Nokea
A client's medical record states a history of intermittent claudication. In collecting data about this symptom, the nurse should ask the client about which symptom?
- A. Chest pain that is dull and feels like heartburn
- B. Leg pain that is sharp and occurs with exercise
- C. Chest pain that is sudden and occurs with exertion
- D. Leg pain that is achy and gets worse as the day progresses
Correct Answer: B
Rationale: Intermittent claudication is a symptom characterized by a sudden onset of leg pain that occurs with exercise and is relieved by rest. It is the classic symptom of peripheral arterial insufficiency. Chest pain can occur for a variety of reasons, including indigestion or angina pectoris. Venous insufficiency is characterized by an achy type of leg pain that intensifies as the day progresses.
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The maternity nurse is teaching a pregnant client about the physiological effects and hormone changes that occur in pregnancy. Which information should the nurse provide to the client about the purpose of estrogen?
- A. It maintains the uterine lining for implantation.
- B. It stimulates metabolism of glucose and converts the glucose to fat.
- C. It prevents the involution of the corpus luteum and maintains the production of progesterone until the placenta is formed.
- D. It stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation.
Correct Answer: D
Rationale: Estrogen stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation. Progesterone maintains the uterine lining for implantation and relaxes all smooth muscle. Human placental lactogen stimulates the metabolism of glucose and converts the glucose to fat. Human chorionic gonadotropin prevents involution of the corpus luteum and maintains the production of progesterone until the placenta is formed.
A female client is treated for trichomoniasis with metronidazole (Flagyl). The nurse instructs the client that:
- A. The medication should not alter the color of the urine.
- B. She should discontinue oral contraceptive use during this treatment.
- C. She should avoid alcohol during treatment and for 24 hours after completion of the drug.
- D. Her partner does not need treatment.
Correct Answer: C
Rationale: Metronidazole can cause a disulfiram-like reaction with alcohol, so avoiding alcohol during and 24 hours after treatment is critical.
The nurse administers an intradermal injection to a client. Proper technique has been used if the injection site demonstrates which of the following?
- A. No swelling.
- B. Tissue pallor.
- C. Evidence of a bleb.
- D. Erythema.
Correct Answer: C
Rationale: A bleb (small wheal) at the injection site indicates correct intradermal technique, as the medication is deposited just under the skin.
Which federal law is most closely associated with the highly restrictive 'need to know'?
- A. The Patient Self Determination Act
- B. The Mental Health Parity Act
- C. The Health Insurance Portability and Accountability Act
- D. The Americans with Disabilities Act of 1990
Correct Answer: C
Rationale: The Health Insurance Portability and Accountability Act (HIPAA) enforces the 'need to know' principle, restricting access to protected health information to only those who require it for their job functions.
A client has a history of fibrocystic disorder of the breasts. The nurse determines that the client understands the nature of the disorder when the client states that symptoms are most likely to occur at which time?
- A. After menses
- B. Before menses
- C. In the spring months
- D. In the winter months
Correct Answer: B
Rationale: Fibrocystic breast disorder is characterized by cyclical breast pain and tenderness due to hormonal fluctuations, with symptoms most pronounced before menses when estrogen levels peak, leading to breast tissue swelling and cyst formation. Symptoms typically subside after menses. Seasonal changes, such as spring or winter months, do not influence fibrocystic breast symptoms.