
- C. Agnosia
- D. Dysarthria
Correct Answer: C
Rationale: Agnosia is the inability to recognize objects, like a washcloth, despite intact sensory function, common post-CVA, unlike apraxia (motor planning), aphasia (language), or dysarthria (speech articulation).
An elderly client is severely dehydrated. Which is the best way to assess the effectiveness of fluid restoration therapy?
- A. Assess the client's skin turgor every shift.
- B. Record weights daily.
- C. Ask the client if she is thirsty.
- D. Record all intake.
Correct Answer: B
Rationale: Daily weights provide an objective measure of fluid restoration, as 1 kg approximates 1 L of fluid. Skin turgor is less reliable in elders, thirst is subjective, and intake alone doesn't confirm absorption.
A client is admitted with a lower urinary tract infection from an obstructing ureteral stone. Which tasks can the nurse delegate to the experienced unlicensed assistive personnel? Select all that apply.
- A. Collecting a urine specimen for culture and sensitivity
- B. Frequent turning and repositioning of the client
- C. Measuring and documenting urine output
- D. Monitoring the color and characteristics of urine output
- E. Teaching the client to strain urine while voiding
Correct Answer: B,C
Rationale: Turning and measuring output are within UAP scope. Collecting specimens , monitoring characteristics , and teaching require nursing judgment.
The nurse has taught the parents of a 6-year-old client with cystic fibrosis who has a prescription for pancreatic enzymes. Which of the following statements by a parent would require follow-up?
- A. It is acceptable for my child to chew the medication before swallowing it
- B. I should give the medication with or just before my child has a meal or snack
- C. I need to monitor the total amount of medication that I give to my child every day.
- D. It is acceptable to open the capsule and sprinkle the medication on a tablespoon of applesauce.
Correct Answer: A
Rationale: Chewing pancreatic enzymes destroys the enteric coating, reducing efficacy. Timing with meals , monitoring doses , and sprinkling on applesauce are correct practices.