Nokea
A nurse is admitting a client at 42 weeks gestation to the labor and delivery unit for induction of labor. What is a predictor of a successful induction?
- A. Bishop score of 10
- B. Firm and posterior cervix
- C. History of precipitous labor
- D. Reactive nonstress test
Correct Answer: A
Rationale: A Bishop score of 10 indicates a favorable cervix (soft, dilated, effaced, anterior), predicting a higher likelihood of successful induction.
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A neonate born 12 hours ago to a methadone maintained woman is exhibiting a hyperactive MORO reflex and slight tremors. The newborn passed one loose, watery stool. Which of these is a nursing priority?
- A. Hold the infant at frequent intervals.
- B. Assess for neonatal withdrawal syndrome
- C. Offer fluids to prevent dehydration
- D. Administer paregoric to stop diarrhea
Correct Answer: B
Rationale: Assess for neonatal withdrawal syndrome. These symptoms indicate possible opioid withdrawal, requiring immediate assessment.
A client with a below-the-knee amputation is experiencing phantom limb pain. Which action by the nurse would be most effective in relieving the pain?
- A. Acknowledging the presence of the pain
- B. Elevating the stump on a pillow
- C. Applying a transcutaneous nerve stimulator unit (TENS)
- D. Rewrapping the stump
Correct Answer: C
Rationale: Applying a TENS unit can help relieve phantom limb pain by stimulating nerves and reducing pain signals. Acknowledging the pain is supportive but does not directly relieve it. Elevating the stump may help with swelling but not specifically phantom pain. Rewrapping the stump may provide comfort but is less effective than TENS for pain relief.
The nurse is reviewing prescriptions for assigned adult clients. The nurse should question the prescription for
- A. 0.45% sodium chloride for a client with syndrome of inappropriate antidiuretic hormone secretion who has a decreased sodium level
- B. 0.9% sodium chloride for a client with gastrointestinal bleeding who has a decreased hemoglobin level
- C. 1,000 mL bolus of 0.9% sodium chloride for a client with septic shock who has an increased WBC count
- D. lactated Ringer solution for a client with hypovolemic shock and a thermal burn who has an increased hematocrit level
Correct Answer: A
Rationale: 0.45% sodium chloride is hypotonic and can worsen hyponatremia in SIADH by further diluting serum sodium, requiring clarification for a hypertonic solution.
The nurse is planning care for a client who has a hearing impairment. Which action will likely help the most with communication?
- A. Repeat everything twice.
- B. Speak loudly.
- C. Speak slowly and clearly.
- D. Use gestures.
Correct Answer: C
Rationale: Speaking slowly and clearly enhances comprehension for hearing-impaired clients. Repeating, shouting, or gestures may confuse or overwhelm.
The nurse is assigning client care tasks to unlicensed assistive personnel. Which statement by the nurse is appropriate?
- A. I need you to take vital signs on all clients in rooms 1 through 10 this morning
- B. Mrs. Jones fell out of bed during the night while walking to the commode. Please monitor her closely.
- C. Please ensure that Mr. Garcia in room 8 ambulates several times.
- D. Please take Mr. Wu's vital signs in 10 minutes and let me know if his systolic blood pressure is <100.
Correct Answer: A
Rationale: Assigning vital signs for multiple clients is clear, specific, and within the UAP's scope of practice, ensuring safe delegation.