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A nurse is providing teaching for a client who has a new prescription for combined oral contraceptives. Which of the following findings should the nurse include as an adverse effect of this medication?
- A. Depression
- B. Polyuria
- C. Hypotension
- D. Urticaria
Correct Answer: A
Rationale: The correct answer is A: Depression. Combined oral contraceptives are known to potentially cause mood changes, including depression, in some individuals due to hormonal fluctuations. This adverse effect is important for the nurse to include in teaching to monitor the client's mental health. Polyuria (B) is excessive urination, which is not typically associated with oral contraceptives. Hypotension (C) is low blood pressure, which is not a common side effect of this medication. Urticaria (D) is hives or skin rash, which is not a typical adverse effect of combined oral contraceptives.
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The nurse conducting a physical assessment notes that a 1-day-old newborn with dark skin has a bluish-gray discoloration over the lower back, the buttocks, and the scrotum. How should this assessment finding be documented?
- A. Extensive bruising
- B. Mongolian spots
- C. Nevus flammeus
- D. Acrocyanosis
Correct Answer: B
Rationale: The correct answer is B: Mongolian spots. This finding is common in newborns with dark skin and appears as bluish-gray discoloration in areas like the lower back, buttocks, and scrotum. Mongolian spots are benign and typically fade over time. Extensive bruising (A) would present differently and usually indicates trauma. Nevus flammeus (C) refers to a port-wine stain, which is a different type of birthmark. Acrocyanosis (D) is a condition characterized by bluish discoloration of the extremities due to poor circulation, not related to the described finding.
The dosage of a pediatric medication is 120mg/kg/day to be given t.i.d. The patient weighs 12 pounds. What is the correct dose for the nurse to administer?
- A. 120 mg
- B. 480 mg
- C. 218 mg
- D. 651 mg
Correct Answer: C
Rationale: The patient weighs twelve pounds, which converts to kilograms by dividing 12 by 2.2 (1 kg = 2.2 lb.). In this example, the child's weight converts to 5.4 kg. The daily dose of 120 mg is given t.i.d: each individual dose is 40 mg/kg. Then multiply the weight in kilograms by the individual dose (40mg). The individual dose is 218 mg.
A nurse is caring for a 3-year-old child with strabismus. Which of the following actions should the nurse advise the parents to implement to help prevent amblyopia?
- A. Wear corrective biconcave lenses.
- B. Prevent trauma to the eyes.
- C. Patch the strong eye.
- D. Instill artificial tears.
Correct Answer: C
Rationale: The correct answer is C: Patch the strong eye. Patching the strong eye helps improve vision in the weaker eye, which is essential in preventing amblyopia. By covering the strong eye, the brain is forced to rely on the weaker eye, strengthening its visual acuity. Wearing corrective biconcave lenses may help with refractive errors but does not directly address amblyopia prevention. Preventing trauma to the eyes is important for overall eye health but does not specifically target amblyopia prevention. Instilling artificial tears is used for dry eye syndrome and does not play a role in preventing amblyopia.
A nurse is caring for a client who is at 22 weeks of gestation and is HIV positive. Which of the following actions should the nurse take?
- A. Administer penicillin G 2.4 million units IM to the client
- B. Instruct the client to schedule an annual pelvic examination
- C. Tell the client she will start medication for HIV immediately after delivery
- D. Report the client’s condition to the local health department
Correct Answer: D
Rationale: Rationale: Reporting the client's HIV positive status to the local health department is crucial for monitoring and preventing the spread of the infection. This action ensures proper follow-up care, contact tracing, and support services for the client and at-risk individuals. Administering penicillin G (choice A) is not indicated for HIV positive status. Instructing the client to schedule a pelvic examination (choice B) is unrelated to the client's HIV status. Delaying HIV medication until after delivery (choice C) can pose risks to both the mother and the baby.
With routine prenatal screening, a woman in the second trimester of pregnancy is confirmed to have gestational diabetes. How may the nurse explain the role of diet and insulin in the management of blood sugar during pregnancy?
- A. You will need to take an oral hypoglycemic, which is a pill to lower your blood sugar.
- B. Insulin lowers an elevated blood sugar during pregnancy to meet the increased metabolic needs of the baby.
- C. There is a good possibility you will be taking insulin for the rest of your life.
- D. You should eat three large meals per day to maintain steady glucose load.
Correct Answer: B
Rationale: The correct answer is B: Insulin lowers an elevated blood sugar during pregnancy to meet the increased metabolic needs of the baby. During pregnancy, the placenta produces hormones that can make it difficult for insulin to work effectively, leading to gestational diabetes. Insulin helps to lower blood sugar levels in the mother, which in turn provides the necessary glucose for the developing baby's growth and development. The other choices are incorrect because: A) Oral hypoglycemics are not typically prescribed during pregnancy due to potential risks to the baby. C) Gestational diabetes usually resolves after delivery and does not require lifelong insulin use. D) Eating three large meals per day can cause blood sugar spikes and is not recommended for managing gestational diabetes.