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A diabetic client asks the nurse why she should use a diaphragm as a method of contraception instead of birth control pills. The best explanation for the use of a diaphragm is:
- A. A diaphragm will best prevent pregnancy because oral contraceptives are rendered ineffective by increased glucose levels.
- B. A diaphragm is a noninvasive method of contraception that will not alter the blood glucose levels.
- C. A diaphragm will provide intrauterine contraception by preventing implantation of the embryo.
- D. A diaphragm is a noninvasive method of contraception that prevents the egg from being released from the ovary.
Correct Answer: B
Rationale: A diaphragm does not affect blood glucose, unlike oral contraceptives, which can alter glycemic control. Oral contraceptives are not ineffective due to glucose levels, diaphragms do not prevent implantation or ovulation, and they are not intrauterine.
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Which nursing action is essential in the care of an adult following a left side cardiac catheterization?
- A. Keep the client NPO for two hours.
- B. Ask the client about a shellfish allergy.
- C. Check pulses proximal to the insertion site.
- D. Check the insertion site for bleeding.
Correct Answer: D
Rationale: Checking the insertion site for bleeding is critical post-catheterization to detect hematoma or hemorrhage, ensuring patient safety.
The nurse is caring for a client with an exacerbation of asthma following a viral respiratory illness. When collecting data, the nurse expects to find which clinical characteristics of a severe asthma exacerbation? Select all that apply.
- A. Accessory muscle use
- B. Chest tightness
- C. High-pitched expiratory wheeze
- D. Prolonged inspiratory phase
- E. Tachypnea
Correct Answer: A,B,C,E
Rationale: Severe asthma exacerbations cause accessory muscle use, chest tightness, high-pitched wheezing, and tachypnea due to airway obstruction. Prolonged expiration, not inspiration, is typical as air is trapped.
The nurse is teaching a client about newly prescribed amlodipine. Which adverse effect would be most important for the nurse to include?
- A. Depression
- B. Dizziness
- C. Dry cough
- D. Erectile dysfunction
Correct Answer: B
Rationale: Dizziness, due to amlodipine’s vasodilatory effect, is a common and critical side effect, risking falls, especially in the elderly. Depression, cough, and erectile dysfunction are less common or associated with other drugs.
A nurse is caring for a client with an exacerbation of chronic obstructive pulmonary disease (COPD) and a history of type 2 diabetes mellitus requiring insulin. The client has been prescribed prednisone. The nurse anticipates which need?
- A. Close monitoring for hypotension
- B. Gradually increasing the prednisone dose
- C. Increasing the insulin dose
- D. Monitoring and recording intake and output
Correct Answer: C
Rationale: Prednisone increases blood glucose, necessitating a higher insulin dose in diabetes. Hypotension is not a primary concern, prednisone is not typically titrated upward, and intake/output monitoring is less critical.
There have been several clients recently who have fallen in the long-term care facility. The nurse would like to reduce the number of falls. Which action is likely to do the most to help prevent falls?
- A. Ask the nursing assistants to watch the clients more closely.
- B. Restrain clients who cannot walk independently.
- C. Provide call bells so the clients can carry with them when they walk.
- D. Keep beds in the lowest position unless the nurse is performing care for the client.
Correct Answer: D
Rationale: Low bed height minimizes fall injury risk, a key prevention strategy. Closer watching, restraints, or call bells are less effective or restrictive.