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The client delivered a newborn by cesarean birth 1 day ago.
A nurse is caring for a client who delivered a newborn by cesarean birth 1 day ago. The client requests nonpharmacological interventions to manage pain when changing positions. Which of the following responses should the nurse make?
- A. You can apply counterpressure to your back with each position change.
- B. You should change positions as little as possible.
- C. You can splint the incision with a pillow when changing positions.
- D. You should use patterned-paced breathing when changing positions.
Correct Answer: C
Rationale: Splinting the incision with a pillow reduces pain during movement.
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A nurse is assisting with the care of a client following electroconvulsive therapy for the treatment of a depressive disorder. Which of the following findings should the nurse expect 15 min following the procedure?
- A. Sleep apnea
- B. Paresthesias
- C. Disorientation
- D. Tonic-clonic seizures
Correct Answer: C
Rationale: Disorientation is common shortly after ECT.
The client is expressing suicidal ideations.
A nurse is collecting data from a client who is expressing suicidal ideations. Which of the following questions is the nurse's priority?
- A. Do you have a plan for harming yourself?
- B. Has anyone in your family ever died by suicide?
- C. Do you have someone to discuss your feelings with?
- D. Can you tell me about the stresses in your life?
Correct Answer: A
Rationale: Assessing a plan determines immediate risk, the priority in suicide assessment.
The client is taking multiple medications and asks about possible interactions.
A nurse is caring for a client who is taking multiple medications and asks about possible interactions. To which of the following members of the interdisciplinary team should the nurse make a referral?
- A. Social worker
- B. Advanced practice nurse
- C. Patient care technician
- D. Psychologist
Correct Answer: B
Rationale: An advanced practice nurse can expertly assess medication interactions.
The client has a chlamydial infection and a new prescription for doxycycline. The client reports nausea and vomiting after starting the medication.
A nurse is caring for a client who has a chlamydial infection and a new prescription for doxycycline. The client reports nausea and vomiting after starting the medication. Which of the following recommendations should the nurse make?
- A. Take the medication with calcium-fortified orange juice.
- B. Take the medication with crackers.
- C. Take the medication and then lay down for 30 min.
- D. Take the medication with an antacid.
Correct Answer: B
Rationale: Taking doxycycline with crackers reduces GI upset without affecting absorption.
A nurse is reinforcing teaching about car seat safety with a parent of a newborn. Which of the following statements by the parent indicates an understanding of the teaching?
- A. I should place my baby in the car seat at a 90-degree angle.
- B. I should keep my baby rear-facing in the car seat until she is 2 years old.
- C. I should position the car seat's retainer clip at the level of my baby's belly button.
- D. I should enable the airbag when my baby is in the front seat of the car.
Correct Answer: B
Rationale: Rear-facing until age 2 aligns with current safety guidelines.