Nokea
A nurse is caring for a client who is in labor and requires augmentation of labor. Which of the following conditions should the nurse recognize as a contraindication to the use of oxytocin?
- A. Diabetes mellitus
- B. Shoulder presentation
- C. Postterm with oligohydramnios
- D. Chorioamnionitis
Correct Answer: B
Rationale: Shoulder presentation is a contraindication for oxytocin because it can increase the risk of complications during labor, such as shoulder dystocia. Diabetes mellitus (Choice A) is not a contraindication for the use of oxytocin. Postterm with oligohydramnios (Choice C) and chorioamnionitis (Choice D) may actually necessitate the use of oxytocin to induce or augment labor for the well-being of the mother and baby.
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A client with heart failure is prescribed furosemide. What finding should the nurse report to the provider?
- A. Sodium 140 mEq/L
- B. Heart rate of 82/min
- C. Potassium level of 2.8 mEq/L
- D. Oxygen saturation 95%
Correct Answer: C
Rationale: The correct answer is C. A potassium level of 2.8 mEq/L is low and should be reported to the provider. Furosemide can cause potassium depletion, leading to hypokalemia. Low potassium levels can result in cardiac dysrhythmias, which is a serious concern in clients with heart failure. Choices A, B, and D are within normal ranges and do not require immediate reporting. Sodium level of 140 mEq/L, heart rate of 82/min, and oxygen saturation of 95% are all acceptable findings.
A healthcare provider is providing dietary teaching to a client who has a new diagnosis of irritable bowel syndrome (IBS). Which of the following foods should the healthcare provider instruct the client to avoid?
- A. Lean cuts of pork.
- B. Low-fat yogurt.
- C. White bread.
- D. Oatmeal.
Correct Answer: D
Rationale: The correct answer is D, oatmeal. Oatmeal contains insoluble fiber, which can exacerbate the symptoms of irritable bowel syndrome. Choices A, B, and C are not typically problematic for individuals with IBS. Lean cuts of pork, low-fat yogurt, and white bread are generally well-tolerated and may even be recommended as part of a balanced diet for individuals with IBS.
A nurse is teaching a client who has a new prescription for alendronate. Which of the following client statements indicates an understanding of the teaching?
- A. I should take this medication at bedtime to prevent drowsiness.
- B. I should take this medication with a full glass of water before breakfast.
- C. I should avoid taking this medication with dairy products.
- D. I should remain upright for at least 30 minutes after taking this medication.
Correct Answer: B
Rationale: The correct answer is B. Alendronate should be taken with a full glass of water before breakfast to prevent esophageal irritation and improve absorption. Choice A is incorrect as alendronate is not associated with causing drowsiness. Choice C is incorrect because alendronate can be taken with or without food, so avoiding dairy products is not necessary. Choice D is incorrect as the recommended time to remain upright after taking alendronate is 30 minutes to 1 hour, not just 30 minutes.
A nurse is caring for a client who has a urinary tract infection (UTI) and is prescribed ciprofloxacin. The nurse should instruct the client to monitor for and report which of the following adverse effects?
- A. Tinnitus.
- B. Photosensitivity.
- C. Urinary frequency.
- D. Insomnia.
Correct Answer: B
Rationale: The correct answer is B: Photosensitivity. Ciprofloxacin, an antibiotic commonly used to treat UTIs, can cause photosensitivity as an adverse effect. This reaction makes the skin more sensitive to sunlight, potentially leading to severe sunburns or skin damage. It is crucial for the client to be aware of this adverse effect to take precautions and report any signs of photosensitivity promptly. Choices A, C, and D are incorrect because tinnitus, urinary frequency, and insomnia are not typically associated with ciprofloxacin use. While urinary frequency might be a symptom of UTI, it is not an adverse effect of the medication itself.
A nurse is caring for an adolescent who has sickle-cell anemia. Which of the following manifestations indicates acute chest syndrome and should be immediately reported to the provider?
- A. Substernal retractions
- B. Hematuria
- C. Temperature of 37.9°C (100.2°F)
- D. Sneezing
Correct Answer: A
Rationale: Substernal retractions indicate respiratory distress in a sickle-cell client, which can be a sign of acute chest syndrome. This condition is a serious complication of sickle-cell anemia characterized by chest pain, fever, cough, and shortness of breath. Reporting this symptom promptly is crucial for timely intervention. Choice B, hematuria, is not typically associated with acute chest syndrome but may indicate other issues such as a urinary tract infection. Choice C, a temperature of 37.9°C (100.2°F), is slightly elevated but not a specific indicator of acute chest syndrome. Choice D, sneezing, is not a typical symptom of acute chest syndrome and would not warrant immediate reporting to the provider in this context.