Nokea
An obstetrical client with diabetes has an amniocentesis at 28 weeks gestation. Which test indicates the degree of fetal lung maturity?
- A. Alpha-fetoprotein
- B. Estriol level
- C. Indirect Coombs
- D. Lecithin sphingomyelin ratio
Correct Answer: D
Rationale: The lecithin-sphingomyelin (L/S) ratio measures fetal lung maturity by assessing surfactant production, critical for preventing respiratory distress syndrome in preterm infants.
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The nurse is teaching a client with a new diagnosis of gout about dietary modifications. Which food should the client avoid?
- A. Shellfish
- B. Apples
- C. Carrots
- D. Rice
Correct Answer: A
Rationale: Shellfish are high in purines, which increase uric acid levels, worsening gout. Apples, carrots, and rice are low-purine foods and safe.
An 11-year-old boy has received a partial-thickness burn to both legs. He presents to the emergency room approximately 15 minutes after the accident in excruciating pain with charred clothing to both legs. What is the first nursing action?
- A. Apply ice packs to both legs.
- B. Begin débridement by removing all charred clothing from wound.
- C. Apply Silvadene cream (silver sulfadiazine).
- D. Immerse both legs in cool water.
Correct Answer: D
Rationale: Emergency care of a thermal burn is immersing both legs in cool water. Cool water permits gradual temperature change and prevents further thermal damage.
The most important goal in the care plan for a child who was hospitalized with an accidental overdose would be to:
- A. Determine child's activity pattern
- B. Reduce mother's sense of guilt
- C. Instruct parents in use of ipecac
- D. Teach parents appropriate safety precautions
Correct Answer: D
Rationale: This goal is not the most important. There is always some guilt when an accident occurs; however, the priority is to be sure future accidents are prevented. Ipecac is not used for caustic alkali and acid ingestions. Determining the parent's knowledge about safety hazards and teaching appropriate preventive measures are likely to prevent recurrence of accidents.
A client suspected of having anorexia nervosa is placed on bed rest with an IV infusion and a high-carbohydrate liquid diet. Within 72 hours, the results of her lab work show a return to normal limits. She is transferred to the psychiatric service for further treatment. A behavior modification plan is initiated. Three days after her transfer, the client tells the nurse, 'I haven't exercised in 6 days. I won't be eating lunch today.' This statement by her most likely reflects:
- A. Her lack of internal awareness about the outcome of the behavior
- B. Increased knowledge about personal exercise plans
- C. A manipulative technique to trick the nurse into allowing her to miss a meal
- D. A true desire to stay fit while in the hospital
Correct Answer: A
Rationale: Indirect self-destructive behavior such as that seen in anorexia nervosa is characterized by the client's lack of insight and the awareness that the outcome of the dieting, exercising, and weight loss will ultimately result in death if uninterrupted.
A client with a history of a brain tumor is receiving Decadron (dexamethasone). The nurse should monitor the client for:
- A. Weight gain
- B. Hypotension
- C. Hypoglycemia
- D. Hair loss
Correct Answer: A
Rationale: Dexamethasone, a corticosteroid, causes weight gain due to fluid retention and increased appetite. Hypotension, hypoglycemia, and hair loss are not typical side effects.