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A nurse is assessing a client with hyperemesis gravidarum. Which of the following findings should the nurse expect?
- A. Oliguria
- B. Diplopia
- C. Hypoglycemia
- D. Dizziness
Correct Answer: A
Rationale: The correct answer is A: Oliguria. Hyperemesis gravidarum is severe nausea and vomiting during pregnancy, leading to dehydration and electrolyte imbalances. Oliguria, decreased urine output, is expected due to dehydration. Diplopia (B) and dizziness (D) are not specific to hyperemesis gravidarum. Hypoglycemia (C) may occur due to poor oral intake but is not a defining feature.
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A nurse is planning a program about healthy eating at an elementary school where most students select French fries and pizza at lunch every day. Which of the following actions should the nurse plan to take first?
- A. Give positive feedback to students who make appropriate choices.
- B. Help students recognize the value of making healthy food choices.
- C. Provide students with resources about making wise choices independently.
- D. Determine students' motivation to learn about healthy food choices.
Correct Answer: D
Rationale: The correct answer is D: Determine students' motivation to learn about healthy food choices. This is the first step because understanding the students' motivation will help tailor the program effectively. By assessing their motivation, the nurse can identify potential barriers to making healthy choices and address them in the program. Positive feedback (A) and resources (C) are important but should come after understanding motivation. Helping students recognize the value of healthy choices (B) is crucial, but motivation assessment precedes this step.
A hospice nurse is talking with the partner of a client who is near death. The partner states, 'How will I go on without them? I already feel alone.' Which of the following actions should the nurse take?
- A. Express sympathy to the client's partner.
- B. Ask the client's partner if they need anything.
- C. Hug the client's partner.
- D. Reassure the client's partner that it will get better.
Correct Answer: A
Rationale: Correct Answer: A: Express sympathy to the client's partner.
Rationale: Expressing sympathy acknowledges the partner's emotions, validates their feelings, and shows empathy. It helps the partner feel heard and supported during a difficult time. This action focuses on the partner's emotional needs, offering comfort and understanding.
Summary:
B: Asking if the partner needs anything is helpful but may not address the emotional distress directly.
C: Hugging without consent may not be appropriate and could make the partner uncomfortable.
D: Reassuring without acknowledging the partner's feelings may come across as dismissive and invalidating.
A nurse is providing education to a group of adolescents who are pregnant and attending high school. Which of the following information should the nurse include in their teaching?
- A. The need for supplemental folic acid is greatest during the third trimester
- B. The incidence of high birth weight infants is higher in adolescent pregnancy
- C. Pregnant adolescents need to gain less weight than adult mothers
- D. Caffeinated beverages should be replaced with caffeine-free beverages
Correct Answer: D
Rationale: The correct answer is D: Caffeinated beverages should be replaced with caffeine-free beverages. Pregnant adolescents should limit their caffeine intake as excessive caffeine can lead to complications during pregnancy. Caffeine can cross the placenta and affect the baby's heart rate and sleep patterns. It is important for pregnant adolescents to switch to caffeine-free beverages to ensure the health and well-being of both the mother and baby.
A: The need for supplemental folic acid is not specific to the third trimester, it is important throughout pregnancy.
B: The incidence of high birth weight infants is not necessarily higher in adolescent pregnancy compared to adult mothers.
C: Pregnant adolescents actually need to gain weight within the recommended range, similar to adult mothers, to support fetal growth and development.
A community health nurse is planning a smoking cessation class. Which of the following factors will have the greatest effect on the success of the class?
- A. Presenter's teaching strategies
- B. Presenter's credibility
- C. Client's motivation
- D. Client's education level
Correct Answer: C
Rationale: The correct answer is C: Client's motivation. Motivation plays a crucial role in behavior change like quitting smoking. Without intrinsic motivation, clients may not fully engage in the class or follow through with quitting. Presenter's teaching strategies (A) and credibility (B) are important but not as impactful as client motivation. Client's education level (D) may influence comprehension but not motivation.
A client who has diabetes mellitus asks a home health nurse to help her adapt some of her traditional cultural foods to fit her meal plan. Which of the following is the first action the nurse should take when assisting this client?
- A. Provide the client with a printed recipe
- B. Observe the client during preparation of traditional foods
- C. Use cookbooks to include traditional foods in meal plans
- D. Explain the diabetes exchange list
Correct Answer: B
Rationale: The correct answer is B. Observing the client during the preparation of traditional foods allows the nurse to understand the client's current cooking practices, ingredients used, and portion sizes. This information is crucial in determining how to modify the traditional foods to fit the client's meal plan. Providing a printed recipe (A) may not consider the client's cultural preferences or cooking methods. Using cookbooks (C) may not align with the client's traditional foods or cooking techniques. Explaining the diabetes exchange list (D) is important but should come after understanding the client's current food habits.