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A woman has been recently diagnosed with systemic lupus and shares with the nurse, 'I am thinking about getting pregnant, but I don't know how I will be able to tolerate a pregnancy since I have lupus.'
- A. What is the best response by the nurse to a woman with systemic lupus considering pregnancy?
- B. Most women find that they feel better when they are pregnant.'
- C. How long have you been in remission?'
- D. Women with lupus frequently have slightly longer gestations.'
- E. It is best to become pregnant within the first six months of diagnosis.'
Correct Answer: B
Rationale: The nurse should assess the duration of remission, as women with systemic lupus erythematosus (SLE) should be in remission for at least 5 months before conceiving to minimize risks of maternal and fetal complications. Pregnancy does not typically improve SLE symptoms, gestation length is unaffected, and early pregnancy post-diagnosis is not recommended.
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The nurse is caring for a client with a history of hyponatremia.
- A. Which intervention is most appropriate for a client with hyponatremia?
- B. Administer hypertonic saline slowly.
- C. Encourage a low-sodium diet.
- D. Restrict fluid intake.
- E. Administer a diuretic.
Correct Answer: A
Rationale: Administering hypertonic saline slowly corrects hyponatremia by raising serum sodium levels, preventing cerebral edema. Low-sodium diets worsen hyponatremia, fluid restriction is for hypervolemic cases, and diuretics are contraindicated.
An adult is admitted with histoplasmosis. What is most likely to be in the client's history because he has histoplasmosis?
- A. He is a chicken farmer.
- B. He ate raw shellfish recently.
- C. He consumed contaminated water.
- D. He drinks raw milk.
Correct Answer: A
Rationale: Histoplasmosis is caused by inhaling Histoplasma spores, often found in bird or bat droppings, common in chicken farming environments, unlike shellfish, water, or milk.
A 4 lb 10 oz baby boy delivered at 32 weeks gestation. The infant is admitted to the neonatal intensive care unit and placed in an incubator. He has mottling of the skin and acrocyanosis with irregular respirations of 60.
The nurse should recognize these findings as signs of
- A. hypoglycemia.
- B. cold stress.
- C. birth asphyxia.
- D. hypovolemia.
Correct Answer: B
Rationale: Strategy: Think about each answer choice. (1) blood sugar less than 25 mg/dL, would see cyanosis, apnea, tachypnea, irregular respirations, diaphoresis, jitteriness, weak cry, lethargy, convulsions, coma (2) correct-symptoms describe cold stress (3) would see meconium stained amniotic fluid (4) would see symptoms of shock
The nurse is working at a student health clinic at a large university. Which of the following signs and symptoms would cause the nurse to suspect cocaine abuse in a 20-year-old college student?
- A. Frequent sneezing, complaints of a sore throat, and a temperature of 100°F (37.8°C).
- B. Diarrhea, vomiting, and abdominal pain.
- C. Fatigue, dilated pupils, and anorexia.
- D. Complaints of insomnia, rhinorrhea, and facial pain.
Correct Answer: D
Rationale: Insomnia, rhinorrhea, and facial pain are associated with cocaine inhalation, the most common administration route. Options A, B, and C are less specific: A suggests infection, B indicates GI issues, and C could apply to other substances.
A client is admitted with the diagnosis of meningitis. Which finding would the nurse expect when assessing this client?
- A. Hyperextension of the neck with passive shoulder flexion
- B. Flexion of the hip and knees with passive flexion of the neck
- C. Flexion of the legs with rebound tenderness
- D. Hyperflexion of the neck with rebound flexion of the legs
Correct Answer: B
Rationale: Flexion of the hip and knees with passive flexion of the neck. This is a positive Brudzinski's sign, indicative of meningitis.