Nokea
A pregnant client comes to the office for her first prenatal examination at 10 weeks. She has been pregnant twice before; the first delivery produced a viable baby girl at 39 weeks 3 years ago; the second pregnancy produced a viable baby boy at 36 weeks 2 years ago. Both children are living and well. Using the gravida and para system to record the client's obstetrical history, the nurse should record:
- A. Gravida 3 para 1
- B. Gravida 3 para 2
- C. Gravida 2 para 1
- D. Gravida 2 para 2
Correct Answer: B
Rationale: Gravida=3 (current pregnancy), Para=2 (two births after 20 weeks).
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A client with a history of a kidney transplant is being discharged. The nurse should teach the client to:
- A. Avoid contact sports
- B. Eat a high-protein diet
- C. Limit fluid intake
- D. Take antibiotics daily
Correct Answer: A
Rationale: Contact sports risk trauma to the transplanted kidney, located in the pelvis, and should be avoided. High-protein diets, fluid limits, and daily antibiotics are not standard.
A client is 6 weeks pregnant. During her first prenatal visit, she asks, 'How much alcohol is safe to drink during pregnancy?' The nurse's response is:
- A. Up to 1 oz daily
- B. Up to 2 oz daily
- C. Up to 4 oz weekly
- D. No alcohol
Correct Answer: D
Rationale: No amount of alcohol has been determined safe for pregnant women. Alcohol should be avoided owing to the risk of fetal alcohol syndrome. The recommended safe dosage of alcohol consumption during pregnancy is none.
Place in correct sequence the steps from 1-7 used when performing tracheostomy suctioning.
- A. Suction the oral cavity.
- B. Auscultate breath sounds for effectiveness.
- C. Set suction control at 80-120 mm Hg.
- D. Ambu or oxygenate at 100% O2
- E. Apply suction while withdrawing the suction catheter.
- F. Turn the head toward the side to be suctioned.
- G. Auscultate breath sounds prior to suctioning.
Correct Answer: G, C, D, F, E, B, A
Rationale: Sequence: Auscultate breath sounds (G), set suction pressure (C), oxygenate (D), turn head (F), apply suction (E), auscultate post-suction (B), suction oral cavity (A) to clean.
A client with gallstones and obstructive jaundice is experiencing severe itching. The physician has prescribed cholestyramine (Questran). The client asks, “How does this drug work?” What is the nurse’s best response?
- A. “It blocks histamine, reducing the allergic response.”
- B. “It inhibits the enzyme responsible for bile excretion.”
- C. “It decreases the amount of bile in the gallbladder.”
- D. “It binds with bile acids and is excreted in bowel movements with stool.”
Correct Answer: D
Rationale: Cholestyramine binds bile acids in the intestine, forming complexes excreted in stool, reducing circulating bile acids that cause itching. It doesn’t block histamine (A), inhibit enzymes (B), or reduce gallbladder bile (C).
A 40-year-old client is admitted to the coronary care unit with chest pain and shortness of breath. The physician diagnosed an anterior wall myocardial infarction. What tests should the nurse anticipate?
- A. Reticulocyte count, creatinine phosphokinase (CPK)
- B. Aspartate transaminase, alanine transaminase
- C. Sedimentation rate, WBC count
- D. Lactic dehydrogenase, CPK
Correct Answer: D
Rationale: Lactic dehydrogenase and CPK are enzymes released from injured myocardial tissue.