Nokea
A patient 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: C
Rationale: Postterm pregnancy with oligohydramnios is a contraindication for the use of oxytocin due to the increased risk of uterine hyperstimulation and fetal distress. Oxytocin can further stress the fetus in this scenario, potentially leading to adverse outcomes. Therefore, it is crucial for the nurse to recognize this contraindication to ensure the safety of both the mother and the baby during labor.
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A healthcare provider is performing a gastric lavage for a client who has upper gastrointestinal bleeding. Which of the following actions should the healthcare provider take?
- A. Instill 500 ml of solution through the NG tube.
- B. Insert a large-bore NG tube.
- C. Use a cold irrigation solution.
- D. Instruct the client to lie on their right side.
Correct Answer: B
Rationale: During a gastric lavage procedure for upper gastrointestinal bleeding, inserting a large-bore NG tube is essential to effectively remove gastric contents and blood. This tube allows for efficient irrigation and suction, aiding in the removal of harmful substances from the stomach. Instilling a large volume of solution or using a cold irrigation solution can lead to complications such as fluid overload or hypothermia. Instructing the client to lie on their right side is not directly related to the gastric lavage procedure.
A healthcare provider 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 37.9°C (100.2°F)
- D. Sneezing
Correct Answer: A
Rationale: Substernal retractions are a concerning sign of respiratory distress and can indicate acute chest syndrome, a severe complication of sickle-cell anemia. It results from vaso-occlusion in the pulmonary vasculature, leading to impaired oxygenation. Prompt reporting of this symptom is crucial for early intervention to prevent further complications. Hematuria, a high temperature, and sneezing are not specific manifestations of acute chest syndrome and would not warrant immediate notification to the provider in this context.
A healthcare professional is reviewing the laboratory results of a client who has rheumatoid arthritis. Which of the following findings should the healthcare professional report to the provider?
- A. WBC count 8,000/mm³
- B. Platelets 150,000/mm³
- C. Aspartate aminotransferase 10 units/L
- D. Erythrocyte sedimentation rate 75 mm/hr
Correct Answer: D
Rationale: In clients with rheumatoid arthritis, an elevated erythrocyte sedimentation rate (ESR) is a common finding and indicates inflammation in the body. A high ESR value suggests active disease activity and potential joint damage. Therefore, the healthcare professional should report an ESR of 75 mm/hr to the provider for further evaluation and management of the client's rheumatoid arthritis.
A client with vision loss is under the care of a nurse. Which of the following actions should the nurse AVOID?
- A. Keep objects in the client's room in the same place
- B. Ensure there is high-wattage lighting in the client's room
- C. Approach the client from the side
- D. Allow extra time for the client to perform tasks
Correct Answer: C
Rationale: Approaching a client with vision loss from the side can startle them and may lead to accidents or discomfort. It is important to approach them from the front so they are aware of your presence. Keeping objects in the same place aids in familiarity and reduces the risk of falls. High-wattage lighting enhances visibility for the client. Allowing extra time for tasks accommodates the client's potential slower pace and ensures they can perform tasks safely.
When caring for a client who is on contact precautions, which of the following measures should the nurse include in the teaching?
- A. Remove the protective gown after leaving the client's room.
- B. Place the client in a room with negative pressure.
- C. Wear gloves when providing care to the client.
- D. Wear a mask when in the client's room.
Correct Answer: C
Rationale: Contact precautions are used for clients with known or suspected infections that are spread by direct or indirect contact. The most important measure for healthcare workers when caring for a client on contact precautions is to wear gloves when providing care. This helps prevent the transmission of infectious agents between the client and the healthcare worker. Removing the protective gown after leaving the client's room, placing the client in a room with negative pressure, and wearing a mask when in the client's room are not specific to contact precautions and may not be necessary for all clients on contact precautions.