Nokea
After instruction of a primigravid client at 8 weeks' gestation about measures to overcome early morning nausea and vomiting, which of the following client statements indicates the need for additional teaching?
- A. "I'll eat dry crackers or toast before arising in the morning."
- B. "I'll drink adequate fluids separate from my meals or snacks."
- C. "I'll eat two large meals daily with frequent protein snacks."
- D. "I'll snack on a small amount of carbohydrates throughout the day."
Correct Answer: C
Rationale: Two large meals may worsen nausea; smaller, more frequent meals are recommended.
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The nurse in the newborn nursery has just received shift report about a group of newborns and is to receive another admission in 30 minutes. In order to provide the safest care and plan for the new admission, the nurse should do which of the following in order of first to last?
- A. Move quickly from room to room and assess all clients.
- B. Check the room to which the new client will be admitted to be sure all supplies and equipment are available.
- C. Log on to the clinical information system and determine if there are new orders.
- D. Review notes from shift report and prioritize all clients; make rounds on the most critical first.
Correct Answer: D,C,A,B
Rationale: First, review and prioritize clients (D). Then, check for new orders (C), assess all clients (A), and finally prepare the room for the new admission (B).
While the nurse is caring for a primiparous client on the first postpartum day, the client asks, "How is that woman doing who lost her baby from prematurity?" Which of the following responses by the nurse would be most appropriate?
- A. Ignore the client's question and continue with morning care.
- B. Tell the client "I'm not sure how the other woman is doing today."
- C. Tell the client "I need to ask the woman's permission before discussing her well-being."
- D. Explain to the client that "Nurses are not allowed to discuss other clients on the unit."
Correct Answer: D
Rationale: Nurses must maintain patient confidentiality, making it inappropriate to discuss another client's status.
A client asks about the disadvantages of the vaginal contraceptive ring. Which of the following would the nurse include?
- A. It requires daily insertion.
- B. It may cause nausea or breast tenderness.
- C. It is less effective than condoms.
- D. It causes permanent infertility.
Correct Answer: B
Rationale: The vaginal contraceptive ring may cause nausea or breast tenderness, especially initially. It is inserted once every 3 weeks, is more effective than condoms when used correctly, and does not cause permanent infertility.
A primiparous client expresses concern, asking the nurse why her neonate's eyes are crossed. Which of the following would the nurse include when teaching the mother about neonatal strabismus?
- A. The neonate's eyes are unable to focus on light at this time.
- B. The neonate's eye muscles are not fully developed, causing temporary misalignment.
- C. The condition requires immediate surgical correction.
- D. The neonate's vision is permanently impaired.
Correct Answer: B
Rationale: Neonatal strabismus is common due to immature eye muscle coordination and typically resolves as the muscles develop.
Assessment of a 23-year-old primigravid client at term who is admitted to the birthing unit in active labor reveals that her cervix is 4 cm dilated and 100% effaced. Contractions are occurring every 4 minutes. The nurse is developing a care plan with the client to relieve pain based on the gate-control theory of pain. The nurse should explain which of the following to the client?
- A. Input from the large sensory fibers opens the gate.
- B. Labor pain is a matter of individual perception.
- C. Slow abdominal breathing can open the gate.
- D. The gating mechanism is in the spinal cord.
Correct Answer: D
Rationale: The gate-control theory posits that pain signals are modulated in the spinal cord, where non-painful stimuli (e.g., touch) can 'close the gate' to pain transmission. Input from large fibers closes the gate, perception varies but is not the mechanism, and slow breathing helps manage pain but does not open the gate.