Nokea
After instructing a primiparous client who is breast-feeding on how to prevent nipple soreness during feedings, the nurse determines that the client needs further instruction when she states which of the following?
- A. I should position the baby the same way for each feeding.'
- B. I should make sure the baby grasps the entire areola and nipple.'
- C. I should air dry my breasts and nipples for 10 to 15 minutes after the feeding.'
- D. I shouldn't use a hand breast pump if my nipples get sore.'
Correct Answer: A
Rationale: Varying the baby's position during feeding prevents nipple soreness, so using the same position indicates a need for further instruction.
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A client with a history of heart failure is admitted with shortness of breath. The nurse should place the client in which of the following positions?
- A. Supine.
- B. Prone.
- C. Fowler's position.
- D. Trendelenburg position.
Correct Answer: C
Rationale: Fowler's position (semi-sitting) promotes lung expansion and reduces cardiac workload in heart failure clients with shortness of breath.
The nurse is caring for a client post-laparoscopic cholecystectomy. Which discharge instruction is most important?
- A. Resume normal diet immediately
- B. Report fever or yellowing of skin
- C. Avoid bathing for 2 weeks
- D. Lift heavy objects as tolerated
Correct Answer: B
Rationale: Fever or jaundice post-cholecystectomy may indicate complications like infection or bile duct injury, requiring immediate reporting.
Neuroleptic malignant syndrome is suspected in a client who is prescribed an atypical antipsychotic medication. Which medication should the nurse prepare in anticipation of being prescribed to treat this adverse effect related to the use of this medication?
- A. Bromocriptine
- B. Protamine sulfate
- C. Enalapril maleate
- D. Phytonadione (vitamin K)
Correct Answer: A
Rationale: Bromocriptine is a dopamine pathway medication used in the treatment of neuroleptic malignant syndrome. Protamine sulfate is the antidote for heparin overdose. Vitamin K is the antidote for warfarin overdose. Enalapril maleate is an angiotensin-converting enzyme inhibitor and an antihypertensive that is used in the treatment of hypertension.
A client has had a cardiac catheterization. The left femoral dressing has a moderate amount of bloody drainage, and the client has severe pain in that area. The nurse should first:
- A. Assess the airway.
- B. Administer oxygen.
- C. Apply pressure to the site.
- D. Assess the pulse in the left extremity.
Correct Answer: C
Rationale: Applying pressure to the site controls bleeding, which is the priority in this scenario.
The nurse instructs the client in mixing and administering regular and NPH insulin. Which of the following statements indicates that the client needs additional instruction?
- A. I draw up the regular insulin first
- B. I shake the bottle of NPH insulin before drawing it up
- C. I store the insulin in a cool place
- D. I insert the needle at a 90-degree angle
Correct Answer: B
Rationale: Shaking NPH insulin can damage it; it should be gently rolled. Drawing up regular insulin first, cool storage, and a 90-degree injection angle are correct practices.