A woman who comes in for prenatal care has a history of herp...

A woman who comes in for prenatal care has a history of herpes with outbreaks that occur every six months to a year. She asks if this means she will have a cesarean delivery. How should the nurse respond?

A. If you have active lesions when you go into labor, you will need a cesarean section.'
B. Cesarean delivery is the only way to protect your baby from herpes.'
C. Cesarean delivery is no longer recommended for persons with herpes.'
D. Your obstetrician will decide at the time of delivery which is best for you.'

Correct Answer: A

Rationale: Active herpes lesions at labor necessitate a cesarean to prevent neonatal herpes transmission; otherwise, vaginal delivery may be possible.

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An elderly client has a 17-mm induration after a tuberculin skin test. Based on this result, which statement is most accurate?

A. The client has a false-positive reaction due to advanced age
B. The client has a tuberculosis infection
C. The client has active tuberculosis disease
D. The client must be isolated immediately

Correct Answer: B

Rationale: A 17-mm induration in an elderly client indicates TB infection, as the threshold is â‰¥10 mm for high-risk groups. It doesn't confirm active disease, which requires further testing (e.g., chest X-ray). False positives are possible but not assumed based on age alone. Isolation isn't required without active disease.

The home care nurse is observing the client's spouse performing a colostomy irrigation. Which action needs correction?

A. The spouse holds the irrigating solution about 18 inches above the stoma.
B. The client is sitting on the toilet seat for the irrigation.
C. The spouse is using 1000 mL of irrigating solution.
D. The spouse uses petroleum jelly to lubricate the tip of the catheter.

Correct Answer: D

Rationale: Petroleum jelly is not suitable for lubricating colostomy irrigation catheters, as it may degrade materials or harbor bacteria; water-soluble lubricant is preferred. The height, volume, and position are appropriate.

The nurse has delegated care of a client who is very hard of hearing to an unlicensed person. Which of the following would be the least helpful information to give to the unlicensed person to better facilitate communications with the client?

A. Reduce background noise.
B. Adjust the hearing aid.
C. Anticipate what the client may say and finish the statement for the client.
D. Face the client when speaking to the client.

Correct Answer: C

Rationale: Anticipating and finishing statements risks miscommunication and frustration, least helpful for effective communication with a hearing-impaired client.

The nurse is reinforcing teaching about ulcer prevention with a client newly diagnosed with peptic ulcer disease. Which of the following client statements indicate appropriate understanding of teaching? Select all that apply.

A. I need to avoid taking medicines like ibuprofen without a prescription.
B. I should avoid drinking excess coffee or cola.
C. I should enroll in a smoking cessation program.
D. I should reduce or eliminate my intake of alcoholic beverages.
E. I will eliminate whole wheat foods, like breads and cereals, from my diet.

Correct Answer: A,B,C,D

Rationale: Avoiding NSAIDs (ibuprofen), excess coffee/cola, smoking, and alcohol reduces ulcer irritation and promotes healing. Whole wheat foods are beneficial for digestion and not contraindicated.

The practical nurse is assisting the registered nurse in creating a care plan for a client who is intubated, on mechanical ventilation, and receiving continuous enteral tube feedings via a small-bore nasogastric tube. Which interventions should be included to prevent aspiration in this client? Select all that apply.

A. Check gastric residual every 12 hours
B. Keep head of the bed at â‰¥30 degrees
C. Maintain endotracheal cuff pressure
D. Monitor for abdominal distension every 4 hours
E. Use caution when administering sedatives

Correct Answer: B,C,D,E

Rationale: Elevating the head of the bed (â‰¥30 degrees) reduces reflux, proper cuff pressure seals the airway, monitoring distension detects feed intolerance, and cautious sedation prevents respiratory depression. Residual checks every 4-6 hours are standard, not 12.