Nokea
A primigravid client at 26 weeks' gestation asks the nurse what causes heartburn during pregnancy. The nurse should explain to the client that heartburn during pregnancy is usually caused by which of the following?
- A. Increased peristaltic action during pregnancy.
- B. Displacement of the stomach by the diaphragm.
- C. Decreased secretion of hydrochloric acid.
- D. Backflow of stomach contents into the esophagus.
Correct Answer: D
Rationale: Heartburn is caused when stomach contents enter the distal end of the esophagus, producing a burning sensation. To avoid heartburn during pregnancy, the client should avoid spicy foods; eat smaller, more frequent meals; and avoid lying down after eating. Peristalsis usually decreases during the latter half of pregnancy. Displacement of the stomach by the uterus, not the diaphragm, may contribute to heartburn. Increased, not decreased, secretion of hydrochloric acid can exacerbate heartburn.
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A client with a history of epilepsy is prescribed phenobarbital. The nurse should monitor the client for which of the following side effects?
- A. Drowsiness.
- B. Hypertension.
- C. Weight gain.
- D. Hyperglycemia.
Correct Answer: A
Rationale: Phenobarbital commonly causes drowsiness, which the nurse should monitor in clients with epilepsy.
A client experiencing low back pain asks the nurse which type of exercise will strengthen the lower back muscles. Which exercise should the nurse encourage the client to participate in to best strengthen the lower back muscles?
- A. Tennis
- B. Diving
- C. Canoeing
- D. Swimming
Correct Answer: D
Rationale: Walking and swimming are very beneficial in strengthening back muscles for the client with low back pain. The other options involve twisting and pulling of the back muscles, which is not helpful to the client experiencing back pain.
During an appointment with the nurse, a client says, 'I need to find the good,' the nurse responds, 'Oh, don't feel that way. We're making progress in these sessions.' The nurse's statement demonstrates a failure to do which of the following?
- A. Look for meaning in what the client says.
- B. Explain to the client why he may think as he does.
- C. Add to the strength of the client's support system.
- D. Give the client credit for solving his own problems.
Correct Answer: A
Rationale: The nurse's response dismisses the client's statement, failing to explore its underlying meaning, which is essential for therapeutic communication.
Which of the following clients is at greatest risk for extravasation?
- A. The client with heart failure who is receiving Ringer's lactate
- B. The client with cancer who is receiving bendamustine
- C. The client who is receiving potassium supplementation intravenously
- D. The client who is receiving total parenteral nutrition
Correct Answer: B
Rationale: Bendamustine, a chemotherapy drug, is a vesicant, posing a high risk for extravasation, which can cause severe tissue damage if it leaks into surrounding tissues.
The nurse is caring for a client with a history of benign prostatic hypertrophy who is prescribed finasteride (Proscar). The nurse should instruct the client that this medication works by:
- A. Relaxing bladder muscles.
- B. Reducing prostate size.
- C. Increasing urine flow.
- D. Preventing urinary infections.
Correct Answer: B
Rationale: Finasteride reduces prostate size by inhibiting testosterone conversion, relieving urinary obstruction in BPH.