Nokea
A labor and delivery nurse is caring for a client in active labor. The fetal monitor shows late decelerations. The nurse should first
- A. place the client in high-Fowler's position in preparation to push.
- B. place the client in left lateral recumbent position.
- C. increase the rate of IV Pitocin.
- D. call the physician and report fetal distress.
Correct Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency. The left lateral position improves placental perfusion, addressing the immediate cause.
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The client's intravenous (IV) line has a gauze pad wrapped around the IV catheter at the insertion site and a transparent dressing over the gauze dressing. How long after application should the nurse change the dressing?
- A. At the normal rotation time for the IV.
- B. When the transparent dressing loosens.
- C. In 48 hours.
- D. In 24 hours.
Correct Answer: B
Rationale: Transparent dressings should be changed when they loosen (B) or per facility policy (typically every 5-7 days unless soiled or loose). Fixed intervals (C, D) or IV rotation (A) do not apply directly.
A client with metastatic cancer of the lung has just been told the prognosis by the oncologist. The nurse hears the client state, 'I don't believe the doctor; I think he has me confused with another patient.' This is an example of which of Kubler-Ross' stages of dying?
- A. Denial
- B. Anger
- C. Depression
- D. Bargaining
Correct Answer: A
Rationale: The client's statement reflects denial, a stage where patients refuse to accept a terminal diagnosis, per Kubler-Ross' model.
All of the following are risk factors for sudden infant death syndrome (SIDS) EXCEPT
- A. low birth weight.
- B. placing the child on his back to sleep.
- C. young maternal age.
- D. maternal smoking during pregnancy.
Correct Answer: B
Rationale: Placing an infant on their back to sleep reduces SIDS risk. Low birth weight, young maternal age, and maternal smoking are known risk factors.
The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?
- A. Roast beef, gelatin salad, green beans, and peach pie
- B. Chicken salad sandwich, coleslaw, French fries, ice cream
- C. Egg salad on wheat bread, carrot sticks, lettuce salad, raisin pie
- D. Pork chop, creamed potatoes, corn, and coconut cake
Correct Answer: A
Rationale: Roast beef is a good source of heme iron, which is more easily absorbed, making this meal plan the best choice for a client with iron-deficiency anemia.
When preparing a client for admission to the surgical suite, the nurse recognizes that which one of the following items is most important to remove before sending the client to surgery?
- A. Hearing aid
- B. Contact lenses
- C. Wedding ring
- D. Dentures
Correct Answer: B
Rationale: Contact lenses must be removed before surgery to prevent corneal damage or injury under anesthesia, especially if electrocautery is used, which could cause burns if foreign objects are present in the eyes.