Nokea
A type I diabetic client is diagnosed with cellulitis in his right lower extremity. The nurse would expect which of the following to be present in relation to his blood sugar level?
- A. A normal blood sugar level
- B. A decreased blood sugar level
- C. An increased blood sugar level
- D. Fluctuating levels with a predawn increase
Correct Answer: C
Rationale: Hyperglycemia occurs due to glucose production in response to the stress and illness of cellulitis.
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A client is admitted to the labor room. She is dilated 4 cm. She is placed on electric fetal monitoring. Which of the following observations necessitates notifying the physician?
- A. Contractions every 2 minutes, lasting 100 seconds
- B. Fetal heart decelerations during a contraction
- C. Beat-to-beat variability between contractions
- D. Fetal heart decelerations at the beginning of contractions
Correct Answer: A
Rationale: These are tetanic in nature and can cause rupture of the uterus. The FHR decreases during contractions owing to vasoconstriction and should recover after the contraction. Beat-to-beat variability is a normal finding and demonstrates fetal well-being. The FHR may decrease at the beginning of a contraction owing to head compression.
A new mother tells the nurse that she is getting a new microwave so that her husband can help prepare the baby's feedings. The nurse should:
- A. Explain that a microwave should never be used to warm the baby's bottles.
- B. Tell the mother that microwaving is the best way to prevent bacteria in the formula.
- C. Tell the mother to shake the bottle vigorously for one minute after warming in the microwave.
- D. Instruct the parents to always leave the top of the bottle open while microwaving so heat can escape.
Correct Answer: A
Rationale: Microwaving baby bottles can cause uneven heating, leading to burns, so it should be avoided; warming under running water or in a bottle warmer is safer.
A female client has been treated since childhood for mitral valve prolapse. The antibiotic of choice for her during pregnancy would be:
- A. Sulfa
- B. Tetracycline
- C. Hydralazine
- D. Erythromycin
Correct Answer: D
Rationale: Sulfa is a teratogen and will cause kernicterus. Tetracycline is a teratogen and will affect tooth development. Hydralazine is not an antibiotic but a calcium channel blocker. Erythromycin is safe during pregnancy and can be used when the client is allergic to penicillin.
The nurse is teaching a client with a history of osteoporosis about dietary modifications. The nurse should tell the client to increase intake of:
- A. Calcium-rich foods
- B. High-fiber foods
- C. Low-fat foods
- D. High-protein foods
Correct Answer: A
Rationale: Calcium-rich foods strengthen bones and help prevent further bone loss in osteoporosis, a critical dietary modification.
The physician has prescribed Zyvox (linezolid) for a patient with VRE. The concurrent use of which medication may result in serotonin syndrome?
- A. Nexium (esomeprazole)
- B. Zoloft (sertraline)
- C. Lipitor (atorvastatin)
- D. Zyrtec (cetirizine)
Correct Answer: B
Rationale: Linezolid, a monoamine oxidase inhibitor, can cause serotonin syndrome when combined with SSRIs like Zoloft (sertraline), due to excessive serotonin accumulation. Nexium, Lipitor, and Zyrtec do not interact in this way.